Waimar Tun, Jennifer Gomez-Berrospi, Samuel Janson, Demarc Hickson, Christian Morris, Julie Pulerwitz, Mamaswatsi Kopeka, Jesse Yao, Rikiyah Mixson, Amanda McHale, Rachel Macey, Christian Buchanan, Bukola Rinola, Naana Koranteng-Yorke, Deanna Kerrigan, Oluwaseun Adebayo Bamodu, Donaldson F. Conserve & BRIDGE Research Team
University of Washington affiliated authors are displayed in bold.
Published: October 2025
Elena P Rosenberg-Carlson, Tamra B Loeb, Raquel G Hernandez, Jane J Lee, Aima A Ahonkhai, Jessica M Perkins, Chunqing Lin, Sung-Jae Lee, Sharon Hurt, Luke Johnsen & Alison B Hamilton.
University of Washington affiliated authors are displayed in bold.
Published: September 2025
In recent years, social media has emerged as a pivotal tool in implementation science efforts to address the HIV epidemic. Engaging community partners is essential to ensure the successful and equitable implementation of social media strategies. There is a notable lack of scholarship addressing the operational considerations for studies using social media strategies in community-partnered HIV research. This article seeks to bridge this gap by consolidating field notes and practical considerations derived from 3 ongoing NIH-supported studies focused on Ending the HIV Epidemic in the United States.
This article aims to inform the design, planning, and implementation of operationally effective community-partnered social media strategies in HIV research, ultimately contributing to enhancements in HIV practice and improved outcomes across the HIV prevention and care continua.
Supported by the University of California, Los Angeles Rapid, Rigorous, Relevant (3R) Implementation Science Hub, the 3 Ending the HIV Epidemic projects convened to form the community-partnered social media campaigns working group. The working group used the Consolidated Framework for Implementation Research to help identify and organize key barriers and facilitators of relevance to implementation of the projects’ social media strategies. Given the high degree of interrelatedness across reported factors, the working group thematically synthesized the content into 5 practical considerations to inform use of community-partnered social media strategies in HIV research.
The practical considerations identified by the community-partnered social media campaigns working group include the following: (1) the power and pitfalls of social media platforms (ie, opportunities and challenges inherent to social media platforms that may affect use of social media strategies in HIV research), (2) messengers and messages matter (ie, ensuring the appropriateness, acceptability, and quality of social media messengers and content), (3) the significance of the sociopolitical environment (ie, characterizing the sociopolitical environment surrounding HIV and its potential impact on implementing social media strategies to reach priority populations), (4) investing in academic-community partnerships (ie, cultivating positive and productive academic-community partnerships to support implementation of social media strategies in HIV research), and (5) the alignment of the institutional environment and research approach (ie, assessing and working to address features of institutional environments that may impact implementation of social media strategies in community-partnered HIV research).
As use of social media in HIV research and practice continues to grow, the practical considerations presented in this paper can help research teams anticipate factors that may impact implementation of community-partnered social media strategies and take early action to mitigate potential challenges. By understanding and addressing the unique challenges and opportunities of social media in community-partnered HIV research, we can leverage these platforms to accelerate progress toward ending the HIV epidemic.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Everlyn Kisembe, C Nathan Nessle, Julia Dettinger, Lenah Nyamusi, Sarah Kinja, Mercy Ndung'u, Sandra Langat, Kenneth Busby, Gilbert Olbara, Terry A Vik, Cheryl A Moyer & Festus Njuguna
University of Washington affiliated authors are displayed in bold.
