- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05785169
Ending the HIV Epidemic With Equity: an Intervention to Reduce the Impact of Racism and Discrimination (TRAnscenDS)
Ending the HIV Epidemic: An All-facility Intervention to Reduce the Impact of Structural Racism and Discrimination on Patient and Healthcare
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Roberta Scheinmann, MPH
- Phone Number: 917-769-8078
- Email: rs536@cumc.columbia.edu
Study Locations
-
-
New York
-
New York, New York, United States, 10032
- Recruiting
- Columbia University School of Nursing
-
Contact:
- Corina Lelutiu-Weinberger, PhD
- Email: cl4265@cumc.columbia.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Selected Ryan White Clinics. Selection based on the following:
First, clinic leaders will complete a 15-min Site Characteristics Survey, assessing suitability for participation and clinic comparability for randomization purposes. Staff and leadership at Ryan White clinics will next complete an anonymous 15-minute Eligibility Survey. Clinics will meet initial eligibility if scores are between 4-5 (showing high motivation) on 90% of the items.
Exclusion Criteria:
- Non-Ryan White Clinics
- Clinics that do not serve a primarily BIPOC population
- Clinics that are not interested in addressing Structural Racism and Discrimination
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: First Cluster
The intervention will be implemented across three steps with a total of 6 clinics (two clinics per step). The earliest roll-out of the intervention will be at the clinics randomized to Cluster 1. The intervention consists of a mix of Workshops, Interactive Trainings and Learning Circles (virtual and in-person). In the first workshop, the investigators will present baseline findings to all clinic members to 1) raise awareness for the need for intervention to reduce Structural Racism and Discrimination (SRD) , 2) facilitate collaborative processes, 3) catalyze change for practice transformation, to 4) guide the intervention process. This workshop will be followed by a series of interactive trainings covering topics from the history of structural racism, to intersectional stigma and discrimination, bias, systems of accountability, and the creation of a manual to guide the implementation and sustainability of SRD reduction efforts. |
The HP+ curriculum includes total-site training and co-facilitation via participatory modules.
To transform clinic culture, a multi-level approach that includes the whole facility and reaches all parties is required.
The intervention aims to modify top-down mechanisms of influence.
TRAnscenDS is modeled on these principles and supports the development of multiple SRD-reduction strategies (instituting comprehensive anti-racist and Diversity, Equity and Inclusion policies, monitoring and feedback systems; workforce equity), at the top two levels of the socioecological model (organizational/policy and systems/providers/staff), to in turn impact individual-level out-comes.
Other Names:
|
Experimental: Second Cluster
The intervention will be implemented across three steps with a total of 6 clinics (two clinics per step). The earliest roll-out of the intervention will be at the clinics randomized to Cluster 1. The intervention consists of a mix of Workshops, Interactive Trainings and Learning Circles (virtual and in-person). In the first workshop, the investigators will present baseline findings to all clinic members to 1) raise awareness for the need for intervention to reduce Structural Racism and Discrimination (SRD) , 2) facilitate collaborative processes, 3) catalyze change for practice transformation, to 4) guide the intervention process. This workshop will be followed by a series of interactive trainings covering topics from the history of structural racism, to intersectional stigma and discrimination, bias, systems of accountability, and the creation of a manual to guide the implementation and sustainability of SRD reduction efforts. |
The HP+ curriculum includes total-site training and co-facilitation via participatory modules.
To transform clinic culture, a multi-level approach that includes the whole facility and reaches all parties is required.
The intervention aims to modify top-down mechanisms of influence.
TRAnscenDS is modeled on these principles and supports the development of multiple SRD-reduction strategies (instituting comprehensive anti-racist and Diversity, Equity and Inclusion policies, monitoring and feedback systems; workforce equity), at the top two levels of the socioecological model (organizational/policy and systems/providers/staff), to in turn impact individual-level out-comes.
