Bridges2Scale (2023-2028)

Bridges2Scale: Testing implementation strategies for an intervention among young people affected by AIDS

Principal Investigators: Fred M. Ssewamala, PhD; Byron Powell, PhD; Noeline Nakasujja, MBChB, PhD (Makerere University)

Funding Agency: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Project Team Members: Ozge Sensoy Bahar, PhD; Proscovia Nabunya, PhD; Rachel Brathwaite, PhD; Derek Brown PhD; Mary McKay, PhD; Torsten Neilands, PhD (University of California San Francisco), Fred Semitala, PhD (Makerere University)

Implementing Partners: Abel Mwebembezi, PhD (Reach the Youth Uganda), Barbara Mukasa (Mildmay Uganda).

Study Coordinators: Richard Bwogi, Vincent Ssentumbwe

Bridges2Scale will use a two-arm Hybrid III effectiveness-implementation cluster randomized clinical trial, where we will compare two multifaceted strategies (standard vs. enhanced) for scaling the Bridges interventions (consisting of financial literacy training, peer mentorship, family income-generating , and youth development accounts). The standard implementation strategy has been applied in our prior and ongoing studies and involves educational meetings that prepare staff members to deliver Bridges with minimal disruption to site workflow. This will be compared to an enhanced strategy that will be developed using Implementation Mapping, a systematic protocol for developing implementation strategies using theory, evidence, and stakeholder input. The study will use the public school system to recruit 1440 youth affected by HIV (ages 13-17 years) from 48 schools in the Greater Masaka region of Uganda. Assessments will be conducted at baseline, 12, 24, 36, and 48 months.

The study will address a critical challenge: how to best support the implementation, scale-up, and sustainment of economic empowerment interventions, which have been proven to be highly efficacious in improving youth-focused HIV prevention, care, and support outcomes, but are yet to be widely scaled up.