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 identified, implemented, and evaluated three evidence-informed interventions to improve engagement and retention of Black men who have sex with men (MSM) in HIV care. The interventions were piloted by six HIV service organizations in the Ryan White HIV/AIDS Program.
Watch this introductory video to the three interventions.
E2i Black MSM Toolkits
- Tailored Motivational Interviewing (TMI)
- TXTXT: Text Messaging Intervention to Improve Antiretroviral Adherence among HIV-Positive Youth
- Project CONNECT: Client-Oriented New Patient Navigation to Encourage Connection to Treatment
E2i identified, implemented, and evaluated three evidence-informed interventions focused on integrating behavioral health care into HIV primary care settings. The interventions were piloted by eight HIV service organizations in the Ryan White HIV/AIDS Program.
This introductory video provides an overview of the three interventions.
Behavioral Health Intervention Toolkits
- Collaborative Care Management (CoCM): An integrated care approach to treating common psychiatric disorders in primary care
- SBIRT: Screening, Brief Intervention, and Referral to Treatment (SBIRT) in HIV Service Delivery Organizations
- Buprenorphine Treatment for Opioid Use Disorder in HIV Primary Care
E2i identified, implemented, and evaluated three interventions that aim to identify and address trauma among people with HIV. The interventions were piloted by 5 HIV service organizations in the Ryan White HIV/AIDS Program.
Watch an introductory video about these three interventions.
E2i Addressing and Identifying Trauma Toolkits
- Cognitive Processing Therapy (CPT): Treatment for post-traumatic-stress disorder (PTSD)
- Seeking Safety: Teaches safe coping skills to help people deal with PTSD and/or addiction
- TIA/CHANGE: Trauma-Informed Approach & Coordinated Assistance & Navigation for Growth & Empowerment
E2i identified, implemented, and evaluated two evidence-informed interventions designed for transgender women with HIV. Each intervention was piloted by three HIV service organizations in the Ryan White HIV/AIDS Program.
Watch this introductory video to learn more about these interventions and their implementation during E2i.
E2i: Toolkits for Transgender Women with HIV
- Healthy Divas: Empowers transgender women with HIV to identify and accomplish individualized health care goals related to gender affirmation and HIV
- Transgender Women Engagement and Entry to Care (T.W.E.E.T.): Linking transgender women to HIV care by empowering them to become their own advocates
About E2i
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.
E2i:
- 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
Funded Organizations
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
Funding Source
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.
Intervention Strategy Selection Process
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.
Site Selection Process
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.
Subawarded Sites
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 published articles in peer-reviewed journals about the E2i experience.
- 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.
Legal Disclaimer
The TargetHIV website provides access to downloadable digital and print material (“Material”) that are included as part of the E2i Intervention Toolkits (Grant numbers: U69HA31067 and U90HA31099). All images, text, help files, and data files (“Contents”) contained within the Material provided via download are proprietary and copyrighted and are subject to copyrights owned by Rocketship Creative Inc, The Fenway Institute, or other individuals or entities and are protected by United States copyright laws. Any reproduction, retransmission, distribution or republication of all or part of the Material is expressly prohibited, except for those specifically granted by the license agreement below.
We reserve the right to change or update this license at anytime.
Photo Disclaimer
The persons shown in photographs on the Material are stock photography models (Models) and are not actual patients of, nor are they affiliated with, TargetHIV, HHS, HRSA, HIV/AIDS Bureau, or its affiliates (“Affiliates”), or the E2i Intervention. Rocketship Creative Inc and The Fenway Institute have obtained the rights to use the photographs via license agreements with certain third party stock photography companies, and the use of the photographs is in compliance with the terms of those license agreements.
The photographs showing the Models are used on this Material for illustrative purposes only. The Models do not personally endorse TargetHIV, or any products, services, causes, or endeavors associated with, or provided through the TargetHIV website. The context in which the photographs are used on this website and the Material is not intended to reflect personally on any of the Models shown in the photographs. TargetHIV, Rocketship Creative Inc, The Fenway Institute, and Affiliates, their respective officers, directors, employees, agents and/or independent contractors assume no liability for any consequence relating directly or indirectly to the use of the photographs showing the Models on this material.
Terms of Use and End User License Agreement
This is a non-exclusive, non-transferable license agreement between you and Rocketship Creative Inc and its affiliates through TargetHIV, granting you the right to use, modify (except as expressly prohibited herein) and disseminate the Material subject to the limitation set forth herein. Please read this agreement carefully before using the Material. If you choose not to accept this agreement, you must return the Material. By using any part of the Material, you are agreeing to the following terms:
- The material may only be used in promotion of the E2i interventions
- The material must be provided free of charge, and you may not repackage, sell, or redistribute the material.
- The material may be used, changed, and altered to adapt the E2i intervention information to your practice. For example, you may add contact text information, or include your own images in place of the art provided. You may not sell or incorporate the content for distribution in another product, or give the contents of this material to a third party for any other purpose.
- You may not alter the material that presents the E2i Intervention negatively, portrays any person depicted in visual content (a “Model”) in a way that a reasonable person would find offensive, including but not limited to depicting a Model: a) in connection with pornography, “adult videos”, adult entertainment venues, escort services, dating services, or the like; b) in connection with the advertisement or promotion of tobacco products; c) in a political context, such as the promotion, advertisement or endorsement of any party, candidate, or elected official, or in connection with any political policy or viewpoint; d) as suffering from, or medicating for, a physical or mental ailment; or e) engaging in immoral or criminal activities.
- You may not use the content as part of another product you create. For example, you may not make a copy of a stock photo visual and include it in any product or as a standalone visual. All content is provided for use for only the single purpose of promotion of the E2i intervention.
- You may not falsely represent, expressly or by way of reasonable implication, that any Visual Content was created by you or a person other than the copyright holder(s) of that Visual Content.
- You agree to indemnify and hold harmless TargetHIV, Rocketship Creative Inc, its Affiliates,– all of its officers, directors, employees and agents (“Those Indemnified”) for any and all losses, damages, liabilities, claims, costs or expenses, including reasonable attorneys’ fees, incurred directly or indirectly by Those Indemnified in connection with the use of the material for any purpose.
- You may not sell, sublicense, loan, give, or transfer any part of the Contents to a third-party, or allow the Contents to be accessed by anyone outside of your organization. A third party must download the material directly through the TargetHIV website and accept the license agreement independently.
- You accept the content and material ‘As-is’ with no express or implied warranty.
- You will notify Rocketship Creative Inc your intended physical print amount of the material and will not exceed a print run of 1000 copies without notifying Rocketship Creative Inc.
Please direct any licensing inquiries and questions to Rocketship Creative Inc. Include ‘E2i Digital and Print Material Licensing’ in the subject header.
Contact Information
Project Contacts:
HRSA Contacts:
Funding:
Recipient Organization: Fenway Community Health Center, Inc., in collaboration with AIDS United (Technical Assistance) and University of California San Francisco (Evaluation)
Grant number: U69HA31067 (TA), U90HA31099 (Eval)
Project Period: 8/1/2016 - 7/31/2021