Foundation E

PHFE CDPH ELC 2019-2024

CALIFORNIA EMERGING INFECTIONS PROGRAM

PHFE CDPH ELC 2024-2029 - ELC NWSS MPOX APPLICATION

CALIFORNIA ELC 2014

SAN FRANCISCO VACCINE AND PREVENTION UNIT

CALIFORNIA EMERGING INFECTIONS PROGRAM - IN THIS PROPOSAL, THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH (CDPH), THE UNIVERSITY OF CALIFORNIA, BERKELEY SCHOOL OF PUBLIC HEALTH (UCB-SPH), SELECTED LOCAL AND COUNTY HEALTH DEPARTMENTS, AND OTHER PARTNERS REQUEST AN ADDITIONAL FIVE YEARS OF SUPPORT FOR THE CALIFORNIA EMERGING INFECTIONS PROGRAM (EIP), WHICH WAS ESTABLISHED IN 1994 WITH SUPPORT FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION AND HAS BEEN RE-FUNDED FOUR TIMES SINCE THEN. WE PROPOSE TO MAINTAIN CORE DISEASE SURVEILLANCE AND RESPONSE CAPABILITIES AND TO IMPLEMENT OR CONTINUE DATA MODERNIZATION EFFORTS WITH THE ACTIVE BACTERIAL CORE SURVEILLANCE AND RELATED ACTIVITIES (ABCS); ACTIVE POPULATION-BASED LABORATORY SURVEILLANCE FOR FOODBORNE DISEASES AND RELATED ACTIVITIES (FOODNET); INFLUENZA AND RSV INFECTIONS RESULTING IN HOSPITALIZATION; POPULATION-BASED SURVEILLANCE FOR HOSPITALIZATIONS RESULTING FROM LABORATORY-CONFIRMED SARS-COV-2, (RESP-NET); SURVEILLANCE FOR AND RELATED STUDIES OF HEALTHCARE-ASSOCIATED INFECTIONS (HAI) AND ANTIMICROBIAL RESISTANCE; SURVEILLANCE FOR HPV INFECTION AND RELATED STUDIES OF THE IMPACT OF HPV VACCINE (HPV-IMPACT); SURVEILLANCE FOR PRION DISEASE, MYALGIC ENCEPHALOMYELITIS/ CHRONIC FATIGUE SYNDROME (ME/CFS) AND ME/CFS-LIKE POST-COVID CONDITIONS, AND THE MPOX VACCINE EFFECTIVENESS EVALUATION AS WELL AS MAINTAIN SURGE CAPACITY THAT CAN ASSIST IN FLEXIBLE RESPONSES TO NEWLY EMERGING INFECTIOUS DISEASE THREATS AND PARTICIPATE IN RAPID POPULATION SURVEYS. IN ADDITION, WE PROPOSE TO CONTINUE TO PROVIDE APPROPRIATE ISOLATES AND/OR SPECIMENS TO CDC; COLLABORATE WITH CDC AND OTHER EIP SITES IN THE MANAGEMENT, ANALYSIS, INTERPRETATION, AND PUBLICATION OF DATA FROM EIP PROJECTS; PROVIDE TRAINING TO WORKING PUBLIC HEALTH PROFESSIONALS, STUDENTS, AND FELLOWS; PARTICIPATE IN AN EXCHANGE PROGRAM; ACT AS A RESOURCE FOR STATES AND OTHER PARTS OF CALIFORNIA WITHOUT EIPS; AND ENSURE REVIEW OF VARIOUS EIP PROJECTS BY APPROPRIATE INSTITUTIONAL REVIEW BOARDS WHENEVER NE CESSARY (FOR CURRENT IRB APPROVALS SEE APPENDIX X). THE CALIFORNIA EIP WILL CONTINUE TO BE ADMINISTERED BY PUBLIC HEALTH FOUNDATION ENTERPRISES, INC., BASED IN THE CITY OF INDUSTRY, CALIFORNIA.

CALIFORNIA EMERGING INFECTIONS PROGRAM

CALIFORNIA ELC 2014

CALIFORNIA EMERGING INFECTIONS PROGRAM

EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES

THE AFFORDABLE CARE ACT: BUILDING EPIDEMIOLOGY LABORATORY HAI

SAN FRANCISCO VACCINE AND PREVENTION UNIT

CAPACITY BUILDING ASSISTANCE (CBA) FOR HIGH IMPACT HIV PREVENTION; INTEGRATED HIV ACTIVITIES AND STRUCTURAL INTERVENTIONS; COMPONENT 2, TRACK C: SUPPLEMENTAL FUNDING

CAPACITY BUILDING ASSISTANCE (CBA) TO IMPROVE THE DELIVERY AND EFFECTIVENESS OF

SHERO: INTEGRATING TECH-ENABLED COMSS INTO PERINATAL SYSTEMS OF CARE TO ADVANCE EQUITY IN NEW ORLEANS, LA - THE US CONTINUES TO LEAD ALL INDUSTRIALIZED NATIONS WITH THE HIGHEST RATES OF MATERNAL MORTALITY AND MORBIDITY (MMM) WITH UNRELENTING RACIAL & ETHNIC DISPARITIES. BLACK WOMEN AND THEIR BABIES DIE 3-5XS MORE THAN THEIR WHITE COUNTERPARTS. THE HIGHEST BLACK MMM RATES ARE OBSERVED IN THE DEEP SOUTH. NEW ORLEANS, LOUISIANA (NOLA) OFFERS A UNIQUE OPPORTUNITY COMBAT THESE DISPARITIES THROUGH OUR INNOVATIVE, TECH-ENABLED, COMMUNITY-BASED MATERNAL SUPPORT SERVICES PERINATAL HEALTH MODEL (COMSS); ENTER STAGE LEFT OR SWIPE RIGHT IF YOUR TECH SAVVY, SHERO “SHAPING HEALTHY EQUITABLE REPRODUCTIVE OUTCOMES” POWERED BY BIRTH BY US (BBU) IN NOLA. OUR COMSS MODEL LEVERAGES PROPRIETARY TECHNOLOGY AND A 40+ WEEK, EVIDENCE AND ASSET BASED CURRICULUM TO OFFER WEEK BY WEEK PRENATAL, POSTPARTUM AND SOCIAL SUPPORT. WE INTEGRATE THE ONLY 4 INTERVENTIONS INDIVIDUALLY SHOWN TO IMPROVE BLACK PERINATAL OUTCOMES 1) GROUP CARE & SUPPORT, 2) RACIALLY CONCORDANT CARE TEAMS, 3) DOULAS AND CHWS AND 4) HOME VISITATION) INTO ONE SYNERGISTIC SOLUTION;. WE OPERATE VIRTUALLY TO REMOVE SOCIAL DETERMINANTS OF HEALTH (SDOH) BARRIERS. OUR SHERO SQUADS (LICENSED HEALTH PROFESSIONALS, DOULAS AND COMMUNITY HEALTH WORKERS (CHWS) TAKE FULL ACCOUNTABILITY FOR OUR SHERO MOMS AND SERVE AS AN ADDITIONAL SAFETY NET FOR THE HIGHEST RISK, HIGHEST COSTS AND HIGHEST NEED POPULATIONS; THAT WE LOVINGLY CONSIDER THE HIGHEST RETURN ON IMPACT AND INVESTMENT. OUR TEAM WILL CARRY OUT THREE NOVEL OBJECTIVES OVER THE GRANT PERIOD: 1) PILOT, EVALUATE, LAUNCH, SCALE, AND SUSTAIN SHERO NOLA ACROSS THE 4 HIGHEST-RISK PARISHES IN NEW ORLEANS (ORLEANS, JEFFERSON, PLAQUEMINES, AND ST. BERNARD) TO ADVANCE EQUITY AND IMPROVE BLACK PERINATAL OUTCOMES; 2) DEVELOP AND DISTRIBUTE QUANTITATIVE AND QUALITATIVE TOOLS TO ASSESS FATHERS AND BLACK MEN’S ROLES AS KEY PERINATAL STAKEHOLDERS TO IMPROVE BLACK MATERNAL AND INFANT HEALTH; AND 3) RECRUIT, TRAIN, EMPLOY AND DEPLOY BLACK CHW’S (WOMEN AND MEN) TO PROVIDE PERINATAL SUPPORT SERVICES IN NEW ORLEANS. WE WILL SERVE OVER 8,500 BLACK MOMS, BABIES, FATHERS, AND FAMILIES IN NEW ORLEANS AND ACHIEVE OUR PRIMARY GOAL OF SUCCESS WITH 95% OF SHERO MOMS AND 90% OF SHERO INFANTS BEING ALIVE & HEALTHY AT THE TIME THEY GRADUATE FROM SHERO (12 WEEKS POST-PARTUM). OUR GRANT TEAM REPRESENTS SILICON VALLEY TECH-PIONEERS, (MOMENTUM PARK, BIRTH BY US, HELUNA HEALTH, THE UC-IRVINE) AND NEW ORLEANS EQUITY CHAMPIONS, (DOCGRIGGS ENTERPRISES, COMPASSION OUTREACH, XAVIER UNIVERSITY). THE IMPACT OF OUR PROPOSED COMMS PROJECT WILL DISRUPT THE STATUS QUO OF MATERNITY CARE AND THE OVERALL PREGNANCY EXPERIENCE OF BLACK FAMILIES IN NEW ORLEANS.

REPEATED-DOSE BEHAVIORAL INTERVENTION TO REDUCE OPIOID OVERDOSE: A TWO-SITE RANDOMIZED-CONTROLLED EFFICACY TRIAL

PRIME: PREP INTERVENTION FOR PEOPLE WHO INJECT METHAMPHETAMINE

RYAN WHITE TITLE IV PROGRAM

DOT DIARY (D2): DEVELOPING A MOBILE APP WITH COMBINED AUTOMATED DOT AND DAILY SEXUAL DIARY FOR MONITORING AND IMPROVING PREP ADHERENCE

MIRTAZAPINE FOR METHAMPHETAMINE USE DISORDER: DRUG-DRUG INTERACTION STUDY

PREVENTION UMBRELLA FOR MSM IN THE AMERICAS

CAPACITY BUILDING ASSISTANCE (CBA) FOR HIV PREVENTION PROGRAMS TO END THE HIV EPIDEMIC IN THE UNITED STATES - COMPONENT D: TECHNICAL ASSISTANCE FOR HIGH-IMPACT HIV PREVENTION PROGRAMS - SIGNIFICANT PROGRESS HAS BEEN MADE IN HIV BIOMEDICAL INTERVENTIONS OVER THE PAST DECADE. THE ENDING THE HIV EPIDEMIC (EHE) INITIATIVE HAS SET NATIONAL GOALS TO REDUCE NEW HIV INFECTIONS BY 75% BY 2025 AND 90% BY 2030. TO EFFECTIVELY END THE HIV EPIDEMIC IN THE UNITED STATES, HEALTH DEPARTMENTS AND COMMUNITY-BASED ORGANIZATIONS NEED TO ADDRESS BARRIERS IN HIV PREVENTION, CARE, AND TREATMENT. SOCIAL DETERMINANTS OF HEALTH (SDOH) PLAY A CRUCIAL ROLE IN INFLUENCING HEALTH OUTCOMES AND ARE A MAJOR FACTOR CONTRIBUTING TO HEALTH DISPARITIES AMONG POPULATIONS DISPROPORTIONATELY AFFECTED BY HIV. ACHIEVING THE GOALS OF EHE AND PROMOTING HEALTH EQUITY REQUIRES ONGOING EFFORTS TO ADDRESS HISTORICAL AND CONTEMPORARY INJUSTICES, OVERCOME ECONOMIC AND SOCIAL OBSTACLES TO HEALTHCARE, AND ELIMINATE PREVENTABLE HEALTH DISPARITIES. THE CALIFORNIA PREVENTION TRAINING CENTER (CAPTC) HAS NEARLY 3 DECADES OF EXPERIENCE WORKING DIRECTLY WITH A WIDE ARRAY OF HIV PROVIDERS IN HEALTH DEPARTMENTS (HDS) AND COMMUNITY-BASED ORGANIZATIONS (CBOS) SETTINGS. THE CAPTC HAS BEEN A NATIONAL LEADER IN DELIVERING SDOH TECHNICAL ASSISTANCE, WORKING WITH HDS AND CBOS WITH IDENTIFYING SOCIAL AND ECONOMIC INEQUITIES THAT PREVENT PRIORITY POPULATIONS FROM RECEIVING CULTURALLY RELEVANT HIV PREVENTION, CARE, AND TREATMENT SERVICES. UNDER COMPONENT D, THE CAPTC INTENDS TO STREAMLINE THE DELIVERY OF CBA TO STRENGTHEN THE CAPACITY OF HDS AND CBOS TO ASSESS AND ADDRESS PROGRAMMATIC CHALLENGES TO EFFECTIVELY PLAN, INTEGRATE, IMPLEMENT, EVALUATE, AND SUSTAIN HIV PREVENTION PROGRAMS. THE CAPTC WILL COLLABORATE WITH THE CDC AND THE CBA PROVIDER NETWORK (CPN) TO DELIVER TECHNICAL ASSISTANCE (TA) AND SERVICES TO THE CDC-FUNDED HIV PREVENTION WORKFORCE, INCLUDING HEALTH DEPARTMENT STAFF, CBOS, CLINICIANS, AND COMMUNITY PARTNERS. THROUGH COLLABORATION, COMMUNICATION, AND COORDINATION, THE CAPTC WILL FOCUS ON ADDRESSING COMPONENT D CONTENT AREAS AND SOCIAL DETERMINANTS OF HEALTH THAT CONTRIBUTE TO INEQUITIES IN HIV PREVENTION, CARE, AND TREATMENT. THE TA PROVIDED BY THE CAPTC AIMS TO STRENGTHEN THE CAPACITY OF CDC-FUNDED HIV PREVENTION PROGRAMS AND THEIR LOCAL PARTNERS IN IDENTIFYING AND ADDRESSING SYNDEMIC CONDITIONS SUCH AS VIRAL HEPATITIS, SEXUALLY TRANSMITTED INFECTIONS (STIS), MENTAL HEALTH DISORDERS, SUBSTANCE USE, AND DISPARITIES AMONG PRIORITY POPULATIONS. ADDITIONALLY, THE CAPTC WILL OFFER TA TO HELP OVERCOME CHALLENGES IN MONITORING AND EVALUATION, AIMING TO IMPROVE THE PERFORMANCE AND EFFECTIVENESS OF CDC-FUNDED HIV PREVENTION PROGRAMS. TO ENSURE COMPREHENSIVE CAPACITY BUILDING ASSISTANCE (CBA), THE CAPTC WILL CONTINUE TO BUILD ON ITS LONG HISTORY OF WORKING WITH OTHER CBA PROVIDERS TO FURTHER ENHANCE THE SKILLS OF A MULTIDISCIPLINARY HIV WORKFORCE TO ACHIEVE THE GOALS OF EHE AND HEALTH EQUITY. THE CAPTC HAS ESTABLISHED EXPERTISE IN THE SPECIFIC STRATEGIES OUTLINED IN THIS FOCUS AREA (CATEGORY D) AND LOOKS FORWARD TO CONTINUING IMPECCABLE WORKING RELATIONSHIPS WITH CDC-FUNDED HDS AND CBOS AND THEIR PARTNERS TO SUPPORT THEIR HIV PREVENTION GOALS, INCLUDING EHE RESPONSE PLANS, THROUGHOUT THE FUNDING CYCLE.

CAPACITY BUILDING ASSISTANCE FOR HIGH-IMPACT HIV PREVENTION - CATEGORY A HEALTH D

EPIDEMIOLOGY AND LABORATORY CAPACITY FOR INFECTIOUS DISEASES

HOME: A COMPREHENSIVE HIV TESTING AND LINKAGE PACKAGE FOR YOUNG MSM OF COLOR

PREP-3D: AN INTEGRATED PHARMACY DIGITAL DIARY AND DELIVERY STRATEGY TO INCREASE PREP USE AMONG MSM

ENHANCING PREP IN COMMUNITY SETTINGS (EPIC)

THE TRANSNATIONAL COHORT: GLOBAL HIV EPIDEMIOLOGY AND PREVENTION RESEARCH FOR TRANSWOMEN.

MIRTAZAPINE FOR THE TREATMENT OF METHAMPHETAMINE DEPENDENCE AMONG MSM WITH HIGH-R

NALTREXONE FOR THE TREATMENT OF ACTIVELY-USING MET-DEPENDENT MSM WITH HIGH-RISK B

COHORT STUDY OF OPIOIDS, PAIN, AND SAFETY IN AN ERA OF CHANGING POLICY (COPING)

CAPACITY BUILDING ASSISTANCE FOR HIGH-IMPACT HIV PREVENTION - CATEGORY A HEALTH D

THE BRIDGE CLINIC: OPTIMIZING INJECTABLE PREP DELIVERY FOR TRANSGENDER AND NON-BINARY PEOPLE - PROJECT SUMMARY/ABSTRACT TRANSGENDER AND NONBINARY (TNB) PEOPLE ARE DISPROPORTIONATELY AFFECTED BY HIV, WITH INCREASING NUMBERS OF NEW DIAGNOSES FROM 2015-2019. PRE-EXPOSURE PROPHYLAXIS (PREP) HAS GREAT POTENTIAL TO REDUCE NEW HIV INFECTIONS, BUT HAS YET TO IMPROVE HIV DISPARITIES AMONG TNB POPULATIONS. WITH THE RECENT FDA APPROVAL OF LONG-ACTING INJECTABLE CABOTEGRAVIR (CAB-LA) FOR PREP, THERE IS A CRITICAL OPPORTUNITY TO LEVERAGE THIS SCIENTIFIC ADVANCE TO INCREASE PREP USE IN TNB POPULATIONS. IN PRIOR WORK, WE PILOTED A FLEXIBLE, LOW- THRESHOLD, TRANS-AFFIRMING PREP CLINIC (BRIDGE CLINIC) WHICH ACHIEVED HIGHER PREP UPTAKE AND REACHED TNB INDIVIDUALS AT HIGHER RISK FOR HIV ACQUISITION THAN THOSE RECEIVING PREP IN GENDER AFFIRMING PRIMARY CARE CLINICS. KEY COMPONENTS OF THE BRIDGE CLINIC MODEL INCLUDE A NURSE-LED PREP CLINIC WITH FLEXIBLE HOURS; PREP SUPPORT PROVIDED BY A TRANS PEER NAVIGATOR; TEXT-MESSAGING SUPPORT VIA PREPMATE, A CDC-ENDORSED EVIDENCE BASED INTERVENTION; TRANSPORTATION SUPPORT; AND A TNB COMMUNITY-LED PREP AWARENESS CAMPAIGN. IN THIS PROPOSAL, WE WILL USE RAPID-CYCLE RESEARCH (RCR) METHODS TO ENHANCE THE BRIDGE CLINIC TO INCORPORATE CAB-LA DELIVERY, REFINE THIS MODEL THROUGH ITERATIVE ADAPTATIONS, AND ASSESS KEY IMPLEMENTATION OUTCOMES. WE WILL ALSO EVALUATE FOR ANY DRUG INTERACTIONS BETWEEN GENDER AFFIRMING HORMONES AND CAB-LA, AN IMPORTANT QUESTION TO ADDRESS FOR THE TNB COMMUNITY. IN AIM 1, WE WILL CONDUCT A SERIES OF NOMINAL GROUPS WITH ENGLISH- AND SPANISH-SPEAKING TNB PEOPLE AND SEMI-STRUCTURED INTERVIEWS WITH THEIR PROVIDERS TO EXPLORE PATIENT- AND PROVIDER-IDENTIFIED BARRIERS AND FACILITATORS TO CAB-LA DELIVERY IN THE TNB COMMUNITY. WE WILL ALSO ELICIT FEEDBACK ON OUR IMPLEMENTATION STRATEGIES TO GUIDE THE ENHANCEMENT OF OUR PROTOCOL AND ENGAGEMENT APPROACHES TO INCORPORATE CAB-LA. IN AIM 2, WE WILL IMPLEMENT THE CAB-LA ENHANCED BRIDGE CLINIC MODEL IN AN OPEN COHORT OF 200 TNB INDIVIDUALS OVER A 3-YEAR PERIOD, WITH MID-COURSE ADAPTATIONS GUIDED BY THE RCR PROCESS. USING THE RE-AIM FRAMEWORK, WE WILL ASSESS THE REACH, EFFECTIVENESS, ADOPTION, IMPLEMENTATION, AND MAINTENANCE OF THE ENHANCED BRIDGE CLINIC MODEL VIA SURVEYS AND INTERVIEWS WITH PROVIDERS, STAFF, AND PATIENTS, AND MEDICAL RECORD DATA REVIEW. IN AIM 3, WE WILL ENROLL A SUBSET OF PARTICIPANTS RECEIVING INJECTABLE PREP AT THE BRIDGE CLINIC INTO TWO PHARMACOKINETIC SUBSTUDIES TO EVALUATE THE BIDIRECTIONAL EFFECTS OF GENDER AFFIRMING HORMONE THERAPY AND CABOTEGRAVIR PLASMA CONCENTRATIONS IN TNB INDIVIDUALS. OUR WORK ACROSS AIMS WILL BE GUIDED BY A STAKEHOLDER ADVISORY BOARD COMPRISED OF LOCAL AND NATIONAL COMMUNITY ACTIVISTS, LEADERS, HEALTH PROFESSIONALS, AND STAFF SERVING THE TNB COMMUNITY WHO WILL MEET QUARTERLY TO PROVIDE INPUT ON STUDY DESIGN AND IMPLEMENTATION, PRIORITIZATION OF ADAPTATIONS, AND ENSURING THE BRIDGE CLINIC MODEL IS GENERALIZABLE TO OTHER PRACTICE SETTINGS. UPON STUDY COMPLETION, WE WILL HAVE OPTIMIZED AND EVALUATED A NOVEL PREP DELIVERY MODEL TO INCREASE UPTAKE AND PERSISTENCE TO LONG-ACTING INJECTABLE PREP IN TNB PEOPLE, AND ASSESSED FOR DRUG INTERACTIONS BETWEEN GENDER AFFIRMING HORMONES AND CAB-LA IN A REAL-WORLD COHORT OF TNB INDIVIDUALS.

IMPLEMENTING NEW DIRECTIONS IN HIV PREVENTION IN SAN FRANCISCO: A COMPREHENSIVE C

LONGITUDINAL RESEARCH TO ASSESS HIV RISK AND RESILIENCE AMONG TRANS-FEMALE YOUTH

RYAN WHITE TITLE IV WOMEN, INFANTS, CHILDREN, YOUTH AND AFFECTED FAMILY MEMBERS AIDS HEALTHCARE

GLUTIDE FOR ENDING METHAMPHETAMINE - PROJECT SUMMARY/ABSTRACT METHAMPHETAMINE USE AND TOXICITY HAS INCREASED SUBSTANTIALLY OVER THE PAST DECADE, WITH DEATHS ATTRIBUTED TO METHAMPHETAMINE TOXICITY, LARGELY CONSISTING OF CARDIOVASCULAR COMPLICATIONS, INCREASING 9-FOLD FROM 2012- 2021. THERE REMAINS NO FDA-APPROVED MEDICATION TO TREAT METHAMPHETAMINE USE DISORDER (MEUD), NOTWITHSTANDING DECADES OF EFFORTS. MOREOVER, MOST EXPERTS NOW FEEL THAT A COMBINATION OF AGENTS WILL BE REQUIRED TO EFFECTIVELY TREAT MEUD, ADDRESSING MULTIPLE NEUROTRANSMITTER SYSTEMS SIMULTANEOUSLY. WHILE MANY AGENTS THAT HAVE SHOWN PROMISE ARE ANTI-DEPRESSANT MEDICATIONS, GLP-1 AGENTS HAVE SIGNIFICANT POTENTIAL PROMISE AND AN ENTIRELY DISTINCT MECHANISM OF ACTION. GLP-1 AGONISTS, AND SEMAGLUTIDE IN PARTICULAR, HAVE DEMONSTRATED A MARKED ABILITY TO REDUCE CRAVING FOR PEOPLE WITH SUBSTANCE USE DISORDERS. CRAVING IS A MAJOR COMPONENT OF MEUD AND REDUCING THIS COMPONENT MAY HAVE A SIGNIFICANT IMPACT ON METHAMPHETAMINE USE. SOME CONCERNS EXIST IN THE USE OF GLP-1 AGONISTS IN THIS POPULATION, MOST NOTABLY THE WEIGHT LOSS INDUCED BY GLP-1 AGONISTS, GIVEN THE FACT THAT SOME PEOPLE WITH MEUD ARE SIGNIFICANTLY UNDERWEIGHT. HOWEVER, THIS WEIGHT LOSS MAY BE A BENEFIT FOR THE SUBSTANTIAL PROPORTION OF PEOPLE WITH MEUD WHOSE METHAMPHETAMINE USE IS AT LEAST PARTIALLY DRIVEN BY WEIGHT LOSS OR WEIGHT CONTROL BENEFITS. ABSTENTION FROM METHAMPHETAMINE USE IS ASSOCIATED WITH SUBSTANTIAL WEIGHT GAIN, WHICH MAY BE PREVENTED BY GLP-1 AGONIST TREATMENT. WE PROPOSE A TWO-PHASE STUDY OF SEMAGLUTIDE FOR MEUD. IN THE FIRST PHASE, WE WILL CONDUCT AN OPEN-LABEL SINGLE-ARM PHASE IIA TRIAL OF SEMAGLUTIDE FOR MEUD. IF THE ELIGIBLE:ENROLLMENT RATIO, MEDICATION ADHERENCE, AND WILLINGNESS TO CONTINUE THERAPY MEET PRESPECIFIED LEVELS, AND THERE IS EVIDENCE OF REDUCED METHAMPHETAMINE USE, WE WILL PROCEED TO A PHASE IIB PLACEBO-CONTROLLED RANDOMIZED TRIAL OF SEMAGLUTIDE VERSUS PLACEBO TO DETERMINE THE EFFICACY OF THIS MEDICATION IN ACHIEVING A CLINICALLY-MEANINGFUL REDUCTION IN METHAMPHETAMINE USE. THESE STUDIES WILL BE DONE UNDER FDA IND, IN ORDER TO ALLOW FOR POTENTIAL FUTURE STUDIES THAT COULD LEAD TO A NEW INDICATION FOR SEMAGLUTIDE AS THE FIRST MEDICATION APPROVED FOR MEUD.

CALIFORNIA ENVIRONMENTAL HEALTH SPECIALIST NETWORK (EHS-NET) FOOD SAFETY AND WATE

REDUCING HIV RISK AMONG EPISODIC SUBSTANCE-USING MSM

PPHF 2012-EMERGING INFECTIONS PROGRAM (EIP)

SHINE STRONG: BUILDING THE PIPELINE OF HIV BEHAVIORAL SCIENTISTS WITH EXPERTISE IN TRANS POPULATION HEALTH

ADDRESSING SYNDEMICS THROUGH PROGRAM COLLABORATION AND SERVICE INTEGRATION

BEHAVIORAL SAFETY AND FENTANYL EDUCATION: BSAFE - FENTANYL OVERDOSE MORTALITY HAS SKYROCKETED OVER THE PAST DECADE. MOST OF THESE DEATHS ALSO INVOLVE STIMULANTS (COCAINE OR METHAMPHETAMINE). MULTIPLE INVESTIGATIONS HAVE DEMONSTRATED A SUBSTANTIAL CONTRIBUTION OF UNINTENTIONAL FENTANYL USE (UFU) TO MEDICALLY-ATTENDED OPIOID OVERDOSE AND OPIOID OVERDOSE MORTALITY. THIS MOSTLY OCCURS AMONG PEOPLE USING STIMULANTS (COCAINE OR METHAMPHETAMINE). WHILE CONTAMINATION OF DRUGS CONTRIBUTES TO UFU, THE MECHANISM IS USUALLY RELATED TO HOW DRUGS ARE OBTAINED, PREPARED, AND CONSUMED (E.G., FINDING A DRUG THAT IS ASSUMED TO BE A STIMULANT, LETTING SOMEONE ELSE PREPARE A DRUG FOR USE, OR USING A PIPE THAT WAS USED BY SOMEONE ELSE). THIS MECHANISM OF RISK CAN BE READILY INTERVENED UPON WITH BEHAVIORAL AND EDUCATIONAL STRATEGIES. WE PROPOSE TO ADAPT A SUCCESSFUL OPIOID OVERDOSE PREVENTION INTERVENTION TO ADDRESS UFU AMONG PEOPLE WHO USE STIMULANTS AND DO NOT INTENTIONALLY USE OPIOIDS AND ADAPT THAT INTERVENTION TO ENSURE ACCEPTABILITY AMONG HIGH-RISK PERSONS. THE REPEATED-DOSE INTERVENTION, B-SAFE, WILL FOCUS ON DEVELOPING AN INDIVIDUALIZED UFU PREVENTION PLAN, AUGMENTED WITH WEEKLY SMS REMINDERS AND LINKAGE TO CARE FOR STIMULANT USE TREATMENT. WE WILL TEST THE INTERVENTION AGAINST USUAL CARE (REFERRALS TO LOW-THRESHOLD SERVICES AND TREATMENT, ON-SITE ACCESS TO OVERDOSE PREVENTION SUPPLIES) WITH ATTENTION CONTROL IN A RANDOMIZED-CONTROLLED TRIAL OF 160 PERSONS SEEN EVERY 4 MONTHS OVER 16 MONTHS. RESULTS FROM THIS TRIAL, CONDUCTED AT THE SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH, WILL ALLOW US TO EVALUATE A CRITICAL INTERVENTION TO REDUCE FENTANYL OVERDOSE AND RESULTANT DEATH AMONG A POPULATION THAT SHOULD NOT BE EXPERIENCING OPIOID OVERDOSE AT ALL. IF THE INTERVENTION PROVES EFFECTIVE, THE HEALTH DEPARTMENT IS WELL-POSITIONED TO CONTINUE PROVIDING THE SERVICE.

SPECIAL PROJECTS OF NATIONAL SIGNIFICANCE

CALIFORNIA HEMOGLOBINOPATHIES SURVEILLANCE INITIATIVE (CHSI)

LEVERAGING PSYCHOLOGICAL AUTOPSIES TO ACCELERATE RESEARCH INTO STIMULANT OVERDOSE MORTALITY

ARIPIPRAZOLE TO REDUCE METHAMPHETAMINE USE AMONG MSM WITH HIGH-RISK HIV BEHAVIORS

SHARP: SUMMER HIV/AIDS RESEARCH PROGRAM

BEHAVIORAL HEALTH WORKFORCE EDUCATION AND TRAINING PROGRAM FOR PARAPROFESSIONALS - THE PROPOSED PROJECT IS DESIGNED TO TRAIN COMMUNITY MEMBERS TO BE PARAPROFESSIONALS HELPING TO ADDRESS THE MENTAL HEALTH NEEDS OF THEIR COMMUNITIES. THE COMMUNITIES WHERE THE TRAINING WILL TAKE PLACE INCLUDE AREAS OF CALIFORNIA’S INLAND EMPIRE WITHIN SAN BERNADINO AND RIVERSIDE COUNTIES AS WELL AS BORDERING AREAS. A BROAD COALITION OR COMMUNITY-BASED ORGANIZATIONS, HEALTH SERVICE PROVIDERS, A MANAGED CARE PLAN, A LOCAL SCHOOL DISTRICT, AND LOCAL UNIVERSITIES WILL COLLABORATE TO PREPARE A FUTURE WORKFORCE CAPABLE OF EXTENDING THE REACH OF MENTAL HEALTH SERVICES IN THE AREA. SPECIFICALLY, THE TWO-LEVEL COMMUNITY MENTAL HEALTH WORKER (CMHW) TRAINING AND CERTIFICATION PROGRAM IS TO PREPARE CAPABLE INDIVIDUALS RECRUITED FROM THE COMMUNITY TO WORK WITHIN HEALTH CARE TEAMS TO PROVIDE A MEDLEY OF INDIVIDUAL AND RESOURCE ASSESSMENT, TRIAGE, CASE MANAGEMENT, REFERRAL, NAVIGATION, COACHING, AND ADVOCACY SKILLS TO ASSIST CHILDREN/ADOLESCENTS AND THEIR FAMILIES TO ATTAIN OPTIMAL LEVELS OF NEUROCOGNITIVE AND SOCIAL-EMOTIONAL DEVELOPMENT THROUGH CRITICAL PERIODS FROM CHILDHOOD TO EARLY ADULTHOOD. THE LEVEL 1 TRAINING INVOLVES TWO MAIN ASPECTS OVER THE COURSE OF A YEAR. THE FIRST IS A DIDACTIC COMPONENT THAT FEATURES SHORT COURSES IMPLEMENTED BY LOCAL COMMUNITY AND HEALTH CARE ORGANIZATIONS AS WELL AS TWO LOCAL UNIVERSITIES. THE SECOND IS AN EXPERIENTIAL COMPONENT WHERE TRAINEES WORK UNDER SUPERVISION WITH COMMUNITY-BASED HEALTH CARE TEAMS IN VARIOUS SETTINGS INCLUDING COMMUNITY CLINICS AND LOCAL ELEMENTARY, MIDDLE, AND HIGH SCHOOLS. LEVEL 2 TRAINING EXTENDS LEVEL 1 TRAINING BY ADDING A FORMAL ONE-YEAR APPRENTICESHIP AT A LOCAL HEALTH CARE SERVICE ORGANIZATION. LEVEL 2 TRAINEES WILL WORK DIRECTLY WITH CLIENTS AND CONDUCT COMMUNITY OUTREACH AND SCREENINGS UNDER SUPERVISION AND WITH THE AID OF MENTORS. WE ARE REQUESTING A FUNDING PRIORITY (PRIORITY 1) AS OUR PROJECT EMPHASIZES THE ROLE OF THE FAMILY AND LIVED EXPERIENCE OF CONSUMERS AND FAMILY MEMBERS IN BEHAVIORAL HEALTH TRAINING. WE ARE ALSO REQUESTING A FUNDING PREFERENCE (QUALIFICATION 3) AS WE ARE A NEW HEALTH PROGRAM. MORE DETAIL IS AVAILABLE IN ATTACHMENT 8.

