Implementing and evaluating evidence-informed behavioral health models
Historically, Black men who have sex with men (Black MSM) have been harder hit by HIV and had poorer health outcomes than other groups. In 2018 alone, they represented more than one of every four new HIV diagnoses (26%) among all gay and bisexual men. While progress has been made toward improving health outcomes for Black MSM with HIV, there is still work to be done.
The Special Projects of National Significance program of the Health Resources and Services Administration chose NORC to provide technical assistance and evaluation support for a three-year initiative studying the implementation of interventions designed to help Black MSM with HIV.
Launched in 2018, “Implementation of Evidence-Informed Behavioral Health Models to Improve HIV Health Outcomes for Black Men who have Sex with Men” provides eight sites with funding to implement evidence-informed behavioral health interventions and/or models of care (MOCs) and engage, link, and retain Black MSM living with HIV in medical care and supportive services. These sites chose from four interventions/MOCs that contain strategies to integrate behavioral health services—including substance use disorder treatment—and other components such as social marketing campaigns, case management programs, recreation-based peer support, and motivational interviewing.
NORC serves at the Evaluation and Technical Assistance Provider (ETAP) for this effort. As such, we have four overarching project goals:
Goal 1: Provide technical assistance and capacity building to the eight recipients
Goal 2: Implement a comprehensive multi-site evaluation
Goal 3: Develop and disseminate successful models, findings, best practices, and lessons to the Ryan White HIV/AIDS Program (RWHAP) community, a network of providers and community-based organizations that receive funding through the federal RWHAP mechanism to support people with HIV
Goal 4: Promote successful replication of effective evidence-informed interventions and/or models of care, trainings, publications, and other dissemination products
Toward these ends, we’ve undertaken a culturally responsive, sequential, transformative, mixed-method study of the eight sites that evaluates the impact of the Initiative via assessment of the following:
- Processes associated with implementing evidence-informed interventions, including barriers and facilitators to implementation
- Impact of the evidence-informed interventions on clinical or behavioral health outcomes
- Costs of adapting and implementing interventions by measuring labor and programmatic costs as well as expenditures incurred by each site
This multi-site evaluation (MSE) draws upon participant surveys, medical records, site visits, key informant interviews, and document review as data sources. In addition to conducting the MSE, NORC provides assistance and support to each site's local evaluators.
Findings will inform the development of implementation toolkits and other dissemination products that can be replicated and used—across the RWHAP and in other health care settings—to help Black men who have sex with men live healthier lives.