Sexually transmitted infection (STI) testing is critical to improving reproductive health, especially for adolescents.

Wake Invests in Women is focusing on STEM occupations — science, technology, engineering and math — because that’s where the gender gaps are greatest. In STEM fields, Black women account for only 5% of the workforce in Wake County, while Latina women account for only 1% of the workforce. The goal of Wake Invests in Women is to increase the number of women in the pipeline for the higher-wage, higher-demand jobs in STEM-related fields, and to achieve pay equity. The first year of the Wake Invests in Women Challenge is being launched as a pilot. The goal is to encourage most — if not all — local employers to rise to the challenge next summer. Wake Invests in Women is funded by Wake County and supported by numerous organizations, including the Raleigh Chamber, the NCSU Belk Center, the NC Business Committee for Education (NCBCE), RTI International, CREE/Wolfspeed, and Wake Tech Trustee Dr. Saundra Williams.

OVC competitively awarded funds to RTI in FY 2018 to provide TTA to sites funded under the Improving Outcomes for Child and Youth Victims of Human Trafficking ("Improving Outcomes") program. The continuation funding will support RTI in continuing to provide this TTA, as well as expanding its TTA to additional Improving Outcomes program sites that OVC anticipates funding in FY19 and FY20.

The purpose of the Improving Outcomes for Child and Youth Victims of Human Trafficking Program is to improve outcomes for children and youth who are victims of human trafficking by integrating human trafficking policy and programming at the state or tribal level and enhancing coordinated, multidisciplinary, and statewide approaches to serving trafficked youth. With this award, the Research Triangle Institute (RTI) will to provide training and technical assistance (TTA) that is tailored and specific to grantees funded under the Improving Outcomes for Child and Youth Victims of Human Trafficking Program. Specifically, RTI will support the project sites' efforts to prevent, identify, and respond to trafficking of children and youth within service systems such as child welfare, juvenile justice, and runaway and homeless youth providers. Additionally, RTI will help program grantees to develop those critical multidisciplinary collaborations and coordinated strategies, using proven strategies for tailored and proactive training and technical assistance within the Children and Youth Technical Assistance Program. RTI's approach will include group-level approaches such as grantee meetings, webinars, virtual roundtables, and briefs; individual-level approaches such as phone and video-conferencing and site visits; and sustainable materials and resources supporting future initiatives. 

Genetic Alliance has requested RTI evaluation support for Year 3 of their Newborn Screening Family Education Grant. RTI activities will build on evaluation planning and implementation in Years 1 and 2 to include dashboard updates, development of an evaluation plan for their NBS Awareness campaign, and a annual report.

We propose to examine the short-term social, health and health care impacts of COVID-19 in a cohort of highly vulnerable women in the Bay Area of California. We are in a unique position to carry out this research expeditiously by leveraging an existing cohort of women with criminal justice system involvement from the parent study (NIMHD grant#R01 ).  The study population (N=370) is defined by several characteristics that are associated with vulnerability to COVID-19.  For example, 82% report one or more chronic health conditions, including 42% with respiratory conditions (eg, asthma COPD). Forty-nine percent are homeless and 24% are age 55 or older.  Furthermore, nearly three-quarters (72%) of women in the study are African American. Reports are rapidly emerging from multiple U.S. cities that African Americans are disproportionately affected by the virus.

The NCVS measures criminal victimization and victim help-seeking behaviors in the United States. As the nations primary source of data on crimes reported and not reported to police, the NCVS collects information on nonfatal violent and property crimes from a nationally representative sample of persons age 12 or older in U.S. households. In addition to the core collection, the NCVS survey operation also produces data on stalking, identity theft, fraud, school crime, and contact between police and the public. Since the inception of the survey in 1973, BJS has endeavored to maintain and enhance the quality and relevance of estimates produced from this important yet complex survey. As part of recent efforts to promote the quality and relevance of NCVS and related estimates, BJS has maintained an active research and development program in several areas including an effort to explore options for redesign of the NCVS instrument, development of subnational victimization estimates, improvement of hate crime and identity theft measures, and data collection on victim services providers. The primary objective of the NVSSP is to support ongoing statistical and methodological research to enhance the utility and efficiency of BJSs $52 million NCVS, including informing the NCVS survey redesign research and BJSs decisions about various aspects of its victimization statistics program.

