Clinical trial NCT05803720: HIV Provider Intervention to Address Intersectional Stigma and Medical Mistrust
Official title: Development of an Online Provider Intervention to Address Intersectional Stigma and Medical Mistrust in People Living With HIV
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Stigma, Social
Lead sponsor: RAND
Sponsor class: OTHER
Collaborators: name: California Prevention Training Center
name: Brigham and Women's Hospital
First posted: 2023-04-07
Enrollment: 58
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief summary: Intersectional stigma and medical mistrust are prevalent among Black and Latina/Latino Americans living with HIV and are key contributors to racial/ethnic health disparities; yet, there are no evidence-based provider-level interventions available for HIV care providers to address intersectional stigma and medical mistrust with patients. The investigators propose to develop an online provider intervention, with community stakeholders' input, that provides psychoeducation and skills-building around addressing intersectional stigma and medical mistrust with patients. The investigators will conduct a pilot randomized controlled trial with 60 HIV care physicians (30/condition) to test the acceptability and feasibility of the online intervention and to determine preliminary effects (against a no-intervention control group) on providers' use of skills and HIV care delivery outcomes at baseline, immediate post, and 6-month follow-up.

Detailed description: The first aim will be an intervention development process that involves engaging community stakeholders to incorporate their input on the intervention manual and working with a provider training organization to develop an online platform for the initial pilot testing. The intervention will include psychoeducation and skills-building for providers to address intersectional stigma and mistrust, tailored to HIV care. This aim will include a usability test of the online intervention in 10 HIV clinical care providers. The second aim will be to conduct a pilot randomized controlled trial to compare two conditions (i.e., online provider intervention versus no-intervention control) on provider training outcomes (e.g., providers' use of skills learned in the intervention) and HIV care delivery outcomes (e.g., the estimated percentage of patients lost to care in the past year) measured at baseline, immediate post-intervention, and 6-month follow-up. Clinical providers (N = 60) providing care for patients living with HIV will be randomly assigned to the online provider intervention (n = 30) or control with no intervention (n = 30). The intervention will be delivered in groups (5-10 providers per group). A mixed-methods process evaluation at immediate post-intervention will determine the acceptability, feasibility, and appropriateness of the intervention, and will be used to refine the intervention.

Eligibility criteria: Inclusion Criteria:

* clinical providers (including physicians, physician assistants, nurse practitioners, registered nurses/case managers) caring for patients living with HIV,
* the majority of their patients are from racial/ethnic and sexual minority groups,
* can make the time commitment to participate in the study.

Exclusion Criteria:

* not HIV clinical providers
* cannot make the time commitment to participate

Primary outcomes:
measure: Helpful/empathetic responses toward medial mistrust in hypothetical patient scenarios
timeFrame: Change from baseline to immediately after the intervention
measure: Provider use of strategies learned in the provider intervention in a role-play simulation of hypothetical patient scenarios
timeFrame: Change from baseline to immediately after the intervention
Secondary outcomes:
Other outcomes:
Locations:
city: Santa Monica
country: United States
facility: RAND Corporation
state: California
Study officials:
affiliation: RAND
name: Lu Dong, PhD
role: PRINCIPAL_INVESTIGATOR
References: