# PROMISE - Program Refinements to Optimize Model Impact and Scalability based on Evidence

> **NIH NIH R01** · GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY · 2021 · $579,833

## Abstract

Abstract
 In New York, the achievement of 90-90-90 goals is jeopardized not by limited access to affordable care and treatment,
but by persistent disparities in HIV viral suppression (VS). Complex behavioral and structural barriers to achieving and
maintaining VS require coordinated, combination approaches to meet medical and social service needs. In 2009, at 28
Ryan White Part A (RWPA)-funded agencies, the New York City (NYC) Department of Health and Mental Hygiene
(DOHMH) launched a multi-component HIV Care Coordination Program (CCP) directed toward the most vulnerable,
high-need persons living with HIV (PLWH) in NYC. A systematic CCP effectiveness study began in 2013 (R01
MH101028; PIs: Irvine, Nash). Findings to date suggest that the CCP is superior to usual care for high-need subgroups of
PLWH, but there remains substantial room for improvement in short- and long-term VS. In an immediate evidence-to-
practice feedback loop, the DOHMH is implementing a refined CCP model in 2018. Greater focusing, tailoring and
cues for delivery of key components are expected to increase CCP engagement, reach, fidelity, scalability, effectiveness
and impact. The aims of the proposed study are to: 1) Estimate the effectiveness of the revised (vs. original) CCP on
timely VS (≤4 months), using experimental methods (Aim 1); 2) Estimate the effectiveness of the revised CCP (vs. `usual
care') on longer-term VS, including VS at 12 months and durable viral suppression (DVS) at 24-36 months, using
rigorous observational comparison group methods (Aim 2); and 3) Identify attributes and drivers of provider and client
engagement in the intervention and provider and client preferences for future revised-CCP delivery and receipt (Aim 3).
Prior studies have not demonstrated any intervention to be effective at improving short- and long-term VS among the
many PLWH with major barriers to HIV care continuum engagement. The proposed study, to be conducted on a large
scale in real-world HIV service settings, will document the rollout and effects of evidence-informed implementation
course corrections to an intervention model focused on these most vulnerable PLWH. In this way, the work will advance a
second generation of interventions capable of strengthening the care continuum among PLWH who have been unable to
achieve desired ART outcomes in existing interventions, due to major structural or psychosocial barriers.

## Key facts

- **NIH application ID:** 10083232
- **Project number:** 5R01MH117793-04
- **Recipient organization:** GRADUATE SCHOOL OF PUBLIC HEALTH AND HEALTH POLICY
- **Principal Investigator:** Mary Kathryn Irvine
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $579,833
- **Award type:** 5
- **Project period:** 2018-02-15 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10083232

## Citation

> US National Institutes of Health, RePORTER application 10083232, PROMISE - Program Refinements to Optimize Model Impact and Scalability based on Evidence (5R01MH117793-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10083232. Licensed CC0.

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