CALL FOR STUDY COLLABORATORS

Global sites required for Stigma & Discrimination reduction studies in healthcare settings

ViiV Healthcare Implementation Science team are seeking external collaborators for sponsored research studies. The objective of the overall programme is to reduce stigma and discrimination that is experienced within healthcare settings.

We are identifying a broad range of evidence-based interventions that we want to present to our chosen sites at the start of a two-day workshop. We will then agree a combination of interventions that are most likely to reduce stigma and discrimination in their unique setting and finalise a study blueprint to examine their implementation and impact. This will serve to support the global scaling of effective practices to reduce stigma and discrimination in healthcare settings, by identifying which implementation strategies and interventions work in different contexts, and why.

Background

HIV related stigma and discrimination continues to be a global problem within healthcare settings. It remains a significant barrier to hopes of achieving UNAIDS’ 90-90-90 target and realising optimal outcomes for those living with HIV. For individuals the impact of stigma and discrimination within a healthcare setting can be devastating: preventing or inhibiting access to essential care; leaving people afraid to engage or have honest open dialogue their healthcare workers; and impacting an individual’s overall quality of life and outcomes.

ViiV Healthcare want to make a significant difference. There is a need to identify strategies and interventions that can help address this problem. No single intervention can universally have the impact that we want, nor can proposed solutions be applied with equal effect in all areas, because of inherent differences in geographical contexts, settings and populations. We are therefore looking for a number of sites that present different challenges, to work with us to study potential solutions.

What types of collaborators/sites do we want to work with?

We are looking for a diversity of collaborators across several differentiating areas. Numerous studies will be funded and sites will be chosen to ensure we can examine a breadth of situations and challenges.

  • What geographical location? We are seeking interest from all areas of the globe, including low income, middle income and high-income countries.
  • Which patient population? We are looking to research stigma and discrimination strategies across a range of different patient populations living with HIV as we recognise the challenges and solutions may vary significantly.
  • Which type of healthcare setting? We are seeking a range of settings for our studies. This includes sites providing general healthcare and those providing specialist care; small sites and large sites; urban and rural settings.

 

Applications will have a nominated Principal Investigator who is required to assume responsibilities including:

/ Institutional and regulatory submissions and approvals

/ Registration on a public clinical trials registry, if applicable

/ Serious adverse event reporting.

/ Quarterly progress reports.

/ Analysis and interpretation of the results

Project Creation Workshops

The focus of the research will be reducing stigma and discrimination within the healthcare setting. We are not looking to fund broader public health projects aimed at addressing community or population perceptions.

Project creation workshops are key to defining what activities will be conducted in each setting. Each site successfully selected to be part of the project will send key representatives to a 2-day workshop. The workshop will be delivered in English and will help sites to understand evidence-based interventions that have been shown to address stigma and discrimination in healthcare settings; The workshop will then be used to discuss which of the presented intervention(s) and implementation strategies are most likely to be effective in their setting. The workshop will culminate in the forming of an appropriate study blueprint bespoke for each site that will then be implemented at each site post-workshop.

Appropriate travel and expense costs associated with attendance at the workshop will be provided.

Example local implementation strategies currently being considered:

  • Improving patient flow through signage and discussion at reception
  • Engagement with peer during time spent in clinic
  • Knowledge management and decision support
  • Sharing data from surveys of HCWs and PLWH across hospital to sensitize staff to S&D
  • Presentations about factual information (e.g., HIV transmission) and “case studies” at staff meetings
  • Targeted training to service areas identified through survey data as needing further education
  • Development and dissemination of hospital S&D policies
  • Changing symbols on OPD cards, patient files to not reflect HIV status
  • Routine surveys of HCWs and PLWH
  • Patient-centered care
  • Comment boxes—routine opening, sharing of information, analysis, translation into QI activities
  • Integration of patient feedback into peer counseling sessions
  • Development of consumer advisory committees to inform S&D QI activities
  • Discussions with staff from leadership when complaints are identified through comments
  • Targeted training to service areas identified as unfriendly or stigmatizing
  • Routine capture of patient experience information during clinic visits
  • Regular S&D committee meetings—or integration into other committee activities
  • Provincial S&D community input meetings
  • Engagement of provincial and hospital leadership in S&D QI activities
  • Development of facility codes of conduct

Who from the sites should attend the project creation workshops?

