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Laying the Foundation for Connect to Protect ®: A Multi-Site Community Mobilization Intervention to Reduce HIV/AIDS Incidence and Prevalence among Urban Youth

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Abstract

Despite the considerable resources that have been dedicated to HIV prevention interventions and services over the past decade, HIV incidence among young people in the United States remains alarmingly high. One reason is that the majority of prevention efforts continue to focus solely on modifying individual behavior, even though public health research strongly suggests that changes to a community's structural elements, such as their programs, practices, and laws or policies, may result in more effective and sustainable outcomes. Connect to Protect is a multi-city community mobilization intervention that focuses on altering or creating community structural elements in ways that will ultimately reduce youth HIV incidence and prevalence. The project, which spans 6 years, is sponsored by the Adolescent Medicine Trials Network for HIV/AIDS Interventions at multiple urban clinical research sites. This paper provides an overview of the study's three phases and describes key factors in setting a firm foundation for the initiation and execution of this type of undertaking. Connect to Protect's community mobilization approach to achieving structural change represents a relatively new and broad direction in HIV prevention research. To optimize opportunities for its success, time and resources must be initially placed into laying the groundwork. This includes activities such as building a strong overarching study infrastructure to ensure protocol tasks can be met across sites; tapping into local site and community expertise and knowledge; forming collaborative relationships between sites and community organizations and members; and fostering community input on and support for changes at a structural level. Failing to take steps such as these may lead to insurmountable implementation problems for an intervention of this kind.

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Notes

  1. Given the public health urgency of knowing one's HIV status, all sites have also made arrangements with local entities to offer serosurvey participants confidential HIV testing and counseling.