Published: September 2025
Children with cancer in lower-middle-income countries (LMICs) are at increased risk of dying from infections. Prompt treatment of fever episodes improves outcomes, yet poorly described challenges impair management. This qualitative study explored healthcare provider perspectives on barriers to and facilitators of inpatient fever management in children with cancer at a public tertiary referral children’s hospital in Kenya. Healthcare providers involved in fever management were recruited. Semi-structured interviews were audio-recorded, transcribed verbatim, and entered into NVivo software. Coding was informed by a theoretical fever framework and the Consolidated Framework for Implementation Research. Thematic analysis and mind mapping identified recurrent themes and subthemes. Strategies were mapped to identified barriers. The sixteen participants included nurses (n = 2), clinicians (n = 6), pharmacists (n = 2), phlebotomists (n = 2), and microbiology laboratory staff (n = 4). We identified three overarching themes: empowerment of healthcare providers and caregivers, the importance of timely management, and teamwork/human resource availability. Healthcare provider attributes served as facilitators: motivation to improve care, eagerness to learn, willingness to change practice, and need for treatment guidance. Factors within the hospital system were barriers, with subthemes including poor communication between cadres, delays in laboratory results, and staffing shortages. Participants suggested knowledge sharing, a treatment guideline, task shifting, and hiring additional healthcare providers as potential interventions. Managing fever episodes in children with cancer is complex, requiring multiple cadres of healthcare providers and caregiver participation. The proposed interventions may overcome barriers, but future studies are needed to assess the effectiveness of these strategies in improving fever management.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Benn Kwach, Josephine B Odoyo, Amber R Lauff, Victor Omollo, Bernard Rono, Vallery Ogello, Victoria Mann, Zachary Kwena, Katherine Thomas, Monisha Sharma, Jennifer F Morton, Kenneth Ngure, Elizabeth Bukusi, Kenneth K Mugwanya & One-Stop PrEP Care Team
University of Washington affiliated authors are displayed in bold.
Published: September 2025
Oral HIV pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention for HIV prevention, but its access and utilisation are challenging, especially in high-burden settings such as Kenya. For potential PrEP users, long delays and repeated consultations with several providers are obstacles to both PrEP uptake and continuation. The One-Stop PrEP Care project aims to promote the use of PrEP among clients in the health system and enhance client satisfaction by reducing the waiting time.
We are conducting a 1:1 cluster-randomised trial to evaluate whether One-Stop PrEP Care achieves equivalent or better PrEP outcomes compared with the standard of care model in 12 high-volume HIV clinics in Kisumu County, Kenya. In the One-Stop model, all core PrEP components, including HIV risk evaluation, HIV testing and PrEP dispensing, are provided by one provider in a single consultation room. Programme data from ≥2400 new PrEP clients will be abstracted for 12 months each to obtain primary endpoints of PrEP initiation and continuation. Adherence will be assessed via blood drug level testing. A nested cohort of up to 300 PrEP clients will be enrolled and followed every 3 months to provide in-depth data on individual HIV prevention behaviour, risk perception and how they align PrEP use with perceived risk. We will also evaluate programme costs.
Ethical approval was obtained from the University of Washington Institutional Review Board (IRB) on 8 July 2022 (IRB ID: STUDY00015873) and the Kenya Medical Research Institute Scientific and Ethics Review Unit (SERU) with a letter dated 4 May 2023 (Ref: 4697). Project findings will be shared with stakeholders, including the Ministry of Health, County health officials and participants. Results will be disseminated through manuscripts, policy briefs and health meetings.
Plans for communicating important protocol modifications include timely notifications to all study team members and training on the changes, and updates to relevant stakeholders, including the two IRBs, through protocol amendment submissions.
Protocol version V. 2.0 dated 21 May 2024.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Shari S. Rogal, Vera Yakovchenko, Timothy R. Morgan, Jason A. Dominitz, Heather McCurdy, Anna Nobbe, Nsikak R. Ekanem, Chaeryon Kang, Rachel I. Gonzalez, Angela Park, Jennifer Anwar, Brittney Neely, Sandra Gibson, Carolyn Lamorte, Jasmohan S. Bajaj, Heather M. Patton, Yiwen Yao & Andrew J. Gawron
University of Washington affiliated authors are displayed in bold.
Published: August 2025
Screening for gastrointestinal (GI) cancers, specifically colorectal cancer (CRC) and hepatocellular carcinoma (HCC), is often inadequately and inequitably implemented, leading to preventable morbidity and mortality. This protocol paper describes a study designed to compare the effectiveness of external facilitation with patient navigation across hospitals in the Veterans Health Administration (VA).
Two hybrid type 3, cluster-randomized trials will compare the effectiveness of patient navigation versus external facilitation for supporting HCC and CRC screening completion. Twenty-four sites will be included in the HCC trial and 32 in the CRC trial, cluster-randomizing Veterans by their site of primary care. The primary outcome of reach of cancer screening completion will be measured after intervention and during sustainment. Multi-level implementation determinants (i.e., barriers and facilitators), preconditions, and moderators will be evaluated pre- and post-intervention, using Consolidated Framework for Implementation Research (CFIR)-mapped surveys and interviews of Veteran participants and provider participants.
Comparing findings in the two trials will allow researchers to understand how implementation barriers and strategies operate differently for a one-time screening in a relatively healthy population (CRC) vs. repeated screening in a more medically complex population (HCC).