Led by Dr. Marni Kan, a prevention researcher at RTI, this project will evaluate the effectiveness of primary prevention programs, policies, and practices implemented by the CDC’s Rape Prevention and Education (RPE) Program. The goal of the RPE program is to strengthen sexual violence prevention efforts by changing the social norms around sexual assault and increasing bystander intervention in potentially dangerous situations through a Bar Outreach Program developed and implemented by Our Voice in Buncombe County, NC since 2012. Research funded by this grant will expand the evidence base for these strategies which include promoting social norms opposing violence, opportunities to empower girls and women, and creating protective environments.

Situational analysis of Neglected Tropical Diseases in the 11 SEAR countries including prevalence, elimination efforts, strategies and campaigns in each including the documentation of best practices for NTD eradication in the region. Report to be submitted to the South-east Asia regional office of WHO.

FDA's Center for Devices and Radiological Health (CDRH) is commissioning the development of a patient preference survey tool for breast implants. The purpose is to learn about factors influencing patients' choices involving breast implants. The primary objective is to develop, administer, and summarize the results from a patient preference information (PPI) survey instrument on breast implants.

This study is a process evaluation of a model of technology-based telemental health services for victims of crime (VOCs) of El Futuro, a Durham, NC, behavioral health organization serving Latinx and other community members. It will include all El Futuro service providers (n=23) and Latinx adult patient representatives (n=10) to study the implementation and acceptability of the TeleFuturo program and prepare for a future outcome evaluation. Data will be collected from participating providers, patient representatives, and health records to understand the reach and acceptability of TeleFuturo programming, and the nature and fidelity of implementation. Data will be also be used to inform potential adaptations of the program and development of measures for a future outcome evaluation. It will include a pilot study to test the implementation guide and measure fidelity to the guide, outcomes for VOCs, and cost.

This RPN is to support the fifth task order under a single-award IDIQ that RTI holds with the Air Force to conduct sexual assault prevention training development and evaluation via a feasibility trial of Sexual Communication and Consent Tailored Interventions at USAF Basic Military Training. Under this task order, RTI will translate feasibility study findings into intervention and implementation improvements and support sustainability of the intervention in BMT for the remaining duration of the IDIQ.

This program will support projects to build or enhance a community response to address the needs of victims of female genital mutilation and cutting (FGM) and to provide targeted technical assistance to inform frontline providers on how to identify and serve victims and persons at-risk of being victimized. The Purpose Area 1 (Training and Technical Assistance Provider), deliverables include: (1) education and technical assistance to Purpose Area 1 sites in detection of FGM and risk for FGM; (2) two in-person meetings of the Purpose Area 2 Project Site teams, one at the beginning of the 36-month project period, and one at the end for the purpose of fostering learning across sites during the planning and implementation stages of their work; (3) training and technical assistance to each of the approximately eight Purpose Area 2 sites, as needed, to support their work: for example, by developing training for community partners and sustaining that engagement throughout the project period; (4) an outreach campaign to law enforcement, public health professionals, and educators on detecting at-risk girls in localities where FGM is a risk; (5) assistance to communities seeking information about addressing FGM, for example, by distributing electronic or written resources, including to communities that are not part of the Purpose Area 2 cohort; (6) a final report describing how communities in the United States can address FGM, based on the work of the project sites.

Prevention Institute (PI) has received a sole source request from CDC Injury Center to revise the Preventing Suicide Technical Package and provide training and technical assistance around the dissemination of the package to a variety of audiences within 11 months.
 

RTI would be a subcontractor to PI to assist with the technical writing.  In particular, we would assist in conducting an updated literature review, a scan of existing tools in use, updating the technical package, participating in monthly team meetings with PI, participating in monthly meetings with PI and CDC, replying to reviewer feedback, and co-developing some/providing input into the training modules that emerge from the technical package strategies.  The primary deliverable would be text for the technical package.
 

This RPN is for RTI to sub to the International Association of Chiefs of Police (IACP) for the COPS CPD solicitation in the Promising Practices in Law Enforcement Victim Support category. RTI is priming two proposals under the same solicitation in different categories. The first is being led by Travis Taniguchi under Topic 2: Recruiting the Next Generation of Law Enforcement. The second proposal is in response to Topic 1: Law Enforcement Injury Prevention and Rehabilitation Program Toolkit and is being led by Jenn Rineer.
 

Community Policing Development (CPD) funds are used to develop the capacity of law enforcement to implement community policing strategies by providing guidance on promising practices through the development and testing of innovative strategies; building knowledge about effective practices and outcomes; and supporting new, creative approaches to preventing crime and promoting safe communities.

RTI submitted an application (0281901.758) to the FY19 PHTBIRP PSAAD Investigator Initiated Focused Research solicitation, which is designed to address the development or adaptation of prevention efforts to reduce the occurrence of sexual assault or address approaches to better understand, screen for, and prevent Adjustment Disorders among Service members, ultimately benefiting the public at large. 

This opportunity, which aligns well with WGHI expertise, is a chance to work with a new US-based non-profit organization (No Means No Worldwide; NMNW) in South Africa. RTI was solicited to submit a proposal for this organization looking for a research partner to provide technical assistance to their upcoming research in an implementation hub in South Africa. NMNW proposes a mixed methods evaluation to assess the effectiveness of a sexual violence prevention intervention, including a 6-month pilot study followed by a 2-year longitudinal study. The Two objectives are to:

1) Evaluate the impact of the intervention on incidence of sexual violence in the targeted communities

2) Explore processes of change in relation to sexual violence prevention, including impact on knowledge, attitudes, and behaviors.

The purpose of this task order is to contribute to the understanding of the natural history of fragile X syndrome (FXS) across the lifespan and inform selection of health and developmental measures appropriate for future intervention and treatment studies by holding discussions to obtain individual advice and perspectives on research priorities for FXS, and by analyzing and publishing peer-review studies from data collected via CDC’s Fragile X Online Registry with Accessible Database (FORWARD) from 2011 to 2019 and related CDC-funded studies. FORWARD was originally designed to support research to contribute to: a more robust description of FXS, an informed understanding of the natural history of FXS across the lifespan, the impact of treatments and interventions on health outcomes and quality of life, and approaches to measuring cognitive and behavioral status in individuals with FXS.

Multi-mode survey (web, mail, phone) with women who gave birth in the prior 2-4 months. The survey includes batteries of questions about pre- and post-natal maternal health, health related behaviors, and health care systems and resources used by mothers.

New York State Dept of Health's (NYSDOH) breast cancer screening awareness campaign will target African American and low-income women in New York state, aged 40-74, who have never had a mammogram or who have not been screened in the last two years. The campaign will include a call-to-action, which is “talk to your healthcare provider about getting a mammogram.”  The evaluation will assess the target audience's reaction to TV and digital ads; whether exposure to the campaign is associated with reduced barriers to screening; and whether exposure to the campaign is associated with intention to talk to an HCP about getting a mammogram. The evaluation will involve pre- and post-test surveys with the target audience.

The proposed Diversity Supplement to R01 HD094629 will contribute to the parent study by examining pregnancy outcomes of AGYW using PrEP and the factors influencing PrEP use during pregnancy. The study will use a mixed-methods design. All AGYW using PrEP who test positive for pregnancy at baseline, 3-, 6-, or 9-month follow-up will be contacted by study staff and asked to consent to be tracked for pregnancy outcomes up to 8 weeks post-partum. Those who consent to tracking will be contacted monthly for a brief check-in call to assess PrEP use. During the post-partum period, a purposive sample of AGYW will be asked to complete an in-depth interview with study staff to explore the factors that influenced their decision to maintain or discontinue PrEP use during pregnancy. In-depth interviews will also be conducted with providers to assess their attitudes, beliefs, and medical recommendations regarding AGYW PrEP use during pregnancy. The proposed aims are: Aim 1: To compare pregnancy outcomes (i.e. number of AGYW who become pregnant, number who terminate pregnancies, and the infant outcomes) between AGYW who use PrEP and those who do not use PrEP. Aim 2: To compare PrEP uptake and adherence between AGYW who become pregnant ant those who do not become pregnant Aim 3: Among pregnant AGYW using PrEP, explore the factors that influence AGYW’s decision to maintain or discontinue PrEP use Aim 4: Explore provider attitudes and beliefs toward AGYW who are pregnant and use PrEP and the medical recommendations they make regarding PrEP using during pregnancy.

