National HIV Prevention Conference Atlanta, Georgia, USA — July 27 - 30, 2003

Natl HIV Prev Conf 2003 July 27-30:abstract no. M1-D0202
Kegeles SM, Rebchook G
Center for AIDS Prevention Studies, University of California, San Francisco, CA

ISSUE: The Mpowerment Project (MP) is an effective, community-level HIV prevention program for gay/bisexual men ages 18-29. It has been rigorously tested in multiple communities through randomized controlled studies. It is listed in the CDC Compendium of HIV Prevention Interventions with Evidence of Effectiveness and was named an Exemplary Program by SAMHSA's Center for Substance Abuse Prevention. Over 300 community-based organizations and health departments (CBOs/HDs) have requested assistance in implementing the MP. The issues addressed here are: 1) How can a research-based HIV prevention intervention be translated into practice, and 2) What can be done to facilitate the intervention's successful implementation.

SETTING: The site of the intervention developers and the CBOs/HDs that request assistance in translating the MP into practice.

PROJECTS: Four projects will be discussed: 1) the original research and subsequent efforts with CBOs and funders in the research communities to sustain the intervention after the randomized, controlled trials ended, and characteristics of the MP that influence the translation process; 2) experiences in the REP project, including the development of a preliminary replication package collaboratively produced by working with 9 CBOs/HDs; 3) a collaborative research project with a CBO, in which the CBO implemented the intervention; 4) an ongoing project involving state-of-the-art methods of training, technical assistance (TA) and replication materials in collaboration with CBOs/HDs around the U.S. seeking to implement the MP. The effectiveness of the TA/training program is being evaluated and the project also involves studying factors, including characteristics of MP, that present as barriers and facilitators to successful implementation.

RESULTS: The intervention is complex -- it is theoretically sophisticated, involves multiple interrelated components, requires empowering young MSM as decision-makers, and uses community-organizing methods. But current theories about MSM and sexual risk behavior indicate that complex interventions are required to match the complex sociocultural contexts of sexual behavior and psychosocial issues affecting young MSM. Effective translation to practice depends upon the quality of the implementation, which has never been examined previously. We found that replication materials alone were insufficient to effectively translate research to practice. Yet replication materials must provide abundant examples of implementation and guidelines to follow, while not dictating exactly how to implement the program. Training must be intensive and experiential, and involve CBOs/HDs sharing their experiences with each other. TA must be individually-tailored to the CBOs/HDs' unique characteristics, communities, and stage of implementation, Also, it must be provided on a regular basis, not solely when CBOs/HDs recognize the need for it. Organizational issues must be taken into account in replication materials, training, and TA.

LESSONS LEARNED: Effectively translating the evidence-based, community-level MP into practice requires a "second generation intervention," in which the intervention is focused on CBOs/HDs that want to implement the Mpowerment Project. This new intervention is called "The Mpowerment Project Technology Exchange System," (MPTES) and involves extensive collaboration with CBOs/HDs. In addition to replication materials, training and TA, it also involves a website, an internet chat room about the intervention, and an electronic discussion group. Experiences with the MPTES will be discussed.

030727
M1-D0202

Copyright notice: The National HIV Prevention Conference is collaborative effort by the Centers for Disease Control and Prevention, a U.S. Government agency and other governmental and non-government organizations. All abstracts published in by the conference organizers are in the public domain and can be used without permission. Proper citation, however, is required.