Using Evidence-Informed Interventions to Improve Health Outcomes among People Living with HIV (E2i)
E2i was a four-year project where 11 evidence-informed effective interventions were tested in Ryan White HIV/AIDS Program-funded care settings. The project produced multimedia toolkits to help HIV service delivery providers to adapt and implement the interventions.
Watch the video to learn more about E2i and what it can offer your organization.
E2i Focus Areas and Toolkits
E2i's multimedia toolkits are designed to be highly accessible and interactive to support Ryan White HIV/AIDS Program and other HIV service delivery organizations in adapting and implementing the interventions.
E2i's 11 evidence-informed interventions fall into four focus areas:
- Transgender women with HIV
- Black men who have sex with men (MSM) with HIV
- Integrating behavioral health with primary medical care for people with HIV
- Identifying and addressing trauma for people with HIV
E2i was a four-year initiative (2017-2021) with the goal of disseminating resources to support replication across the Ryan White HIV/AIDS Program (RWHAP) of intervention strategies with demonstrated effectiveness at improving health outcomes and reducing disparities.
- Selected 11 intervention strategies with demonstrated effectiveness at improving outcomes for people with HIV
- Implemented these intervention strategies in 25 sites to assess their effectiveness at improving health outcomes among people with HIV, specifically in RWHAP settings
- Evaluated the impact of the intervention strategies on linkage-to-care, prescription of ART, retention in care, and viral suppression
- Assessed the intervention strategies’ feasibility, appropriateness, adoption, and other factors that impact the successful implementation of an intervention strategy
- Designed toolkits to support replication of the 11 intervention strategies, including step-by-step implementation guides, interactive training modules, and videos
- Is sharing FREE toolkits to support replication of these intervention strategies!
This product was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of Ryan White HIV/AIDS Program (RWHAP) Part F - Special Projects of National Significance (SPNS) Program awards totaling $20,307,770 with 0% financed with non-governmental sources, and $2,200,000 with 0% financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, HRSA, HHS, RWHAP SPNS, or the U.S. Government. For more information, please visit HRSA.gov.
Coordinating Center for Technical Assistance: The Fenway Institute, Fenway Health, Boston, MA in partnership with AIDS United, Washington, DC
Evaluation Center: The University of California, San Francisco Center for AIDS Prevention Studies
To choose intervention strategies, E2i collaborated with an advisory committee of HIV research experts, providers, and community leaders to identify and select intervention strategies in the four focus areas. Intervention strategies were reviewed using a systematic scoring tool followed by a national convening. Final selection of intervention strategies considered (1) quality and strength of the evidence; (2) feasibility, cultural and contextual appropriateness, appeal, and relevance; and (3) the quality of available information that would enable implementation in new settings.
E2i awarded funding to sites selected through a competitive Request for Proposals process. A site selection advisory committee of HIV research experts, providers, and community leaders reviewed applications using a systematic scoring tool and came together in workgroups to recommend sites. The final sites were chosen based on the strengths of their applications; additionally, the E2i team looked to grant awards to a broad diversity of provider types, populations served, and geographic regions.
The following RWHAP-funded organizations received subawards to implement the E2i intervention strategies and provide evaluation data to inform E2i’s outcomes and dissemination products.
- AIDS Taskforce of Greater Cleveland: Cleveland, Ohio
- Alaska Native Tribal Health Consortium: Anchorage, Alaska
- Birmingham AIDS Outreach Inc: Birmingham, Alabama
- Broward House: Fort Lauderdale, Florida
- California Prostitutes Education Project, Inc.: Oakland, California
- Centro Ararat: San Juan, Puerto Rico
- COMPASS Cares/HOPE Center: Macon, Georgia
- Corktown Health / Health Emergency Lifeline Programs: Detroit, Michigan
- CrescentCare: New Orleans, Louisiana
- Greater Lawrence Family Health Center: Methuen, Massachusetts
- Henry Ford Health System and the Ruth Ellis Center: Detroit, Michigan
- La Clínica del Pueblo, Inc: Washington, DC
- Med Centro, Inc.: Ponce, Puerto Rico
- Multicultural AIDS Coalition: Boston, Massachusetts
- North Jersey Community Research Initiative: Newark, New Jersey
- Oklahoma State University—Internal Medicine Specialty Services: Tulsa, Oklahoma
- Our Lady of the Lake Hospital – Early Intervention Clinic: Baton Rouge, Louisiana
- Positive Impact Health Centers: Decatur, Georgia
- Poverello Center Inc: Wilton Manors, Florida
- Rutgers New Jersey Medical School Infectious Diseases Practice: Newark, New Jersey
- SUNY Downstate Medical Center, HEAT Program: Brooklyn, New York
- UNIFIED-HIV Health and Beyond: Detroit, Michigan
- University of California San Diego Mother Child Adolescent HIV Program: La Jolla, California
- University of Mississippi Medical Center: Jackson, Mississippi
- Western North Carolina Community Health Services: Asheville, North Carolina
E2i's evaluation assessed the following:
- Client outcomes for engagement in HIV care, prescription of antiretroviral medication, retention in HIV care, and viral suppression
- Implementation outcomes based on Proctor’s Implementation Outcomes Framework, which is an implementation science framework that includes eight concepts: acceptability, appropriateness, adoption, feasibility, fidelity, penetration, sustainability, and cost
E2i also collected valuable feedback and insights from the sites on barriers and facilitators to implementation, and lessons learned from their implementation experience. All evaluation outcomes were integrated into the final toolkits.
E2i has published several articles in peer-reviewed journals about the E2i experience. We will add publications to this list as they are available.
- Marc LG, Goldhammer H, Mayer KH, et al. Rapid implementation of evidence-informed interventions to improve HIV health outcomes among priority populations: The E2i initiative. Public Health Rep. 2021:333549211027849.
- Bourdeau B, Shade S, Koester K, et al. Implementation Science Protocol: evaluating evidence-informed interventions to improve care for people with HIV seen in Ryan White HIV/AIDS program settings. AIDS Care. 2021:1-9.
- Psihopaidas D, Cohen SM, West T, et al. Implementation science and the Health Resources and Services Administration's Ryan White HIV/AIDS Program's work towards ending the HIV epidemic in the United States. PLoS Med. 2020;17(11):e1003128.
- Goldhammer H, Mayer KH, Marc LG, et al. HIV care continuum interventions for Black men who have sex with men in the USA. Lancet HIV. 2021;8(12):e776-e786.
- Goldhammer H, Marc LG, Chavis NS, et al. Interventions for addressing trauma among people with HIV: A narrative review. AIDS Care. 2021:1-10.
- Goldhammer H, Marc LG, Psihopaidas D, et al. HIV care continuum interventions for transgender women: A topical review. Public Health Rep. 2022:333549211065517.