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Acknowledgements

The Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) and Connect to Protect are funded by grant No. U01 HD40506-01 from the National Institutes of Health through the National Institute of Child Health and Human Development (Audrey Smith Rogers, PhD; MPH; Robert Nugent, PhD; Leslie Serchuck, MD), with supplemental funding from the National Institutes on Drug Abuse (Nicolette Borek, PhD), Mental Health (Andrew Forsyth, PhD; Pim Brouwers, PhD), and Alcohol Abuse and Alcoholism (Kendall Bryant, PhD). Connect to Protect has been scientifically reviewed by the ATN's Behavioral and Community Prevention Leadership Groups. The authors would like to acknowledge Connect to Protect's National Coordinating Center staff members and consultants: Audrey Bangi, PhD; Matthew Bowdy, MA; Shayna Cunningham, MHS; Mimi Doll, PhD; Jason Johnson, BA; Rachel Lynch, MPH; Suzanne Maman, PhD; Danish Meherally, BS; Grisel Robles-Schrader, BA; Marizaida Sánchez-Cesáreo, PhD; Nancy Willard, BA; and Stephanie Witt, MPH. The authors also acknowledge support of: DePaul University's Quality Assurance Team member Leah Neubauer, BA; individuals from the ATN Data and Operations Center (Westat, Inc.) including Jim Korelitz, PhD; Barbara Driver, RN, MS; Lori Perez, PhD; Rick Mitchell, MS; Stephanie Sierkierka, BA; and Dina Monte, BSN; and individuals from the ATN Coordinating Center at the University of Alabama including Craig Wilson, MD; Cindy Partlow, MEd; Marcia Berck, BA; and Pam Gore. The following ATN sites have participated in the study: University of South Florida: Patricia Emmanuel, MD; Diane Straub, MD; Shannon Cho, BS; Georgette King, MPA; Mellita Mills Kendrick, BS; and Chodaesessie Morgan, MPH. Childrens Hospital of Los Angeles: Marvin Belzer, MD; Miguel Martinez, MSW/MPH; Veronica Montenegro, Ana Quiran, Angele Santiago, Gabriela Segura, BA; and George Weiss, BA. Children's Hospital National Medical Center: Lawrence D'Angelo, MD; William Barnes, PhD; Bendu Cooper, MPH; and Cassandra McFerson, BA. The Children's Hospital of Philadelphia: Brett Rudy, MD; Antonio Cardoso, ABD; and Marne Castillo, MEd. John H. Stroger Jr. Hospital and the CORE Center: Lisa Henry-Reid, MD; Jaime Martinez, MD; Zephyr Beason, MSW; and Draco Forte, MEd. University of Puerto Rico: Irma Febo, MD; Ileana Blasini, MD; Ibrahim Ramos-Pomales, MPHE; and Carmen Rivera-Torres, MPH. Montefiore Medical Center: Donna Futterman, MD; Sharon S. Kim, MPH; Lissette Marrero, Stephen Stafford, and Carol Tobkes, MPH. Mount Sinai Medical Center: Linda Levin, MD; Meg Jones, MPH; Christopher Moore, MPH and Kelly Sykes, PhD University of California at San Francisco: Barbara Moscicki, MD; Coco Auerswald, MD; Catherine Geanuracos, MSW; Kevin Sniecinski, BS. Tulane University Health Sciences Center: Sue Ellen Abdalian, MD; Lisa Doyle, Trimika Fernandez, MS; and Sybil Schroeder, PhD University of Maryland: Ligia Peralta, MD; Bethany Griffin Deeds, PhD; Sandra Hipszer, MPH; Maria Metcalf, MPH; and Kalima Young, BA. University of Miami School of Medicine: Lawrence Friedman, MD; Angie Lee; Kenia Sanchez, MSW; Benjamin Quiles, BSW; and Shirleta Reid. Children's Diagnostic and Treatment Center: Ana Puga, MD; Dianne Batchelder, RN; Jamie Blood, MSW; Pam Ford, MS;and Jessica Roy, MSW. Children's Hospital Boston: Cathryn Samples, MD; Wanda Allen, BA; Khari Farrell, PhD; Lisa Heughan, BA; Meqdes Mesfin, MPH; and Judith Palmer-Castor, PhD University of California at San Diego: Stephen Spector, MD; Rolando Viani, MD; Stephanie Lehman, PhD; and Mauricio Perez. We would also like to acknowledge staff members who provided data from local public health departments, police departments, state agencies, and other institutions. Finally, we recognize the thoughtful input given by participants of our national and local Youth Community Advisory Boards.

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  1. 5200 Eastern Avenue, Mason F. Lord Bldg., Center Tower, 4th floor-Rm. 4200, Baltimore, MD, 21224, USA

    Jonathan M. Ellen MD

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  1. Mauri A. Ziff
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  2. Gary W. Harper
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  3. Kate S. Chutuape
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  4. Bethany Griffin Deeds
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  5. Donna Futterman
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  6. Vincent T. Francisco
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  7. Larry R. Muenz
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  8. Jonathan M. Ellen MD
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Adolescent Medicine Trials Network for HIV/AIDS Intervention

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Correspondence to Jonathan M. Ellen MD.

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Ziff, Chutuape, and Ellen are with the Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Harper is with the Department of Psychology, DePaul University, Chicago, IL, USA; Deeds is with the Department of Pediatrics, University of Maryland Medical School, Division of Adolescent and Young Adult Medicine, Baltimore, MD, USA; Futterman is with the Albert Einsten College of Medicine and Children's Hospital at Montefiore, Bronx, NY, USA; Francisco is with the Department of Public Health Education, University of North Carolina, Greensboro, USA; Muenz is with the Westat, Inc., Rockville, MD, USA.

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Ziff, M.A., Harper, G.W., Chutuape, K.S. et al. Laying the Foundation for Connect to Protect ®: A Multi-Site Community Mobilization Intervention to Reduce HIV/AIDS Incidence and Prevalence among Urban Youth. JURH 83, 506–522 (2006). https://doi.org/10.1007/s11524-006-9036-7

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