The purpose is to promote nurturing care for the most-vulnerable newborns and young children, starting before birth, through evidence-based integrated programming in early-childhood development to provide for children’s health, nutrition, safety and security, responsive caregiving for social and emotional well-being, and opportunities for early learning. The activity will specifically address stunting through improving nutrition service delivery at health facilities and community, supporting nutrition sensitive agriculture, and promoting safe and secure environments to help children meet critical cognitive and physical developmental milestones. This activity defines “early childhood” as prenatal to five years old, with an emphasis on the first 1,000 days for nutrition interventions. It will give particular attention to supporting the early identification of children with disabilities and timely action by families and the health, education and protection sectors.

Polysubstance use (including alcohol) is extremely common in cases of opioid overdose.  A stronger understanding of the patterns, contexts and motivations for polysubstance use can inform efforts to prevent overdose and other negative health outcomes.  Existing research on polysubstance use relies predominantly on past 30-day timeframes.  This three-year study will use mixed methods to take an in-depth look at SAME-DAY polysubstance use, the timeframe most relevant to overdose risk. In addition, there are few prospective studies of polysubstance use - most are cross-sectional.  It is not known whether or how polysubstance use  patterns change over time, and what factors influence changes.  The study will use the "drug, set and setting" framework to examine combinations of substances used (drug), motivations for their use (set) and social/structural factors influencing use (setting).  

This response to RFA-MH-20-520 (Implementation Research in HRSA Ryan White Sites: Screening and Treatment for Mental and Substance Use Disorders to Further the National “Ending the HIV Epidemic” [EHE] Goals; attached) is motivated in part by one of the RFA’s NIH Project Officer’s strongly encouraging Bryan Garner to submit an application. Additionally, this RFA is perfectly aligned with Bryan’s current program of research, especially Bryan’s Substance Abuse Treatment to HIV care (SAT2HIV Project) that is successfully concluding on 6/30/2020 and the current application would seek to build upon most directly. Per the RFA, “The purpose of this initiative is to enhance screening and treatment for mental and substance use disorders in HRSA Ryan White HIV/AIDS Program funded sites through implementation research, to advance the goals of the ending the HIV epidemic (EHE) initiative. Additionally, the RFA notes “NIH intends to fund an estimate of 4-6 awards.”
 

This Funding Opportunity Announcement (FOA) invites applications to enhance screening and treatment for mental and substance use disorders in HRSA Ryan White HIV/AIDS Program funded sites through implementation research, to advance the goals of the National "End the Epidemic" (EHE) initiative. This FOA is intended to support pilot or feasibility implementation studies to enhance screening and treatment of substance use or mental health disorders in the HRSA Ryan White HIV/AIDS Program.

Our application proposes to work with Ryan White funded health centers in the Atlanta Metro area to develop a clinic-level mobile service intervention to increase mental health and substance use screening and uptake of services.

On August 5, 2019, the proposed prime for this project, Two Oceans in Health (2OIH), submitted a concept paper with inputs from RTI to the United States Department of Defense (DOD) HIV/AIDS Prevention Program (DHAPP). On October 7, we received an email from the DOD, inviting us to submit a full proposal along with several recommendations for adjustments to our original 17-page, single-spaced concept paper. Although there maybe other competitors, this feels a lot like a BAFO. The concept paper did NOT include a formal budget from RTI and that will be one of our main contributions to the full proposal. DHAPP has successfully engaged over 80 countries in an effort to control the HIV epidemic among their respective military services. DHAPP is the DOD implementing agency collaborating with the US Department of State, the Health Resources and Services Administration, Peace Corps, US Agency for International Development (USAID), and the Centers for Disease Control and Prevention (CDC).

The Enhance projects will add value to the existing Livestock Systems innovation Lab (LSIL) projects in 6 countries. RTI is currently working on a LSIL project in Rwanda with ILRI as the prime (project 0215801). In the main project, RTI leads a study that is evaluating the nutrition impacts of behavior change communication component promoting the consumption of milk and other animal source foods in households that have received a cow through the government of Rwanda's livestock asset program for poor families.