IMPLEMENTATION OF AN INTEGRATED DIGITAL NAVIGATION INTERVENTION TO END THE EPIDEMIC IN SAN FRANCISCO COUNTY

THE BET INTERVENTION TO REDUCE HIV PREVENTION AND CARE DISPARITIES AMONG YOUNG TRANSWOMEN IN RIO DE JANEIRO

CALIFORNIA EHS-NET FOOD PROJECT- REDUCING THE RISK OF FOOD ALLERGIC EPISODES AT RETAIL FOOD ESTABLISHMENTS

THE AFFORDABLE CARE ACT: MCV/PCV & PERTUSSIS

IMPLEMENTING NEW DIRECTIONS IN HIV PREVENTION IN SAN FRANCISCO: A COMPREHENSIVE

SUBSTANCE USE OUTCOMES OF OPIOID DOSE REDUCTION AND DISCONTINUATION

PHASTT: A MOBILE PERSONALIZED HIV AND STI TESTING TOOL FOR YOUNG BLACK MEN

2017 VECTOR BORNE DISEASE PREVENTION PROGRAM AT LASSEN VOLCANIC NATIONAL PARK

NATIONAL ANTIMICROBIAL RESISTANCE MONITORING SYSTEM (NARMS) RETAIL FOOD SURVEILLANCE IN SELECTED URBAN AREAS OF NORTHERN CALIFORNIA.

PREP BLUEPRINT: EVALUATING IMPLEMENTATION OF A PREP CHOICE BLUEPRINT ON PREP UPTAKE AND PERSISTENCE - PROJECT SUMMARY/ABSTRACT PREP BLUEPRINT IS A PROJECT DESIGNED TO CREATE A BLUEPRINT TO ASSIST CLINICS CURRENTLY OFFERING PREP IN SCALING UP THESE EFFORTS AND OFFERING ALL TYPES OF PREP OPTIONS TO PERSONS WHO MAY BENEFIT FROM PREP. THE STUDY WILL TAKE PLACE IN TWO PHASES. IN THE FIRST PHASE (AIM 1, YEAR 1), WE WILL ASSEMBLE AND ADAPT THE PREP BLUEPRINT WITH CLIENT, CLINIC STAFF, AND COMMUNITY STAKEHOLDER INPUT. WE WILL DO THIS THROUGH HUMAN CENTERED DESIGN (HCD) WITH CLIENT AND CLINIC STAFF IN SAN FRANCISCO, CALIFORNIA AND BIRMINGHAM, ALABAMA TO IDENTIFY IMPLEMENTATION BARRIERS IN SCALING UP PREP AND WHICH STRATEGIES WOULD BE DESIRED, FEASIBLE, AND CLIENT-CENTERED TO BEST ADDRESS THE NEEDS OF POTENTIAL OR CURRENT PREP USERS. WE WILL CONDUCT THREE HALF-DAY WORKSHOPS WITH 10 CLIENTS, AND 20 STAFF AT EACH OF TWO CLINICS, A COMMUNITY SEXUAL HEALTH CLINIC IN SAN FRANCISCO, AND A UNIVERSITY INFECTIOUS DISEASE CLINIC IN BIRMINGHAM. THE GOAL OF THESE HCD WORKSHOPS IS TO BRAINSTORM NEW IDEAS (IDEATION WORKSHOP) TO IMPROVE PREP IMPLEMENTATION WITHIN THE CLINICAL CONTEXT; DEVELOP POTENTIAL STRATEGIES (PROTOTYPING WORKSHOP) TO ADDRESS THE IMPLEMENTATION CHALLENGES; AND REVIEW THE PROTOTYPES IDENTIFY THE SOLUTIONS WHICH ARE MOST ACCEPTABLE, FEASIBLE, AND EFFICIENT (TESTING WORKSHOP) PRIOR TO IMPLEMENTATION. THROUGH THESE HCD ACTIVITIES WE WILL DETERMINE WHAT IS FEASIBLE FOR EACH OF THE CLINICS TO IMPLEMENT, AND WHAT CLIENT-FACING (E.G., PREP DECISION SUPPORT TOOL TO HELP PEOPLE SELECT THE TYPE OF PREP THAT BEST SUITS THEIR NEEDS) AND CLINIC-FACING RESOURCES (E.G., WORK FLOW TEMPLATES, PROVIDER EDUCATIONAL MATERIALS, INSURANCE FLOWSHEETS, VISIT-TYPE PROTOCOLS) WOULD BEST SERVE THE NEEDS OF THE CLINICS. WE WILL ALSO ESTABLISH AND CONSULT WITH A STAKEHOLDER ADVISORY BOARD TO DISCUSS THE HCD, BRAINSTORM STRATEGIES TO REACH A BROADER NUMBER OF PERSONS IN THE PRIORITY POPULATIONS, AND TO PROVIDE ONGOING FEEDBACK ON THE STUDY IMPLEMENTATION. IN PHASE 2 (AIMS 2 & 3, YEARS 2-5), WE WILL LAUNCH THE PREP BLUEPRINT IN THESE 2 CLINICS AND ASSESS THEIR IMPLEMENTATION AND IMPACT USING THE RE-AIM FRAMEWORK (REACH, EFFECTIVENESS, ADOPTION, IMPLEMENTATION, AND MAINTENANCE). WE WILL MEASURE THESE OUTCOMES THROUGH SURVEYS EVERY 6 MONTHS WITH STAFF AND CLIENTS; INTERVIEWS WITH STAFF; AND EXTRACTING DATA FROM THE ELECTRONIC MEDICAL RECORDS. AT THE END OF THIS PROJECT, WE WILL HAVE AN ADAPTABLE PREP BLUEPRINT THAT WILL CONTAIN MULTIPLE FEATURES THAT A VARIETY OF CLINICS IN THE US COULD USE TO INCREASE THE NUMBER OF PERSONS STARTING AND STAYING ON PREP.

CALIFORNIA ENVIRNOMENTAL HEALTH SPECIALIST NETWORK

VECTOR BORNE DISEASE PREVENTION PROGRAM FOR YOSEMITE NATIONAL PARK

TAKEMEHOME: INNOVATIVE STRATEGIES TO INTEGRATE PREP AND DOXYPEP NAVIGATION INTO A NATIONWIDE HOME HIV/STI SELF-TESTING PROGRAM IN THE UNITED STATES - PROJECT SUMMARY/ABSTRACT PRE-EXPOSURE PROPHYLAXIS (PREP) USE HAS THE POTENTIAL TO SUBSTANTIALLY REDUCE NEW HIV INFECTIONS THROUGHOUT THE US, BUT UPTAKE AND PERSISTENCE REMAIN LOW. DOXYCYCLINE POST-EXPOSURE PROPHYLAXIS (DOXYPEP) HAS BEEN SHOWN TO DECREASE STI RATES, PARTICULARLY SYPHILIS AND CHLAMYDIA, BUT FEW ARE USING IT NATIONWIDE. TAKEMEHOME.ORG IS AN ONLINE HOME HIV/STI TESTING PROGRAM OFFERED IN NEARLY 30 JURISDICTIONS ACROSS THE US. ALTHOUGH A SUBSTANTIAL PROPORTION OF PEOPLE USING TAKEMEHOME FALL INTO ONE OR MORE OF THE HIGH HIV SEROINCIDENCE PRIORITY POPULATIONS FOR PREP USE, PREP UPTAKE IN THIS POPULATION IS VERY LOW. WE PROPOSE TO LEVERAGE THE TAKEMEHOME.ORG PLATFORM AND TEST TWO NOVEL INTERVENTIONS TO INCREASE PREP AND DOXYPEP UPTAKE AND PERSISTENCE AMONG TAKEMEHOME TESTERS. WE DEVELOPED A DIRECT-BOOKING PAGE (DB) TO ALLOW INDIVIDUALS TO SCHEDULE A VIRTUAL VISIT WITH A NAVIGATOR TO FACILITATE LINKAGE TO PREP AND DOXYPEP SERVICES. IN A PILOT PROGRAM, UPTAKE OF THIS SERVICE WAS HIGH, WITH 90% COMPLETING A NAVIGATION VISIT. ADDITIONALLY, WE DEVELOPED A PROGRAM TO LINK TAKEMEHOME USERS TO AN INTERACTIVE TEXT-MESSAGING PROGRAM, PREPMATE, TO FACILITATE ONGOING PREP NAVIGATION AND PROVIDE ADHERENCE SUPPORT FOR PEOPLE STARTING PREP. IN A PILOT STUDY AT 2 TAKEMEHOME SITES, PREPMATE HAD HIGH FEASIBILITY AND ACCEPTABILITY WITH NEARLY A THIRD STARTING PREP. WE PROPOSE A HYBRID TYPE 3 EFFECTIVENESS-IMPLEMENTATION STUDY OF DIRECT-BOOKING WITH A NAVIGATOR (DB) OR DB + PREPMATE TO INCREASE PREP AND DOXYPEP USE ACROSS 4 JURISDICTIONS WITH HIGH HIV PREVALENCE USING TAKEMEHOME. IN AIM 1, WE PROPOSE TO INTERVIEW 10-12 SITE STAFF EACH YEAR IN THESE JURISDICTIONS TO ASSESS INNER AND OUTER CONTEXTUAL, INNOVATION, AND BRIDGING FACTORS THAT INFLUENCE SUCCESSFUL LINKAGE OF TAKEMEHOME TESTERS TO PREP AND DOXYPEP SERVICES BEFORE AND AFTER IMPLEMENTATION OF DB AND PREPMATE. WE WILL ALSO BRING TOGETHER NAVIGATORS FROM COLLABORATING CLINICS TO LEARN FROM EACH OTHER ON HOW BEST TO IMPLEMENT THESE INTERVENTIONS IN A COMMUNITY OF PRACTICE. IN AIM 2, WE WILL ENROLL 300 TAKEMEHOME USERS WHO EXPRESS INTEREST IN PREP INTO A 3-ARM STUDY AND RANDOMLY ASSIGN THEM TO 1) DB ALONE (N=100); 2) DB + PREPMATE (N=100); OR STANDARD OF CARE (LINKAGE TO THE WEBSITE OF A LOCAL PREP CLINIC, N=100). STUDY PARTICIPANTS WILL BE FOLLOWED FOR 9 MONTHS, AND PRIMARY OUTCOMES WILL INCLUDE PREP UPTAKE AND PERSISTENCE ASSESSED BY ELECTRONIC HEALTH RECORD DATA (EHR) OF PARTICIPATING CLINICS. SECONDARY OUTCOMES WILL INCLUDE OBJECTIVE MEASURES OF PREP UPTAKE AND PERSISTENCE (TENOFOVIR DIPHOSPHATE IN DRIED BLOOD SPOTS, PICTURES OF MEDICATION BOTTLES) AND EHR AND SELF-REPORTED DOXYPEP UPTAKE AND PERSISTENCE. LASTLY, IN AIM 3, WE WILL ASSESS THE COST AND COST-EFFECTIVENESS OF BOTH INTERVENTIONS. AT THE END OF THE STUDY, WE WILL HAVE RIGOROUSLY EVALUATED THE IMPLEMENTATION AND EFFECTIVENESS OF TWO INNOVATIVE STRATEGIES TO FACILITATE PREP AND DOXYPEP USE AMONG HOME HIV/STI TESTERS IN THE US.