Other Names:
|
Experimental: Third Cluster
The intervention will be implemented across three steps with a total of 6 clinics (two clinics per step). The earliest roll-out of the intervention will be at the clinics randomized to Cluster 1. The intervention consists of a mix of Workshops, Interactive Trainings and Learning Circles (virtual and in-person). In the first workshop, the investigators will present baseline findings to all clinic members to 1) raise awareness for the need for intervention to reduce Structural Racism and Discrimination (SRD) , 2) facilitate collaborative processes, 3) catalyze change for practice transformation, to 4) guide the intervention process. This workshop will be followed by a series of interactive trainings covering topics from the history of structural racism, to intersectional stigma and discrimination, bias, systems of accountability, and the creation of a manual to guide the implementation and sustainability of SRD reduction efforts. |
The HP+ curriculum includes total-site training and co-facilitation via participatory modules.
To transform clinic culture, a multi-level approach that includes the whole facility and reaches all parties is required.
The intervention aims to modify top-down mechanisms of influence.
TRAnscenDS is modeled on these principles and supports the development of multiple SRD-reduction strategies (instituting comprehensive anti-racist and Diversity, Equity and Inclusion policies, monitoring and feedback systems; workforce equity), at the top two levels of the socioecological model (organizational/policy and systems/providers/staff), to in turn impact individual-level out-comes.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Structural Racial Discrimination Index (SRD)
Time Frame: Baseline and 18 months
|
The SRD is a rating of clinic mission/vision statements, the anti-racist policy, diversity, equity and Inclusion, and the clinic environment.
A change in the mean score of SRD Index, post-intervention implementation will be measured.
Scores range from 0-100, with a higher score indicating increased anti-racist and DEI policies and procedures.
|
Baseline and 18 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Modern Racism Scale (MRS) Score
Time Frame: Baseline and 18 months
|
The MRS is a scale of racial attitudes and consists of 7 items worded as opinion statements.
One item, which is considered non-racist is reverse coded before scoring.
The response scale is 1= strongly disagree to 5= strongly agree.
Scores range from 7-35 with a lower score indicating a better outcome.
|
Baseline and 18 months
|
Change in Cultural Humility Score
Time Frame: Baseline and 18 months
|
Cultural humility as measured by the adapted Trauma-Informed, Resilience-Oriented Care (TI-ROC) Cultural Humility Scale, which assess staff's perceptions of colleagues and clinic environment.
Scores range from 12-60.
The negative items are reverse coded such that higher scores indicate higher cultural humility indicating better outcome.
|
Baseline and 18 months
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Time to Linkage to Care
Time Frame: Baseline and 18 months
|
Change in time to linkage to care from diagnosis at the clinics.
|
Baseline and 18 months
|
Change in Patients Retained in Care
Time Frame: Baseline and 18 months
|
Change in the number of patients retained in care at the clinics.
|
Baseline and 18 months
|
Change in Number of Patients HIV Virally Suppressed
Time Frame: Baseline and 18 months
|
Change in the number of patients virally suppressed at the clinics.
Viral suppression defined as less than 200 copies/mL.
|
Baseline and 18 months
|
Change in Frequency of Perceived Racism and Discrimination
Time Frame: Baseline and 18 months
|
Change in the frequency of perceived racism and discrimination events by patients attending the clinic as collected by self-administered Experiences of Discrimination survey .
|
Baseline and 18 months
|
Change in the Frequency of HIV-Related Stigma
Time Frame: Baseline and 18 months
|
Change in the frequency of HIV-related stigma events by patients attending the clinics.
Stigma measured by the Adapted Stigma 2.0 index.
|
Baseline and 18 months
|
Change in Depression, Anxiety and Stress Scale (DASS-21)
Time Frame: Baseline and 18 months
|
A 21-item scale that assesses depression, anxiety and stress over the past week.
Scores range from 0-63 with a lower score indicating a better outcome.
|
Baseline and 18 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Corina Lelutiu-Weinberger, PhD, Columbia University
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- AAAU1559
- 1R01NR020583 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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