4 - (SYM 51) Implementation Determinants of a Relationship Education and HIV Prevention Program for Young Sexual and Gender Minorities

Abstract Body

Background: Couple-based health-promotion programs have demonstrated effects on relationship functioning and myriad mental and physical health outcomes. Such programs have been adapted for online delivery to enhance reach, adding complexity to community-based implementation. 2GETHER is a relationship education and HIV prevention program for young male couples that has established efficacy and been evaluated in both online and in-person formats. The goal of the current study was to examine key stakeholder perspectives on future implementation of 2GETHER and in diverse settings.

Method: In the context of a hybrid type 1 implementation-effectiveness trial, we conducted 40 in-depth interviews with key stakeholders who were involved in selection of programming and/or service delivery. We purposefully selected individuals who work in 5 types of organizations, including LGBTQ community centers, AIDS-serving organizations, university/college LGBTQ resource centers, LGBTQ-affirming psychotherapy practices, and public health departments. We used the Consolidated Framework for Implementation Research (CFIR) to develop the interview guide and codebook, focusing on determinations of future implementation (i.e., facilitators, barriers), while allowing new themes to emerge. Two staff coded transcripts with consensus >.80.

Results: High perceived cost was a barrier across all settings (psychotherapy practices most frequently noted this barrier), but community-based and AIDS-serving organizations noted that grant-based funding opportunities could facilitate implementation. Staffing issues (i.e., having staff with specific skills to implement an eHealth dyadic program) was a barrier for some organizations (e.g., university centers) and a facilitator in others (e.g., community-based organizations). Most interviewees believed a fully automated, online intervention would be easiest to implement in their setting–except for university centers who preferred in-person. Psychotherapy practices, in particular, described enthusiasm for eHealth, if it could be delivered as an ancillary component to therapy or to couples on their waitlist.

Conclusions: Stakeholders across settings felt that 2GETHER (a relationship education and sexual health promotion program) would benefit their clients. Cost and staffing issues were the most prominent barriers, particularly in settings that are ineligible for grant funding. Implementation research is needed to develop facilitate implementation in diverse settings.