ENDING UNDER‐ENROLLMENT IN UPPER SECONDARY THROUGH PAY‐FOR‐SUCCESS IN MEXICO

STREET PREP: EXPANDING A LOW-BARRIER PREP DELIVERY MODEL AMONG PEOPLE WHO USE DRUGS AND EXPERIENCING HOMELESSNESS IN SAN FRANCISCO - ABSTRACT HIV DISPROPORTIONATELY IMPACTS PEOPLE WHO USE DRUGS WHILE SCALE UP OF PREVENTION INTERVENTIONS LAG FOR THIS POPULATION. NEW HIV DIAGNOSES IN SAN FRANCISCO AMONG PEOPLE WHO INJECT DRUGS INCREASED BY 34% FROM 2019 TO 2021. RISES IN METHAMPHETAMINE AND FENTANYL BOTH BY INJECTION AND NON-INJECTION USE ARE ASSOCIATED WITH NEW HIV INFECTIONS. WHILE EFFORTS TO ADDRESS SUBSTANCE USE HAVE GROWN, LITTLE HAS BEEN DONE TO ADDRESS HIV AMONG PEOPLE WHO USE DRUGS. A 2022 SURVEY OF PEOPLE WHO INJECT DRUGS IN SAN FRANCISCO FOUND THAT HIV TESTING WENT DOWN 30% FROM THE PRIOR 2 YEARS AND ONLY 1.2% OF PARTICIPANTS HAD USED HIV PRE-EXPOSURE PROPHYLAXIS, OR PREP, IN THE PAST YEAR. PEOPLE WHO USE DRUGS FACE UNIQUE STRUCTURAL AND SUBSTANCE USE-RELATED CHALLENGES TO ACCESSING SERVICES, AMPLIFYING THEIR VULNERABILITY FOR HIV AND REDUCING THEIR UPTAKE OF PREP. IN THE FACE OF INCREASING HIV TRANSMISSION, EVIDENCE-BASED INTERVENTIONS DEMONSTRATING SUCCESSFUL PREP UPTAKE AND PERSISTENCE REMAIN LIMITED, REPRESENTING A WIDENING GAP IN PUBLIC HEALTH. OUR TEAM PROPOSES TO TEST THE STREET PREP INTERVENTION, WHICH BRINGS THE STATE OF THE SCIENCE IN HIV PREVENTION DIRECTLY TO PEOPLE WHO USE DRUGS IN SAN FRANCISCO. PEOPLE WHO USE DRUGS AND ARE AT THE HIGHEST RISK OF HIV WILL BE REACHED VIA RESPONDENT-DRIVEN SAMPLING (N=150), LEVERAGING AN EXISTING COHORT STUDY AND CONNECTIONS TO SOCIAL NETWORKS OF PEOPLE WHO USE DRUGS IN SAN FRANCISCO (AIM 1). PARTICIPANTS WILL THEN BE RANDOMIZED TO STANDARD OF CARE CLINIC LINKAGES OR THE STREET PREP INTERVENTION, WHICH INCLUDES ACCESS TO A MOBILE HEALTH CLINIC, TAILORED NAVIGATION TO ADDRESS HIV PREVENTION AND SUBSTANCE USE NEEDS, AND TRANSPORTATION TO LOW-BARRIER DROP-IN CLINICS FOR ONGOING HEALTHCARE (AIM 2). USING A TYPE 2 HYBRID EFFECTIVENESS-IMPLEMENTATION RANDOMIZED TRIAL, WE WILL MEASURE THE IMPACT OF THE STREET PREP INTERVENTION ON PREP UPTAKE AND PERSISTENCE AMONG PEOPLE WHO USE DRUGS IN SAN FRANCISCO. IN AIM 3, WE WILL ASSESS BARRIERS AND FACILITATORS TO IMPLEMENTATION AND EVALUATE IMPLEMENTATION OUTCOMES THROUGHOUT THE COURSE OF THE STUDY VIA QUALITATIVE INTERVIEWS WITH PEOPLE WHO USE DRUGS (N=12-15) AND STAFF (N=5-7). WE HAVE ASSEMBLED A HIGHLY EXPERIENCED, MULTIDISCIPLINARY TEAM OF INVESTIGATORS, COMPRISED OF LEADING PREP, SUBSTANCE USE, HIV, AND IMPLEMENTATION SCIENCE RESEARCHERS, ADDICTION MEDICINE AND HIV PROVIDERS, AND AN EXPERIENCED BIOSTATISTICIAN. IF WE FIND THE INTERVENTION TO BE EFFECTIVE, WE WILL DEVELOP AN IMPLEMENTATION TOOLKIT TO FACILITATE DISSEMINATION OF THE STREET PREP INTERVENTION TO OTHER JURISDICTIONS THAT CAN USE THIS MODEL TO IMPROVE PREP UPTAKE AND PERSISTENCE AMONG PEOPLE AT RISK OF HIV WHO USE DRUGS.

PREPMATE 211: DEVELOPING A MOBILE APP TO SUPPORT THE SAFE AND EFFECTIVE USE OF ON-DEMAND PREP AMONG MSM IN THE US

PS08-801 ADULT VIRAL HEPATITIS PREVENTION COORDINATOR

FAMILY PLANNING SERVICE DELIVERY IMPROVEMENT RESEARCH

VECTOR-BORNE DISEASE PREVENTION PROGRAM FOR YOSEMITE NATIONAL PARK

MYPREP PLUS: DEVELOPMENT AND PILOT TESTING OF NOVEL PRE-EXPOSURE PROPHYLAXIS SUPPORT TOOLS FOR TRANSGENDER WOMEN - PROJECT SUMMARY/ABSTRACT TRANSGENDER WOMEN (TGW) ARE THE POPULATION WITH THE HIGHEST PREVALENCE OF HIV INFECTION IN THE UNITED STATES (US), WITH INCREASING NUMBERS OF NEW DIAGNOSES FROM 2015-2019. THREE TYPES OF PRE-EXPOSURE PROPHYLAXIS (PREP) HAVE BEEN SHOWN TO BE HIGHLY EFFECTIVE IN TGW, BUT UPTAKE REMAINS LOW IN THIS POPULATION. TGW FACE A NUMBER OF BARRIERS IN TAKING UP AND STAYING ON PREP, INCLUDING PILL FATIGUE FROM TAKING PREP AND HORMONE PILLS, CONCERNS ABOUT REDUCED EFFICACY OF GENDER-AFFIRMING HORMONES WHEN TAKING PREP, AND CONCERNS THAT PREP WORKS ONLY FOR MEN WHO HAVE SEX WITH MEN (MSM), AMONG OTHER BARRIERS. MANY OF THESE BARRIERS COULD BE ALLEVIATED BY ADDITIONAL INFORMATION OR BY CHOICE OF A DIFFERENT REGIMEN. DECISION SUPPORT TOOLS CAN BE A USEFUL ADJUNCT TO PATIENT-LED DECISION-MAKING; A PREP DECISION AID FOR CIS-GENDER WOMEN IN SOUTH AFRICA DOUBLED PREP UPTAKE. WE ARE ADAPTING THIS TOOL (MYPREP) FOR USE IN US ENGLISH- AND SPANISH-SPEAKING TGW. HOWEVER, TGW LIKELY NEED ADDITIONAL HELP IN STARTING PREP; THEREFORE, WE ARE COMBINING MYPREP WITH OUR BIDIRECTIONAL SMS COMMUNICATION TOOL (PREPMATE), THE FIRST CDC-ENDORSED EVIDENCE-BASED PREP SUPPORT TOOL SHOWN TO DOUBLE PREP ADHERENCE IN YOUNG MSM. PREPMATE HAS ALREADY BEEN ADAPTED FOR TGW, BUT THE PREP NAVIGATION COMPONENT OF THE TOOL HAS NOT FULLY INCORPORATED ADDRESSING SOME OF THE SOCIAL DETERMINANTS OF HEALTH THAT ARE BARRIERS FOR TGW USING PREP. THEREFORE, IN AIM 1, WE WILL EXPLORE FEATURES OF DIFFERENT PREP MODALITIES THAT ARE OF GREATEST VALUE TO TGW AND EXAMINE SOCIAL DETERMINANTS THAT MAY POSE BARRIERS TO ENGAGING IN PREP, THROUGH THE USE OF FORMATIVE RESEARCH. WE WILL CONDUCT 6 FOCUS GROUPS IN TGW (3 IN ENGLISH, 3 IN SPANISH, 5-7 TGW EACH) AND CONDUCT INTERVIEWS WITH 8-10 PREP PROVIDERS FOR TGW, TO EXPLORE THESE THEMES. THEN, IN AIM 2, WE WILL ADAPT THE MYPREP PATIENT-FACING DECISION SUPPORT TOOL FOR ENGLISH- AND SPANISH-SPEAKING TGW USING ITERATIVE FOCUS GROUPS (2 IN ENGLISH, 2 IN SPANISH, 5-7 TGW EACH). THESE FOCUS GROUPS WILL MEET 3 TIMES OVER 3 MONTHS TO PROVIDE INPUT INTO THE MYPREP WEBSITE FOR TGW, AND TO ENSURE IT IS CULTURALLY AND LINGUISTICALLY APPROPRIATE FOR BOTH ENGLISH- AND SPANISH-SPEAKERS. FINALLY, IN AIM 3, WE WILL CONDUCT A PILOT RANDOMIZED CONTROLLED TRIAL WITH 40 TGW RANDOMIZED TO RECEIVE THE COMBINATION OF MYPREP WITH PREPMATE (MYPREP PLUS), AND 20 RANDOMIZED TO RECEIVE THE CONTROL CONDITION (PLEASEPREPME.ORG WEBSITE). THE RCT WILL EVALUATE THE FEASIBILITY OF MYPREP PLUS USE (MEASURED BY USE OF BOTH COMPONENT TOOLS) AND COMPARE THE ACCEPTABILITY AND PREP UPTAKE OF MYPREP PLUS VERSUS PLEASEPREPME.ORG. AT THE END OF THE MYPREP PLUS STUDIES, WE WILL HAVE ADAPTED MYPREP PLUS FOR ENGLISH- AND SPANISH-SPEAKING TGW, AND WILL DETERMINE WHETHER IT HOLDS ENOUGH PROMISE TO MOVE FORWARD INTO A FULLY POWERED, MULTI-SITE RCT IN TGW TO ASSESS ITS IMPACT ON PREP UPTAKE, ADHERENCE, AND PERSISTENCE.

