3 - (SYM 2) Implementing a Couple-based HIV Prevention Program for LGBTQ Youth in a Psychotherapy Private Practice Setting

Couple-based health-promotion programs improve relational functioning and myriad health outcomes and are increasingly common in HIV prevention and care. 2GETHER is a digital relationship education and HIV prevention program for young LGBTQ couples that has established efficacy in two randomized trials. Despite its promising effects, the complexity of this intervention (i.e., digital content plus relationship and sexual health skills coaching) makes it challenging to implement. In the context of a hybrid type 1 implementation-effectiveness trial, we conducted 33 in-depth interviews with key stakeholders to identify promising implementation venues and generate strategies to enhance implementation. Stakeholders were purposefully selected from 5 types of organizations: health clinics, LGBTQ community centers, public health departments, university resource centers, and psychotherapy private practices. We used the Consolidated Framework for Implementation Research (CFIR) to develop the interview guide and codebook, focusing on determinants of future implementation (i.e., facilitators, barriers) and implementation strategies. Two staff coded transcripts with consensus >.80. Analyses identified psychotherapy private practices as the most promising venue for implementing 2GETHER. Other organizational types identified numerous barriers that were much less of a concern to psychotherapy practices, including lack of staff capacity/skill to administer 2GETHER, limited technological infrastructure to host the digital program, and costs related to maintaining the program. Stakeholders from psychotherapy practices also noted numerous adaptations that would facilitate implementation of 2GETHER in their practices. These implementation strategies included: 1) offering 2GETHER to couples on a waitlist for couple therapy to access the intervention; 2) breaking apart intervention modules for use as homework between therapy sessions; and 3) adaptation of content to be relevant to all LGBTQ populations (not just those at risk for HIV). Based on these findings, we developed an implementation research logic model to conduct an implementation study of 2GETHER at an LGBTQ-affirming psychotherapy private practice in Chicago. This presentation will highlight key findings from our key stakeholder interviews, outline our implementation research logic model, and describe our implementation plan.