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Principal Investigator: Alida M Bouris
Organization: UNIVERSITY OF CHICAGO
Fiscal Year: 2024
Award: $691,176
Funding agency: National Institute of Mental Health
We will conduct a Hybrid Type II effectiveness-implementation randomized controlled trial of a Case
Management Dyad (CM2) intervention, an evidence-based triadic social work intervention that uses a case
manager dyad to engage younger Black sexual minority men (YBSMM) aged 18-35 in economic stability
services. CM2 innovates on existing care continuum engagement models by (1) prioritizing resource counseling
to improve HIV care and prevention continuum outcomes, and (2) utilizing a triadic network approach where a
client meets with a dyadic case management team in tandem–forming a triad with the client–which provides
additional supports for the client and the case managers. CM2 is timely given that intensive interventions are
critical for engaging community members who have not benefited from existing Getting to Zero efforts. CM2 will
also test robust implementation strategies to support CM2 implementation and to enhance the professional
development and prevent burnout in the HIV front-line workforce, some of whom are directly impacted by HIV.
The CM2 intervention and associated implementation strategies emerge from prior work conducted by the
Investigative Team. We will build upon these experiences, infrastructures, and relationships to evaluate the
effectiveness and implementation of CM2 among N=180 YBSMM. Data collection, at baseline, and every 6
months over 18 months, will include surveys and electronic medical record data. To study implementation, we
will use the Consolidated Framework for Implementation Research as the determinant framework and RE-AIM
as the evaluation framework. The specific aims are to: (Aim 1a) Evaluate the primary (financial well-being, food
security) and secondary (integrated PrEP persistence/viral load suppression) effectiveness of CM2 vs routine
Ryan White Non-Medical Case Management and PrEP Resource Counseling among YBSMM; (Aim 1b).
Evaluate the effectiveness (time to successful resource referral completion, CM job satisfaction, CM burnout and
CM-client relationship) of the CM2 intervention vs. routine Ryan White Case Management and/or PrEP Resource
Counseling among case manager study participants; (Aim 2a) Determine the extent to which financial well-being
and food security mediate the relationship between CM2 and downstream 18-month integrated care continuum
outcomes; (Aim 2b) Explore potential differential effects of CM2 on primary (resource) and secondary (care
continuum) outcomes, based on mental health, substance use, housing, employment and HIV serostatus; and
(Aim 3) Evaluate implementation strategies and outcomes at both YBSMM and case manager levels using RE-
AIM to study reach, adoption, implementation, and maintenance. Implementation strategies include individual
and dyadic supervision, team consultation, and a train-the-trainer model, and implementation outcomes are
acceptability, feasibility, appropriateness, feasibility, fidelity and cost. If successful, CM2 will intensify existing
case management resource support systems, which will not only impact the lives and care continua of YBSMM,
but also fulfill an ending the epidemic priority of revitalizing and sustaining the HIV frontline workforce.
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