This project was registered at ClinicalTrials.Gov (NCT06458998) on 6/13/24.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Angela C. Wolff, Kate Absolom, Sara Ahmed, Susan J. Bartlett, Maria Jose Santana, Angela M. Stover & Elizabeth J. Austin
University of Washington affiliated authors are displayed in bold.
Published: July 2025
Although the use of patient-reported outcome measures (PROMs) in practice is increasing, successful implementation is contingent on engaging healthcare providers (HCPs). Using Implementation Science (IS), we present the content of two workshops hosted at the International Society for Quality-of-Life annual conferences for individuals seeking to implement PROMs collection and use in their settings. Our goals were to provide workshop participants with knowledge, tools, and resources to prepare HCPs for PROM adoption and to demonstrate tailored strategies to meet context-specific needs.
An interdisciplinary team with diverse expertise in PROMs implementation delivered two workshops guided by the Capability, Opportunity, Motivation – Behavior (COM-B) model and the Theoretical Domains Framework (TDF). Using dotmocracy, participants were asked to consider, for their local context, the factors most important for changing HCPs’ behaviors to adopt PROMs in daily practice.
The workshops incorporated IS theories, models, and frameworks (TMFs) to identify barriers faced by HCPs, support behavior change, and apply tailored theory-informed implementation strategies to prepare HCPs for PROM integration and evaluate adoption success. The factors rated the most important by workshop participants (n = 53) were woven into the discussions to illustrate the most common barriers encountered by HCPs adopting PROMs. Presenters drew on real-world practice and research experiences to identify promising implementation strategies, including education, training, behavioral modeling, persuasion, environmental restructuring, enablement, and audit and feedback to increase the capability, opportunity, and motivation of HCPs.
Given the increasing evidence base supporting the role of PROMs in patient-centered care, it is imperative to understand the mechanisms and best practices for increasing provider adoption of PROMs. This work offers a roadmap for understanding determinants more important to HCPs and systematically selecting theory-informed implementation strategies that may increase the likelihood of HCP adoption of PROMs. Offering tailored HCP training/education programs and implementation strategies can prepare HCPs for timely and effective PROM implementation.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Annice Brown, Sharon M. Kelly, Tracy Agee, Jeffrey Hsu, Nicholas Schweizer, Geetanjali Chander, Larry W. Chang, Sheree Schwartz & Oluwaseun Falade-Nwulia
University of Washington affiliated authors are displayed in bold.
Published: June 2025
Shumenghui Zhai, Weichao Yuwen, Tiffany L. Zyniewicz, Jennifer Sonney, Jonika Hash, Maida Chen, & Teresa M Ward
University of Washington affiliated authors are displayed in bold.
Published: June 2025
Behavioral intervention technologies (BITs) offer scalable, cost-effective healthcare solutions but often show reduced impacts in community settings and are rarely sustained. Human-centered design (HCD) enhances usability by tailoring BITs to stakeholder needs, while implementation science (IS) identifies contextual barriers and strategies to promote uptake and sustainability. Both HCD and IS aim to improve BIT usability and implementation through iterative, user-focused processes but are rarely integrated.
We introduced the user-centered and sustainable implementation science (USIS) model, a novel and systematic framework that combines HCD and IS principles to enhance BIT effectiveness and sustainability. We aimed to (1) synthesize the HCD and IS outcomes and integrate them into a USIS framework; (2) apply USIS to a case study: the sleep shared-management intervention for children with juvenile idiopathic arthritis and their parents (SLEEPSMART).
We conducted a narrative literature review on HCD and IS outcomes for BITs from the PubMed, CINAHL, and Web of Science databases. Articles were selected based on their focus on usability, implementation outcomes, and evidence-based healthcare practices. This synthesis informed the development of the USIS model.
The USIS model incorporates five domains: (1) user-centeredness (empathy, engagement, and equity), (2) efficiency (cost, timeliness, and rapidity), (3) feasibility (learnability, memorability, error reduction, and low cognitive load), (4) satisfaction (acceptability and appropriateness), and (5) fidelity (adoption, penetration, and sustainability). We applied the USIS model to evaluate the SLEEPSMART project to demonstrate the application of the USIS model in guiding BIT design and refinement. Insights from the review informed the design principles applied during the development and testing stages of SLEEPSMART.
