Systems science modeling for implementation research: An application to tobacco smoking cessation for persons with serious mental illness

Takeru Igusa, PhD
Johns Hopkins University

Elizabeth Stuart, PhD
Johns Hopkins University

Gail Daumit, MD, MHS
Johns Hopkins University

ABSTRACT:
Implementation researchers have sought ways to use simulations to support the core components of implementation, which typically include assessing the need for change, designing implementation strategies, executing the strategies, and evaluating outcomes. The goal of this presentation is to explain how methods in systems science, with an emphasis on agent-based simulations, could fulfill this role. The presentation will include a discussion on explainability, in which modeling results are formulated in terms of constructs used in implementation science frameworks to facilitate the engagement of practitioners in the design and use of the models. This is part of an ongoing project focused on scaling up evidence-based tobacco smoking cessation practices in community mental health clinics in Maryland.

A tailored clinic-level intervention using a stepped-wedge design to increase PrEP uptake in primary care settings

Parya Saberi, PharmD, MAS, AAHIVP
University of California, San Francisco

Wayne Steward, PhD, MPH
University of California, San Francisco

ABSTRACT:
Lack of healthcare provider knowledge, capacity, and willingness to prescribe PrEP are barriers to PrEP delivery in clinical settings. In this presentation, we will discuss details of the PrEP Optimization Intervention (PrEP-OI) which combines a PrEP Coordinator with an online panel management tool to assist providers with PrEP uptake, persistence, and management in a large safety-net system. The intervention was rolled out at 12 primary care San Francisco Department of Public Health clinics using a stepped-wedge design preceding a follow-up phase. Additionally, we will review the challenges the study overcame with the development of PrEP-OI's technology-based component, onboarding and implementation, and response to the SARS-CoV-2 pandemic.