For the Enhance project add-on, we have chosen the "gender" theme. Gender is important in the nutrition of young children in low-resource settings because of its influence on decision-making about the use of household resources, including food and money for food. The team plans to use some of the gender tools developed by the INGENEAS project to hold participatory community meetings to better understand gender norms related to household milk production and consumption.

The project enhancement will  involve an online survey and interviews with cancer patients to address the following research questions related to the impact of COVID-19:

• How has COVID-19 affected cancer patients’ relationships and communication with their cancer care providers (e.g., due to disruptions in care, access issues, changes in mode and nature of appointments )?

• What aspects of patient-centered communication are most important to patients in the context of COVID-19 (i.e. managing uncertainty, sharing information, decision making, enabling self-management, responding to emotions, building a therapeutic relationship)?

• What are differences in patients’ experiences across different care settings (e.g., cancer center, hospital, outpatient clinic), cancer type, stage in continuum of care, and socio-demographic characteristics?

• How can patient-centered communication be strengthened in the context of a crisis that disrupts cancer care?

RTI is the incumbent on the current Early Grade Reading Project (EGRP); USAID and GoN positive about Nepal EGRP, which was likely a strong contributing factor to USAID giving a sole source RFA to RTI. Based on feedback from the AOR, this new phase of programming will provide technical assistance in the education sector of Nepal to strengthen the capacity of national, provincial, and municipal government entities to improve learning outcomes for early grade students. The current Early Grade Reading Program (EGRP) led by RTI is a five-year, $53.8 million project to support the Ministry of Education to improve the foundational reading skills of Nepali primary school students in grades one through three. The project directly supports the National Early Grade Reading Program (NEGRP), which aims to help children to read with fluency and comprehension. NEGRP is led by the Ministry of Education with support from USAID and other donors under the Ministry’s School Sector Development Plan.



The 

The Data, Analytics, and Delivery for Impact group at the World Health Organization has asked RTI to provide additional work on the project to: map General Programme of Work 13 (GPW 13) Health-Related Sustainable Development Goals (HRSDG) Indicators to existing household surveys for a group of least developed countries; and b) map the 37 SDG indicators with the existing major international household surveys to determine what topics/questionnaires are available from existing household surveys that correspond to each of the indicators.

The Robert Wood Johnson Foundation (RWJF) seeks to identify and promote high-value, high-impact policy changes that can help low-income families support the healthy development of their young children. The goal of this agenda is to generate evidence to guide decision-making about policy changes that can better support families with young children. Research supported by this call will address gaps and limitations in SNAP, WIC, and Child and Adult Care Food Programs (CACFP), three federal programs that are instrumental in reducing food insecurity and increasing nutritional adequacy in children from vulnerable and disadvantaged backgrounds. The purpose of this grant is to test the feasibility and efficacy of one retail strategy know as bundling to increase participant satisfaction with the WIC shopping experience, lower average WIC voucher redemption costs, and increase total WIC customer purchasing at participating stores. 

This revised proposal addresses HIV prevention and treatment for young couples through a comprehensive biobehavioral multilevel approach. We plan to conduct stigma-reduction training in clinics and to address alcohol and other drug use, gender-based violence, sexual risk within couples and with other partners, and uptake and adherence to HIV prevention and HIV treatment, with the overarching aim of preventing new cases of HIV.

RTI Project #0216274 is a R01 grant from NICHD to co-PIs Carolyn Halpern (UNC-CPC) and Kerith Conron (UCLA). In synchrony with the multimode Add Health Wave V Program Project, this study will collect, clean, disseminate, and analyze new data from a subset of the Add Health cohort via an ancillary survey that will add critical information about formative experiences more specific to sexual and gender development and enhanced information about socioeconomic status and determinants of socioeconomic status. This project represents an unprecedented opportunity to prospectively study the intersections of sexual orientation, gender identity, SES, and health in a population-based sample across the life course. This additional opportunity is an NIH competing revision to add the additional SGM (~ 715) that meet the UNC/UCLA expanded criteria and to increase the incentive amount. 

