Translating the ABCS Into HIV Care

Study Overview
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Brief Summary
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The overall objective of this project is to develop and rigorously test implementation strategies to address the gap in scientific knowledge of lower use of evidence-based interventions commonly referred to as the ABCS (aspirin, blood pressure control, cholesterol control, and smoking cessation)which contributes to the growing CVD morbidity and mortality among PLH.

Detailed Description
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Our project has two major aims: Aim 1: To assess the impact of the implementation of an evidence-based, multilevel strategy to reduce cardiovascular vascular disease (CVD) among PLH. Aim 2: To assess the process of implementation of these strategies using RE-AIM QuEST. Using both quantitative and qualitative methods, we evaluate the process of implementation by assessing Reach, [Effectiveness addressed in Aim 1], Adoption, Implementation and Maintenance whilst integrating Qualitative Evaluation for Systematic Translation.

Official Title
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Implementation Research: Translating the ABCS Into HIV Care

Conditions
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HIV, Cardiovascular Risk Factor

Intervention / Treatment
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* Behavioral: ABCS training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Sites: Serve a cohort of at least 100 HIV patients Have an Electronic Health Record (EHR) Agree to collaborate on implementing feasible adaptations of intervention strategies Patients: Patient of the site with a diagnosis of HIV Age 40-79 years ≥5% risk for CVD as calculated using the ASCVD Risk Estimator Plus Willing to participate No plans to leave the site in the next 12 months Proficient in either English or Spanish Own a cell phone with texting capabilities Clinicians: Physicians, Physicians Assistants, or Nurse Practitioners who provide direct HIV care to patients Work at a participating site Willing to implement the project's intervention strategies Exclusion Criteria: Patients: Currently participating in another CVD trial Have experienced a prior cardiac or vascular event such as myocardial infarction (MI) or cerebrovascular accident (CVA) Have had a CVD procedure such as installation of a stent or angioplasty Have peripheral vascular disease, intermittent claudication or peripheral arterial disease Are pregnant Lacks capacity to consent Clinicians: • Planning to leave the site within the next 12 months

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 79 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: A stratified clustered randomized stepped wedge design.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Control<br>CVD risk prior to the patient and clinician training | |
| Experimental: Training<br>CVD risk after the patient and clinician training | Behavioral: ABCS training<br>* Clinicians and patients will be given information regarding the ABCS (Aspirin, Blood Pressure control,Cholesterol control, and Smoking Cessation) and for reducing CVD risk among HIV patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 10-year CVD risk reduction | This will be based on the ACVSD risk calculator | 12 months |