BREAKING SYSTEMS BARRIERS FOR TRANS WOMEN OF COLOR LIVING WITH HIV

SHARP: SUMMER HIV/AIDS RESEARCH PROGRAM

REPEATED-DOSE BRIEF INTERVENTION TO REDUCE OVERDOSE AND RISK BEHAVIORS AMONG NALO

SWEEKAR - MULTI-LEVEL INTERSECTIONAL STIGMA REDUCTION TO INCREASE HIV TESTING AND CARE ENGAGEMENT AMONG TRANS WOMEN IN NEPAL - TRANS WOMEN IN LOW- AND MIDDLE- INCOME COUNTRIES MAKE UP THE LARGEST PROPORTION OF TRANS WOMEN AROUND THE GLOBE BUT ARE UNDERSERVED IN THE RESPONSE TO HIV. NEPAL IS A LOWER INCOME COUNTRY IN SOUTH ASIA WHERE TRANS WOMEN ARE A KEY POPULATION HIGHLY IMPACTED BY HIV. IN 2019/20, WE CONDUCTED AN EXPLORATORY STUDY WITH TRANS WOMEN FINDING THAT 11.3% WERE LIVING WITH HIV, AND ONLY 70% WERE ENGAGED IN HIV CARE AND VIRALLY SUPPRESSED. DISCRIMINATION RESULTING IN ANTICIPATED HIV STIGMA AND EXPERIENCED ANTI-TRANS STIGMA WAS A MAIN DRIVER OF LOW HIV TESTING AND HIV CARE ENGAGEMENT. HIV RISK WAS FURTHER EXACERBATED BY ANTI-TRANS STIGMA RESULTING IN BARRIERS TO EDUCATION, EMPLOYMENT, SOCIAL SUPPORT AND EMPOWERMENT. FOR EXAMPLE, BECAUSE MOST TRANS WOMEN FACED DISCRIMINATION IN JOB SEEKING, THE MAJORITY OF PARTICIPANTS IN OUR EXPLORATORY WORK DID SEX WORK FOR INCOME AND HAD HIGH RATES OF CONDOMLESS SEX AND MANY SEXUAL PARTNERS. HIV INTERVENTIONS FOR TRANS WOMEN ARE NEEDED THAT WILL HAVE SUSTAINED IMPACT BY ADDRESSING STIGMA AT MANY LEVELS THAT PRESENT BARRIERS TO HEALTH AND WELLNESS. HOWEVER, FEW HIV PREVENTION AND TREATMENT INTERVENTIONS TACKLE INTERSECTIONAL STIGMA, AND EVEN FEWER ARE DEVELOPED FOR LOW- AND MIDDLE-INCOME COUNTRY SETTINGS. BUILDING ON EVIDENCE FROM OUR EXPLORATORY STUDY, WE PROPOSE TO TEST A MULTI-LEVEL, HIV SEROSTATUS-NEUTRAL STIGMA REDUCTION INTERVENTION CALLED SWEEKAR, OR ACCEPTANCE IN NEPALI. THE PRIMARY INTERVENTION OUTCOMES ARE HIV TESTING AND HIV CARE ENGAGEMENT. TO INCREASE HIV TESTING BY ADDRESSING ANTICIPATED STIGMA, THE INDIVIDUAL LEVEL INTERVENTION COMPONENT IS A TAILORED HIV SELF-TESTING INTERVENTION. TO INCREASE ART ADHERENCE BY ADDRESSING ANTICIPATED AND EXPERIENCES STIGMA, THE SYSTEMS LEVEL INTERVENTION COMPONENT IS HIV TREATMENT HOME DELIVERY. TO ADDRESS STIGMA AT THE COMMUNITY LEVEL, WE WILL CONDUCT A CONTACT INTERVENTION11 INFORMED BY PHOTOVOICE12 TO REDUCE EXPERIENCED AND INTERNALIZED STIGMA. PHOTOVOICE WILL BE USED TO INFORM CONTENT AND DELIVERY OF A SOCIAL MEDIA CAMPAIGN TO REDUCE ANTI-TRANS IN NEPALI SOCIETY, WITH BENEFITS FOR INCREASING SOCIAL SUPPORT AND EMPOWERMENT AMONG TRANS WOMEN IN NEPAL, WHICH WILL HELP MITIGATE INTERNALIZED STIGMA. OUR APPROACH IS COMMUNITY-DRIVEN AND NON-RANDOMIZED TO MAXIMIZE BENEFIT FOR TRANS WOMEN IN IMMEDIATE NEED OF INTERVENTION, WHICH IS AN ESSENTIAL PRACTICE TO REDUCE HEALTH DISPARITIES. FEASIBILITY IS HIGH AS THE US AND NEPALI RESEARCHERS HAVE FORGED A STRONG COLLABORATION OVER THE COURSE OF MORE THAN A DECADE WORKING TOGETHER TO SERVE TRANS WOMEN IN RESEARCH AND SERVICES. FURTHERMORE, COVID-19 HAS CREATED NEW OPPORTUNITIES FOR INNOVATIONS HIV CARE AND PREVENTION THAT WILL BE LEVERAGED IN SWEEKAR. IF SWEEKAR IS SUCCESSFUL, WE WILL IMMEDIATELY USE THE OUTCOME DATA AND LESSONS LEARNED TO DEVELOP MULTI-SITE R01 PROPOSAL TO TEST THE INTERVENTION AT SCALE THROUGHOUT NEPAL AND IN PARTNERSHIP WITH OUR NEPALI RESEARCH AND IMPLEMENTATION TEAM.

2026 NETWORK OF INFLUENZA MODELING AND FORECASTING CENTERS - HELUNA HEALTH, IN PARTNERSHIP WITH THE CALIFORNIA DEPARTMENT OF PUBLIC HEALTH (CDPH) REQUESTS FUNDING UNDER CDC-RFA-IP-26-0102 TO ESTABLISH A NETWORK OF INFLUENZA MODELING AND FORECASTING CENTERS SITE BUILDING ON FOUR CONSECUTIVE SEASONS OF REAL-TIME FLUSIGHT AND FLU SCENARIO MODELING HUB PARTICIPATION. CDPH'S FORECASTING ENSEMBLE ACHIEVED BETTER-THAN-BASELINE ACCURACY IN THREE OF FOUR FLUSIGHT SEASONS AND WAS THE TOP-PERFORMING MODEL FOR STATE-ONLY TARGETS IN 2024-25, DEMONSTRATING SUSTAINED OPERATIONAL FORECASTING CAPACITY WITHIN A PUBLIC HEALTH AGENCY. THIS APPLICATION ADDRESSES TWO RELATED GAPS IN INFLUENZA FORECASTING: FIRST, THAT FORECAST PERFORMANCE VARIES ACROSS SEASONS AND JURISDICTIONS IN WAYS THAT ARE INCOMPLETELY UNDERSTOOD, LIMITING PRACTITIONERS' ABILITY TO KNOW IN REAL TIME HOW MUCH CONFIDENCE TO PLACE IN A GIVEN FORECAST; AND SECOND, THAT EVEN WELL-CALIBRATED FORECASTS HAVE LIMITED PUBLIC HEALTH VALUE IF PRACTITIONERS CANNOT INTERPRET AND ACT ON THEM. UNDER STRATEGY 5, CDPH WILL EXPAND ITS EXISTING CALIFORNIA-FOCUSED FORECASTING PIPELINE TO FULL NATIONAL AND SUB-NATIONAL COVERAGE, SUBMITTING WEEKLY PROBABILISTIC FORECASTS TO CDC’S FLUSIGHT CHALLENGE FOR WEEKLY HOSPITAL ADMISSION AND EMERGENCY DEPARTMENT VISIT TARGETS. BECAUSE THE UNDERLYING ENSEMBLE USES PUBLICLY AVAILABLE NATIONAL HEALTHCARE SAFETY NETWORK (NHSN) HOSPITALIZATION DATA, THIS EXPANSION SCALES EXISTING ARCHITECTURE RATHER THAN REQUIRING NEW INFRASTRUCTURE. CDPH WILL ALSO ADVANCE A DISTINCTIVE RESEARCH PROGRAM ON REAL-TIME FORECAST UNCERTAINTY QUANTIFICATION, BUILDING ON ITS PUBLISHED WORK CHARACTERIZING INFECTIOUS DISEASE "FORECASTABILITY" THROUGH TIME-SERIES COMPLEXITY, EXTENDED THROUGH A METHOD OF ANALOGUES FRAMEWORK THAT MEASURES HOW CLOSELY A CURRENT SEASON RESEMBLES HISTORICAL EXPERIENCE, AND COMPLEMENTED BY AN EXPLORATORY EVALUATION OF HUMAN JUDGMENT FORECASTING AS A METHODOLOGICAL COMPARISON. CDPH WILL FURTHER EVALUATE WHETHER NOVEL DATA SOURCES (E.G., ELECTRONIC LAB REPORTING, SYNDROMIC SURVEILLANCE, AND WASTEWATER DATA) IMPROVE FORECAST ACCURACY BEYOND HOSPITALIZATION DATA ALONE ACROSS SEASONS AND GEOGRAPHIES. UNDER STRATEGY 7, CDPH WILL FORMALIZE AND EXTEND COMMUNICATION ACTIVITIES BUILT ON ITS EXISTING CALIFORNIA COMMUNICABLE DISEASE ASSESSMENT TOOL (CALCAT) WEBSITE AND ITS MONTHLY COMMUNITY OF PRACTICE WITH LOCAL HEALTH JURISDICTIONS, INCLUDING DEVELOPMENT OF A REAL-TIME FORECAST RELIABILITY INDICATOR THAT TRANSLATES UNCERTAINTY SIGNALS INTO TERMS ACCESSIBLE TO NON-MODELERS. UNDER STRATEGY 8, CDPH WILL DEVELOP METHODS TO INCORPORATE REAL-TIME VACCINE EFFECTIVENESS AND COVERAGE ESTIMATES — INCLUDING SUBTYPE-SPECIFIC ESTIMATES FOR INFLUENZA A(H1N1), A(H3N2), AND B — AS FORECASTING INPUTS, POSITIONING THIS VALIDATED SEASONAL METHODOLOGY FOR RAPID ADAPTATION TO A PANDEMIC CONTEXT WHERE POPULATION SUSCEPTIBILITY CARRIES FAR GREATER UNCERTAINTY. IN PARTNERSHIP WITH PREDICTIVE SCIENCE INC. (PSI), CDPH WILL ALSO EVALUATE HIERARCHICAL AGGREGATION OF SUB-STATE FORECASTS TO THE STATE LEVEL. CDPH'S ORGANIZATIONAL CAPACITY IS ANCHORED BY A PRINCIPAL INVESTIGATOR WITH OVER FIVE YEARS LEADING THE AGENCY'S INFECTIOUS DISEASE MODELING WORK AND A DEDICATED TECHNICAL TEAM SPANNING FORECASTING, EPIDEMIOLOGY, AND COMMUNICATION EXPERTISE. THE SITE IS FURTHER SUPPORTED BY ESTABLISHED COLLABORATIONS WITH PSI FOR METHOD OF ANALOGUES AND SUB-STATE FORECASTING AND THE UNIVERSITY OF CALIFORNIA CONSORTIUM FOR METHODOLOGICAL CONSULTATION, ALONGSIDE CDPH'S INSTITUTIONAL RELATIONSHIPS WITH ALL 61 LOCAL HEALTH JURISDICTIONS ACROSS CALIFORNIA. THIS APPLICATION OFFERS CDC A NETWORK SITE WITH A DEMONSTRATED FORECASTING TRACK RECORD, A RESEARCH PROGRAM ADDRESSING REAL-TIME FORECAST RELIABILITY, AND A TEAM SITUATED WITHIN AN OPERATIONAL PUBLIC HEALTH AGENCY PROVIDING UNIQUE PROXIMITY TO PUBLIC HEALTH DECISION-MAKING AND COMMUNICATION OUTCOMES.