We are looking for between 2 and 4 representatives from each site team who can help identify which interventions and implementation strategies are likely to be effective in their setting and agree the study blueprint. The roles may vary between sites, but we would expect a thorough understanding of the clinic operation, patient journey and requirements to implement a research project.

The proposed lead investigator must attend. Community workers and/or patient representation is also encouraged.

Funding and application expectations

  • We expect most studies to be approximately 1 year in length but this is flexible for projects with justified differentiated duration.
  • Applicants who have previously been successful in receiving ViiV Healthcare funding are eligible to apply.
  • Project applications can be from individual site teams, or collaborations, for example with academic partners. Applicants are encouraged to ensure a researcher with some experience in Implementation Science is part of the study team. Community workers and/or patient representation as an integral part of the project is also encouraged.
  • We expect to fund up to 12 implementation science studies. Specific budget expectations, and the process for agreeing this will be discussed in detail with shortlisted parties as part of clarifying the workshop selection process after 13th September 2019. We would expect funding to not exceed $100,000 for each study. Final budgets will be based upon the study agreed during the workshop and costs will be subject to fair market value assessment based upon the geographical location.

How do I express interest in being a study site?

How do I apply to be part of the study? 

To apply to become a study site(s) and be invited to a workshop, we would like the proposed lead investigator to email duncan.x.short@viivhealthcare.com with the information below to help us understand their context, potential stakeholders and motivation.  Please use the email header: ‘Application’:Stigma and Discrimination Reduction Studies In Healthcare Settings. The submitted information must be in English. Please do not send additional attachments. As part of the evaluation process we will reach out to those sites being considered for the workshop for a further information exchange.

Please note - we do not require any additional application form, nor do we expect a study design to be submitted. We are creating a protocol that will form the basis of the study for all sites. This will evolve for each site based upon their contextual factors and the interventions agreed at the workshop.

Information to be forwarded:

  • Lead investigator (name/job/affiliation to the proposed site/email address/contact telephone number)
  • Proposed site(s), address(es):
  • Description of your site(s) (max 250 words)
  • What specific roles from your clinic would you be happy to attend to the workshop (between 2 and 4 representatives are expected)? (max 250 words)
  • What support do you have from the site(s) leadership team to attend the workshop and to conduct a study in this area?

 

1. Why do you think the site(s) would be suitable for a stigma and discrimination reduction study? (max 300 words

2. What work, if any, has been undertaken to address stigma and discrimination at the site(s)? (max 300 words)

3. What specific population or groups would you want to focus a research study upon? (max 300 words)

4. Please feel free to provide any other supporting information that you think will help us to understand your interest. (max 500 words)

 

Timelines:

  • Initial expressions of interest and information requested to be sent to Duncan Short (duncan.x.short@viivhealthcare.com) no later than 13th September 2019. (11.59pm PST)
  • Final site selection will be confirmed before the end of October 2019. Sites may be asked for further information to support final selection. Each site shortlisted after 13th September 2019 will be invited to attend a virtual meeting with the ViiV Healthcare team to discuss in more detail their application, the process and the project before a final site selection is made. Confirmation of the workshop dates and location will be finalized around this time.
  • Workshops will be run end of Q1 2020 (location and date tbc)
  • Studies are expected to start around the end of Q2 2020.

How do I find out more? 

For more information, please contact Duncan Short, Director of Global Implementation Science.
Email duncan.x.short@viivhealthcare.com

Note: This website may be updated with answers to questions, or any clarifications that are made as part of the consultation process to help those considering applying.