The Michael Reese Health Trust and Crown Family Philanthropies have been leading an effort in Chicago "to increase understanding of the clear but under-examined connections between community violence and DV/IPV."  They recently assembled a table of service providers from both sectors to move the conversation forward and subsequently released an RFP for a planning/pilot year to develop “feasible first steps toward a more sustainable approach to preventing and reducing intimate partner and community violence.” Organizations that are participants in the newly formed collaborative are eligible to apply. The intent of the funding opportunity is to identify a group of collaborative leaders that will keep the effort moving forward and guide an innovative pilot.

HRSA requested to modify a contract to include two additional tasks under the existing contract (1) formatting the Home Visiting Budget Assistance Tool (HV-BAT) for 508 compliance and (2) facilitating a listening session on HV-BAT at the All Grantee Meeting in April 2020.

RTI is currently administering the 2019-2020 OPAS for OSU. We are preparing for the 2020 wave of data collection and the client wishes to administer additional questions related to COVID-19 that are not covered in the current scope of work. There will be 4 COVID-19 questions added to the survey for 10 out of the 12 birth cohorts for 2020 data collection. RTI is being asked to submit a budget to cover the additional work. The money will be amended to the current purchase order for the project. Unlike the base OPAS survey, the usual funding source is not able to fund this additional work. The client, OSU, is planning to allocate money to RTI from their own budget.

The Office of Agriculture Research and Policy (ARP) within BFS recently developed a new, internal strategic framework for crop innovation, which provides an integrated approach to support the development and scaling of improved crop varieties to function as drivers of productivity, growth, resilience, and nutrition. Though no one activity can span the entire pipeline of Research and Development (R&D), seed systems, dissemination, extension, and farmer adoption across the GFSS target geography, the crop innovation strategic framework provides a broad foundation to align and coordinate diverse USAID investments, across multiple operating units, for enhanced food and nutrition security impact. Together, activities implemented under this strategic framework tie downstream market demand to a continuously responsive, upstream breeding system; link improved crop varieties to the seed systems that take them to scale; and support seed systems to deliver improved varieties.

HANC has invited Dr. van der Straten to become one of the 10 investigators on the Cross-Network Behavioral Science Consultative Group (BSCG) in coordination and with support from the National Institute of Mental Health (NIMH).  They will provide 5% salary support.  The funding cycle for this project is Dec 1, 2019-November 30, 2020.  The group provides expert opinion as requested to the NIH HIV/AIDS Clinical Trials Networks on the behavioral components of their research agenda and studies.  Dr. van der straten will continue to represent the MTN on the BSCG and will use the connection to multiple networks to foster collaboration with new partners and pave the way for new projects for RTI in the future.

The Child Mind Institute is an independent, national nonprofit dedicated to transforming the lives of children and families struggling with mental health and learning disorders. With funding from JP Morgan, Child Mind Institute is beginning a new project with a comprehensive research phase to determine the information needs of our target audience, along with their attitudes towards mental health and learning disorders. They want to know how their audience accesses information about health and mental health, how they access support and care, and what the best formats are for reaching them. The target audiences for the Digital Parenting Resource are: low SES (family income 1.5 to 2 times federal poverty level); Spanish-speaking (Spanish is primary or co-preferred language at home); geographically isolated (in a designated Mental Health Professional Shortage Area). 

The Kenan Charitable Trust has invited RTI to apply for a grant. This is a planning grant that is issued to us to collaboratively plan how to advance equity in school districts with Village of Wisdom, Profound Gentleman and CREED (organizations that have previously partnered with Kenan). RTI brings the connections with school districts and facilitation acumen. This work just includes planning at this phase in hopes of developing a larger program of service beginning in the fall of 2020.

During this exploratory session, participants will learn how the brain is impacted by trauma and toxic stress and how these elements manifest in school environments. This awareness and reflection will then be applied to an understanding of the relationships between trauma sensitivity and multitiered systems of support. Discussion and implications for taking steps towards a comprehensive and universal approach to trauma sensitivity will follow along with time for planning the next steps. By the end of the session, participants will define and identify trauma and its types in a broad and inclusive way, illustrate and explain how the brain and body respond to stress and trauma, recognize and compare the impact of trauma on students, parents, school staff and the school environment, apply trauma knowledge to trauma sensitivity and multitiered systems of support.