THE NATURAL RESOURCE STEWARDSHIP PROGRAM IS THE PRINCIPLE MEANS THROUGH WHICH THE NATIONAL PARK SERVICE (NPS) EVALUATES AND IMPROVES THE HEALTH OF WATERSHEDS, LANDSCAPES, AND MARINE AND COASTAL RESOURCES, SUSTAINS BIOLOGICAL COMMUNITIES ON THE LANDS AND WATERS IN PARKS, AND ACTIVELY ENDEAVORS TO IMPROVE THE RESILIENCY OF THESE NATURAL RESOURCES AND ADAPT THEM TO THE EFFECTS OF CLIMATE CHANGE. TO CARRY OUT AND FURTHER THIS STEWARDSHIP RESPONSIBILITY, NPS IMPLEMENTS PROGRAMS THAT ENCOMPASS A BROAD RANGE OF RESEARCH, OPERATIONAL, AND EDUCATIONAL ACTIVITIES BY UTILIZING PARK PERSONNEL AND CONTRACTOR SUPPORT OR COOPERATIVE AGREEMENTS. THE RECIPIENT WILL PROVIDE FIVE-YEAR PROGRAM TO ENHANCE THE DELIVERY OF VECTOR-BORNE DISEASE SERVICES AT YOSEMITE NATIONAL PARK. THE PRIMARY ELEMENTS OF THIS PROGRAM WILL INCLUDE THE FOLLOWING ACTIVITIES: (1) RISK REDUCTION, DISEASE PREVENTION AND CONTROL, (2) VISITOR AND EMPLOYEE EDUCATION AND TRAINING, (3) SURVEILLANCE, AND (4) RESEARCH. BENEFICIARIES INCLUDE THE GENERAL PUBLIC.

SAN FRANCISCO-RIO DE JANEIRO COLLABORATIVE RESEARCH ON HIV PREVALENCE, RISK, AND BIOMEDICAL PREVENTION INTERVENTIONS AMONG YOUNG MEN WHO HAVE SEX WITH MEN

REAP RENEWABLE ENERGY SYSTEM (RES) GRANT UNRESTRICTED AMOUNT

HEPATITIS C TREATMENT AS PREVENTION PILOT STUDY WITH LEDIPASVIR-SOFOSBUVIR AMONG PEOPLE ACTIVELY INJECTING DRUGS (TASP-C PILOT)

ENHANICING CALIFORNIA NBS CASE SURVEILLANCE AND SHORT TERM FOLLOW-UP DATA SYSTEM

PHFE/CEIP NARMS RETAIL FOOD SURVEILLANCE PROGRAM

PPHF 2012-EMERGING INFECTIONS PROGRAM (EIP)

THE BET INTERVENTION TO REDUCE HIV PREVENTION AND CARE DISPARITIES AMONG YOUNG TRANSWOMEN IN RIO DE JANEIRO

VIRAL HEPATITIS SURVEILLANCE IN THE CITY AND COUNTY OF SAN FRANCISCO

DEMONSTRATION PROJECTS FOR INTEGRATING NEWBORN SCREENING LONG TERM FOLLOW-UP INTO PRIMARY CARE PRACT

HAIR AS A BIOMARKER OF TENOFOVIR PROPHYLACTIC EXPOSURE

NALOXONE PRESCRIPTION FOR OPIOID SAFETY EVALUATION (NOSE)

LOW EARLY CHILDHOOD DIET QUALITY IS COMMON AMONG CHILDREN IN THE US, AND DIET PATTERNS PERSIST INTO ADULTHOOD, CONTRIBUTING TO OBESITY AND CHRONIC DISEASE RISK ACROSS THE LIFE COURSE. TO SUPPORT HEALTHY DIETS DURING PREGNANCY, THE POSTPARTUM PERIOD, AND EARLY CHILDHOOD, THE US DEPARTMENT OF AGRICULTURE (USDA) MANAGES THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS, AND CHILDREN (WIC), SERVING 6.2 MILLION PARTICIPANTS LIVING IN LOW-INCOME HOUSEHOLDS MONTHLY IN 2021. WIC PROVIDES FOUR CORE SERVICES INCLUDING SUPPLEMENTAL FOOD PACKAGES REDEEMABLE FOR SPECIFIC HEALTHY FOODS AT APPROVED VENDORS, NUTRITION EDUCATION, BREASTFEEDING SUPPORT, AND HEALTH AND SOCIAL SERVICE REFERRALS. WIC PARTICIPATION HAS BEEN LINKED TO POSITIVE NUTRITIONAL OUTCOMES. DIET QUALITY OF WIC-PARTICIPATING CHILDREN IMPROVED AFTER WIC FOOD PACKAGES WERE ALIGNED WITH THE DIETARY GUIDELINES FOR AMERICANS IN 2009, AND ADDITIONAL REVISION OF WIC FOOD PACKAGES WILL OCCUR BY APRIL 2026.THE HEALTHY FOODS IN WIC FOOD PACKAGES COULD IMPROVE DIETS THROUGHOUT EARLY CHILDHOOD GIVEN THE WIDE REACH OF THE PROGRAM INTO LOW-INCOME HOUSEHOLDS, BUT INCOMPLETE FOOD BENEFIT UTILIZATION MAY LIMIT WIC'S IMPACT ON IMPROVING NUTRITIONAL OUTCOMES. BARRIERS TO ACCESSING HEALTHY FOODS, SUCH AS LIMITED GEOGRAPHIC ACCESS TO GROCERY STORES, HAVE BEEN PROPOSED AS A SOURCE OF UNDERLYING DISPARITIES IN DIET QUALITY AND DIET-RELATED CHRONIC DISEASES. THE ASSOCIATION BETWEEN THE 2009 WIC FOOD PACKAGE CHANGE AND REDUCED CHILD OBESITY WAS MODIFIED BY THE NEIGHBORHOOD FOOD ENVIRONMENT, SUGGESTING THAT BARRIERS TO WIC BENEFIT REDEMPTION - LIKE LIMITED GEOGRAPHIC ACCESS TO WIC VENDORS - COULD LIMIT WIC PARTICIPATION'S IMPACT ON OUTCOMES INCLUDING HOUSEHOLD FOOD SECURITY AND CHILD DIET QUALITY VIA ASSOCIATIONS OF VENDOR ACCESS WITH BENEFIT UTILIZATION. DATA ON RELATIONSHIPS BETWEEN WIC VENDOR ACCESS, HOUSEHOLD FOOD SECURITY, AND CHILD DIET AMONG PARTICIPANTS HAVE NOT BEEN EVALUATED. OUR OVERALL GOAL IS TO MAXIMIZE WIC'S IMPACT ON NUTRITIONAL OUTCOMES AMONG CHILDREN IN THE US, BY INFORMING EVIDENCE-BASED INTERVENTIONS TO OPTIMIZE HOUSEHOLD FOOD SECURITY AND HEALTHY DIETARY BEHAVIORS AMONG WIC PARTICIPANTS.OBJECTIVE 1 WILL USE EXISTING DATA OF WIC-PARTICIPATING CHILDREN TO EXPLORE ASSOCIATIONS BETWEEN ACCESS TO WIC VENDORS AROUND THE RESIDENCE (INCLUDING PROXIMITY, DENSITY AND VENDOR TYPE) WITH BENEFIT UTILIZATION, HOW VENDOR ACCESS AND BENEFIT UTILIZATION CONTRIBUTE TO HOUSEHOLD FOOD SECURITY AND CHILD DIETARY BEHAVIORS, AND HOW VENDOR ACCESS CONTRIBUTES TO GROUP-LEVEL DIFFERENCES IN WIC BENEFIT UTILIZATION, HOUSEHOLD FOOD SECURITY, AND CHILD DIETARY BEHAVIORS. CROSS-SECTIONAL DATA ON HOUSEHOLD FOOD SECURITY AND CHILD DIET THAT WERE COLLECTED AS PART OF THE 2023 CALIFORNIA STATEWIDE WIC SURVEY WILL BE MERGED WITH WIC ADMINISTRATIVE DATA ON WIC BENEFIT REDEMPTION AND THE LOCATION OF THE RESIDENCE TO ASSESS THESE RELATIONSHIPS IN A REPRESENTATIVE SAMPLE OF WIC-PARTICIPATING FAMILIES IN CALIFORNIA,FROM 2023. GEOGRAPHIC INFORMATION SYSTEMS DATA ON THE LOCATION OF WIC-APPROVED VENDORS WILL BE USED TO DETERMINE PARTICIPANT ACCESS TO WIC VENDORS AROUND THE HOME. DESCRIPTIVE STATISTICS AND REGRESSION ANALYSIS WILL BE USED TO ASSESS THESE RELATIONSHIPS.OBJECTIVE 2 WILL USE PROSPECTIVELY COLLECTED LONGITUDINAL DATA ON WIC-PARTICIPATING CHILDREN IN SOUTHERN CALIFORNIA TO EXPLORE ASSOCIATIONS OF THE 2026 WIC FOOD PACKAGE REVISIONS WITH WIC BENEFIT REDEMPTION, HOUSEHOLD FOOD SECURITY AND CHILD DIET, AND WHETHER ACCESS TO WIC VENDORS AROUND THE RESIDENCE (INCLUDING PROXIMITY, DENSITY AND VENDOR TYPE) MODIFIES THESE ASSOCIATIONS. THE BASELINE AND FOLLOW-UP SURVEYS WILL BE ADMINISTERED ONLINE IN JANUARY-FEBRUARY 2026 AND JANUARY-FEBRUARY 2027, RESPECTIVELY. WIC ADMINISTRATIVE DATA ON BENEFIT REDEMPTION AND THE LOCATION OF THE RESIDENCE OF RESPONDENTS WILL BE MERGED WITH SURVEY DATA. GEOGRAPHIC INFORMATION SYSTEMS DATA ON THE LOCATION OF WIC-APPROVED VENDORS WILL BE USED TO DETERMINE PARTICIPANT ACCESS TO WIC VENDORS AROUND THE HOME. DESCRIPTIVE STATISTICS AND REGRESSION ANALYSIS WILL BE USED TO ASSESS THESE RELATIONSHIPS.OBJECTIVE 3 WILL ENCOMPASS SEEKING INTERPRETATION FROM WIC PARTICIPANTS AND STAFF- AS KEY STAKEHOLDERS - OF THE PROJECT FINDINGS, ENABLING THE DEVELOPMENT OF EVIDENCE-BASED RECOMMENDATIONS FOR WIC PROGRAM INTERVENTIONS THAT ARE RESPONSIVE TO PARTICIPANT AND STAFF NEEDS TO OPTIMIZE HOUSEHOLD FOOD SECURITY AND DIET QUALITY AMONG PARTICIPANTS. THIS WILL BE ACCOMPLISHED VIA QUALITATIVE ANALYSIS OF TRANSCRIPTS OF THREE FOCUS GROUPS COMPLETED WITH CAREGIVERS OF A WIC-PARTICIPATING CHILDREN AND TWO FOCUS GROUPS WITH WIC LOCAL AGENCY STAFF.THE OVERALL GOAL OF THIS PROJECT IS TOCONDUCT RESEARCH THAT WILL INFORM THE DESIGN OF EVIDENCE-BASED INTERVENTIONS TO IMPROVE HOUSEHOLD FOOD SECURITY AND DIETARY BEHAVIORS AMONG WIC PARTICIPANTS. THIS PROJECT WILL DEVELOP EVIDENCE ABOUT HOW ACCESS TO WIC-APPROVED VENDORS VARIES AMONG PARTICIPATING HOUSEHOLDS ANDHOW IT CONTRIBUTES TO BENEFIT REDEMPTION, HOUSEHOLD FOOD SECURITY, AND CHILD DIET QUALITY. THIS EVIDENCE WILL BE DISSEMINATED IN PEER-REVIEWED PUBLICATIONS, CONFERENCE PROCEEDINGS, AND A NON-TECHNICAL REPORT OF PROJECT FINDINGS TO SHARE WITH PRACTITIONERS AND POLICY MAKERS. THIS PROJECT WILL PROVIDE HIGH QUALITY EVIDENCE TO FACILITATE THE IDENTIFICATION OF AREAS OF OPPORTUNITY FOR IMPROVING ACCESS TO WIC FOOD BENEFITS AMONG PARTICIPANTS, POTENTIALLY BY EXPANDING ACCESS TO WIC VENDORS. IF THIS GOAL IS MET, THE WIC PROGRAM WILL HAVE STRONGER TOOLS AT ITS DISPOSAL TO ADDRESS INCOMPLETE BENEFIT REDEMPTION AMONG PARTICIPANTS AND TO SUPPORT IMPROVEMENTS IN CHILD DIET AND HOUSEHOLD FOOD SECURITY AMONG WIC-PARTICIPATING FAMILIES. THIS COULD HAVE A SUBSTANTIAL IMPACT ON THE BURDEN OF LOW EARLY CHILDHOOD DIET QUALITY IN THE US, AS A SUBSTANTIAL PROPORTION OF CHILDREN PARTICIPATE IN THE WIC PROGRAM BEFORE AGE 5 YEARS.

