# Scale-up of an evidence-based Adolescent Transition Package to support transitional care among youth living with HIV

> **NIH NIH R01** · UNIVERSITY OF WASHINGTON · 2024 · $625,598

## Abstract

ABSTRACT
Youth living with HIV (YLH) have high rates of viral non-suppression and non-retention, particularly during the
period when they transition from adolescent to adult autonomous care. In partnership with the Kenya Ministry of
Health (MoH), we used a community engagement approach to develop the Adolescent Transition Package
(ATP), a healthcare worker (HCW) toolkit that includes structured educational materials and tracking tools to
facilitate the transition process. We recently tested the ATP in a cluster randomized clinical trial (cRCT) of >1000
YLH in 20 clinics and found the ATP effective at improving transition readiness. The ATP was acceptable and
feasible. The Kenya MoH is committed to supporting transition among YLH and scaling up the ATP. We propose
testing strategies to SCALE-UP the ATP in Kenya using a data driven youth led implementation strategy.
Aim 1: Using a hybrid III implementation-effectiveness design, compare two implementation strategies for scale-
up of ATP: Kenya MoH SoC implementation strategy (cascading training of trainers) to an enhanced scale-up
implementation strategy (ATP-YES) (SoC plus youth-led data- driven intervention adaptations). Approach:
Thirty-two HIV clinics (8 per county) will be randomized 1:1 to SoC or ATP-YES. In intervention sites, youth
leaders will lead routine ATP implementation assessments and targeted adaptations to optimize reach,
effectiveness, adoption, and implementation (fidelity) through data audits, cyclical small tests of change and
cross-facility learning. Aim 1a: Compare 3-year ATP reach, adoption and effectiveness between intervention
and control sites. Reach: proportion of YLH age 15-24 years exposed to the ATP intervention. Adoption:
proportion of HCWs using the ATP. Effectiveness: successful transfer to adult care, post-transition retention and
viral suppression and transition readiness scores. Aim 1b: Using the Consolidated Framework for
Implementation Research (CFIR) framework, identify determinants of ATP adoption, implementation (fidelity to
the ATP) and maintenance of the ATP. Aim 1c: Summarize intervention adaptations using the Framework for
Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS).
Aim 2: To evaluate the cost-effectiveness and budget impact of the ATP-YES implementation strategy.
Approach: We will conduct micro costing, HCW interviews and time and motion observations to estimate the
incremental costs of implementing the ATP-YES strategy in routine HIV care. We will combine cost with
effectiveness data from Aim 1a into a Markov model to project the health impact (HIV deaths and morbidity
averted) and financial costs of the intervention compared to standard of care and estimate the cost-effectiveness
and budget impact of ATP-YES implementation.
This implementation science study focuses on sustainable implementation of an evidence-based intervention
through youth-led data-driven intervention adaptations. The project align...

## Key facts

- **NIH application ID:** 11006175
- **Project number:** 1R01MH136897-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Kristin Marie Beima-Sofie
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $625,598
- **Award type:** 1
- **Project period:** 2024-09-11 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11006175

## Citation

> US National Institutes of Health, RePORTER application 11006175, Scale-up of an evidence-based Adolescent Transition Package to support transitional care among youth living with HIV (1R01MH136897-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11006175. Licensed CC0.

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