The USIS model serves as a practical and theoretical guide to improve BIT design and evaluation. By emphasizing implementation considerations early and centering user needs, USIS provides a pathway to bridge HCD and IS approaches to enhance the real-world impact and sustainability of digital health innovations.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Melissa Latigo Mugambi, Annabell Dollah, Rosebel Ouda, Nancy Oyugi, Ben O. Odhiambo, Mary M. Marwa, Judith Nyakina, John Kinuthia, Bryan J. Weiner, Grace John-Stewart, Ruanne Vanessa Barnabas, & Brett Hauber
University of Washington affiliated authors are displayed in bold.
Published: June 2025
The delivery of HIV prevention services (e.g., HIV testing, pre-exposure prophylaxis (PrEP) initiation and refills, and STI testing) in community pharmacies could address clinic barriers faced by pregnant women such as extended travel and wait times. We conducted a qualitative study in Western Kenya to select and prioritize attributes and levels for a discrete choice experiment (DCE) to design pharmacy-based HIV prevention services for pregnant women.
We began by identifying a comprehensive list of attributes and levels relevant to women considering HIV prevention during pregnancy. This list was informed by recommended HIV prevention interventions for pregnant women, our objective to design services for pharmacy settings, and attributes identified in the literature as important for other populations when choosing HIV and pharmacy-based services. From March to November 2022, we recruited participants using stratified purposeful sampling and collected qualitative data through seven focus group discussions with women, four with health providers, and eight individual interviews with technical experts. Interviews were audio-recorded, translated, transcribed, and summarized in debrief reports. We conducted debriefing meetings and analyzed these reports to identify and refine the essential attributes that would influence decisions to access HIV prevention services from a pharmacy during pregnancy.
We initially identified twelve potential attributes that were evaluated during the focus groups. Five attributes were eliminated based on ranking exercises with women and health providers. Additional attributes suggested during the focus groups were ranked low by participants or not mentioned frequently enough and, therefore, not included. We finalized and refined levels for each attribute using insights from the literature, participant feedback, and design considerations. The study identified seven attributes: service location, type of HIV test, STI testing availability, partner HIV testing availability, PrEP availability, service access methods (e.g., appointment versus walk-ins), and service fee.
This study was the first step in data collection toward defining attributes and levels for a DCE survey and successfully identified seven preliminary attributes and levels. Pre-testing and pilot testing activities further explored the feasibility and understanding of the attributes and levels.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Shari S. Rogal, Brittney Neely, Monica Merante, Karen Slazinski, Lorenzo McFarland, Christina Brodkorb, Jada Cooper, Carolyn Lamorte, Sandra Gibson, Emily Comstock, Jamie Morano, Marissa Maier, Lauren A. Beste, Karine Rozenberg, Maggie Chartier, Matthew J. Chinman, David Ross & Vera Yakovchenko
University of Washington affiliated authors are displayed in bold.
Published: June 2025
Pre-Exposure Prophylaxis (PrEP) dramatically reduces the likelihood of acquiring human immunodeficiency virus (HIV), yet it remains under-prescribed, particularly for people in communities with high HIV incidence. While implementation science and health services researchers aim to address disparities in care, few interventions have proven effective in doing so. We aimed to identify implementation strategies associated with higher PrEP prescribing rates and pilot test a tailored intervention as a proof-of-concept in a single Veterans Health Administration (VA) facility.
VA clinicians were surveyed using an instrument derived from the Evidence-based Recommendations for Implementing Change taxonomy to assess the use of various strategies for PrEP in fiscal years 2019–2021. Correlational analyses identified the strategies associated with the frequency of PrEP prescribing and semi-structured interviews with personnel from 11 VA medical facilities with high PrEP prescribing refined and manualized these strategies into the Getting to Implementation (GTI)-PrEP playbook. The playbook was subsequently pilot tested in a VA facility with high new HIV diagnosis rates and low PrEP prescribing rates.
The clinician survey collected 157 responses from 95 unique VA facilities on implementation strategy use. Analysis identified eight strategies significantly associated with PrEP prescribing, including: networking, clinician education, clinical support tools, dashboard utilization, telehealth, pharmacist involvement, direct patient engagement, and enhanced sexual health history taking. In the pilot study, the site completed the GTI-PrEP Playbook with high fidelity and newly implemented seven of the eight strategies, achieving a 363% increase in PrEP prescribing rates among Black Veterans over the one-year period.
This multi-year national evaluation identified a core subset of effective implementation strategies for increasing PrEP prescribing. The process of empirically specifying these strategies and pilot testing them through the GTI-PrEP playbook demonstrates a promising, data-driven approach to improve PrEP prescribing rates and reduce racial disparities in HIV prevention.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**