ARIPIPRAZOLE TREATMENT FOR METHAMPHETAMINE DEPENDENCE AMONG HIGH-RISK MSM

TO STUDY CELLULAR IMMUNE RESPONSE IN NON-B CLADE HIV INFECTION

REDUCING INTERSECTIONAL STIGMA THROUGH INCREASED SOCIAL PARTICIPATION AMONG TRANSWOMEN IN NEPAL

TRANSWOMEN, SEXUAL PARTNERS AND HIV RISK

EAST HOLLYWOOD GANG INTERVENTION TEAM

TO AWARD A GRANT TO THE FOUNDATION EUROPEAN SOFTWARE INSTITUTE CENTER BULGARIA THE SUM OF $199 174.00 TO PROVIDE SUPPORT FOR A PROGRAM ENTITLED ?CHAL

EXPANDING A PUBLIC HEALTH AGENCY?S ABILITY TO MEASURE AND ADDRESS THE DISPARATE IMPACTS OF COVID-19 ON A LARGE AND DIVERSE METROPOLITAN AREA

DEFINING A CRISIS: ENGAGEMENT WITH CRISIS CALL CENTERS AND MOBILE CRISIS TEAMS - 7. PROJECT SUMMARY/ABSTRACT IN JULY 2022, 988 WILL BECOME THE NATIONWIDE 3-DIGIT SUICIDE PREVENTION PHONELINE TO ACCESS THE NATIONAL SUICIDE PREVENTION LIFELINE (NSPL). THE NATIONALLY RECOGNIZED ZERO SUICIDE (ZS) MODEL HAS ENDORSED CRISIS CALL CENTERS (CC) AND MOBILE CRISIS (MC) AS KEY STRATEGIES TO PREVENT SUICIDE. CRISIS SERVICES ARE ALSO ENVISIONED AS A MEANS OF INCREASING ACCESS TO CARE FOR POPULATIONS THAT HAVE HISTORICALLY FACED BARRIERS TO RECEIVING CARE, INCLUDING BLACK/AFRICAN AMERICANS, PEOPLE EXPERIENCING HOMELESSNESS, AND PEOPLE LIVING IN RURAL AREAS. WHEN 988 GOES LIVE, THE NSPL IS EXPECTED TO EXPAND BEYOND ITS CURRENT ROLE AS A SUICIDE HOTLINE AND TRANSFORM INTO AN ENTRY POINT FOR A RANGE OF MENTAL HEALTH CRISES AS WELL AS A MEANS OF DISPATCHING MC TEAMS. HOWEVER, LITTLE IS KNOWN ABOUT WHAT TYPES OF CALLS MAY COME TO 988 OR WHAT FACTORS WILL NEED TO BE CONSIDERED TO DEVELOP BEST PRACTICES IN CRISIS TRIAGE DECISION-MAKING. THERE IS AN URGENT NEED TO EXPAND THE EVIDENCE BASE TO INFORM BEST PRACTICES IN CC AND MC SETTINGS, WHICH ARE ROUTINELY CARING FOR PEOPLE AT HIGH RISK OF SUICIDE. TO FILL THIS GAP, THIS STUDY WILL LEVERAGE A LARGE, COMPREHENSIVE CLINICAL DATASET FROM GEORGIA’S STATEWIDE CRISIS SYSTEM—WHICH IS WIDELY REGARDED AS A NATIONAL LEADER IN CRISIS SERVICES—TO CHARACTERIZE CC AND MC PRACTICES AND PROVIDE GUIDANCE TO CRISIS PROGRAMS AS THE US BEGINS TO ROLL OUT 988. IN AIM 1, WE WILL CONDUCT A LATENT CLASS ANALYSIS TO QUANTITATIVELY DESCRIBE COMMON CLINICAL PHENOTYPES OF ADULTS ACCESSING CRISIS SERVICES THROUGH A STATEWIDE CC BETWEEN 2016 AND 2018 (N=235,762), WHICH CAN INFORM WHAT TYPES OF CRISES NEED TO BE ADDRESSED BY 988 CALL CENTERS. IN AIM 2, WE WILL EXAMINE SOCIODEMOGRAPHIC, CLINICAL AND REGIONAL FACTORS THAT MAY BE ASSOCIATED WITH REFERRAL DECISIONS BY GEORGIA’S CC (N=235,762) AND MC (N=34,371), WITH A PARTICULAR FOCUS ON DISPARITIES AMONG GROUPS THAT HISTORICALLY HAVE POORER ACCESS TO CARE. FINALLY, IN AIM 3, WE WILL LEVERAGE GEORGIA’S USE OF A CLINICAL DECISION-SUPPORT TOOL CALLED THE LEVEL OF CARE UTILIZATION SYSTEM (LOCUS) TO EXAMINE CASES IN WHICH THE ACTUAL CC REFERRAL DIFFERS FROM THE MOST APPROPRIATE LEVEL OF CARE RECOMMENDED BY THE LOCUS, WHICH ALLOWS FOR DETECTION OF CASES WHERE REFERRAL OPTIONS MAY BE LIMITED. THESE STUDIES WILL FILL CRITICAL GAPS IN THE EVIDENCE BASE TO ADVANCE OUR UNDERSTANDING OF BEST PRACTICES FOR SUICIDE PREVENTION IN CRISIS SERVICES AND WILL HELP PREPARE THE US FOR MAJOR CRISIS SYSTEM TRANSFORMATIONS SUCH AS 988. THE FIGURES PRESENTED BELOW ARE THE ACTUAL NUMBER OF MOBILE CRISIS VISITS BETWEEN 1/1/2016 AND 12/31/2018 IN THE GCAL DATABASE.

AN ASSESSMENT OF OPIOID OVERDOSES IN SAN FRANCISCO FROM 2010 THROUGH 2012

JR. AZTEC PROGRAM THAT AZTECS RISING

SUPPRESSOR CD8+ T CELLS IN HIV INFECTION

JUMPSTART IS A 3-MONTH SOCIAL IMPACT INCUBATOR DESIGNED SPECIFICALLY FOR YOUNG WOMEN AGED 18-35 TO GUIDE PARTICIPANTS THROUGH THE PROCESS OF CREATING AND LAUNCHING SOCIAL PROJECTS, FOSTERING ECONOMIC PARTICIPATION AND PROFESSIONAL DEVELOPMENT.

EMPOWER 40 VULNERABLE YOUTH FROM BATKEN OBLAST TO ADDRESS COMMUNITY CHALLENGES RELATED TO VIOLENT EXTREMISM THROUGH LIFE SKILLS TRAINING AND FOSTERING THEIR ACTIVE COMMUNITY ENGAGEMENT.