The purpose of the MITS supplement is to provide administrative support to additional incentive grantees, as well as to support the materials costs for those kits. The supplement also includes funds to support a training center hub, technical support to grantees, a costing study, machine learning to facilitate Cause of Death classification, and additional funding to support more attendees at the annual meeting. This supplement also includes the previously submitted proposal for the Ethiopia Butajra Project. The purpose of that project is to determine cause of death of preterm and term infants at the community level using minimally invasive tissue sampling (MITS) conducted by non-pathologists through a process of task shifting/task sharing in Ethiopia. The availability of data on causes of mortality or stillbirth could facilitate development of a holistic approach to the preventive and curative care of infants in low resource settings, planning and ensuring clinical skills for managing 

RTI International has developed a Microsoft Excel-based costing tool for the World Health Organization and US Centers for Disease Control and Prevention's Global Hearts Initiative- a program that aims to improve the primary health care of noncommunicable diseases by controlling cardiovascular diseases and hypertension. Health departments in countries implementing the Global Hearts program can use the costing tool to provide patients with estimates of the cost treatment. This package leads to better decision making for patients and economic value created through its treatment.

The role of scientific innovation is noted widely in policies targeting economic growth in the U.S., and strategies concentrated on innovation are highly focused on science, technology, engineering, and mathematics (STEM) fields, which hold high potential for economic gains and growth from the commercialization of innovations. However, the effectiveness of policy to promote scientific innovation and economic growth relies on the broad participation of both men and women in all key steps on the path to commercialization; in STEM, the path begins with education and training in STEM fields and continues through STEM entrepreneurship and the development of the intellectual property. Despite the importance of participation across genders, evidence suggests that a gap exists between men and women in their engagement in STEM activities through their educational and professional careers. This report, prepared by RTI International for the National Women in Business Bureau, presents an examination of innovation among women in STEM fields by identifying gaps in their entrepreneurial outcomes and highlighting future opportunities for policy improvements.

Little research has been done to evaluate the campus climate of sexual assault for students with disabilities. In partnership with the National Council of Disability, RTI International helped to investigate current policies, programming, and barriers for students with disabilities in regards to a sexaul assault. The results of the research will provide recommendations for colleges and federeal agencies to create better policies and procedures for students on campus with disabilities who may have to with this issue on campus.

To prevent pregnancy and the spread of sexually transmitted diseases among adolescents, RTI International and the Family & Youth Services Bureau use the Sexual Risk Avoidance Education (SRAE) Program to implement sexual risk avoidance education to teach participants how to refrain from pre-marital sexual activity. By using effective strategies on how to avoid risk, SRAE builds healthy life skills, prevents pregnancy and STIs, and empowers adolescents to make successful life decisions.

In partnership with the U.S. Agency for International Development (USAID), RTI Internation uses research to assess the developmental challenges faced in Laos and customizes resources and assistance programs to create solutions for the development of Laos institutions, services, and skill development in areas such as gender and inclusion, financial management, and strategic planning. The project aims to sustain and improve human resources, create collaboration among civil society institutions across sectors, and increased connectivity of local services of support.

Understanding heart rate during newborn resuscitation in low and lower-middle income countries, can lead to appropriate medical treatment and increased life expectancy. Helping Babies Breathe (HBB) is a standard algorithm used to care for newborns who need resuscitation in low-income areas. Through NeoBeat, a battery-operated device used to measure newborn heart rate, newborns can have their heart rate displayed digitally within 5 seconds. This project will show the effectiveness of using both HBB and Neobeat to reduce stillbirths and generating heart rate guided breathing for 3 minutes. As a result, this project will attempt to reduce the stillbirth rate for these locations.

The Secretary of Health and Human Services’ Advisory Committee on Heritable Disorders in Newborns and Children (ACHDNC) has developed a thorough and rigorous evidence review process to evaluate disorders that are nominated for addition to the Recommended Uniform Screening Panel. The Florida Department of Health contracted with RTI International to develop a similar framework for the addition of conditions to the state’s mandated screening panel and to apply this framework to new conditions under consideration by the Florida Genetics and Newborn Screening Advisory Council (GNSAC) for the potential recommendation for addition to the state’s mandated panel.

In order for newborns to be identified with a disorder that affects them, newborn screening specimens (NBS) must be transported quickly to and from collection sites to the screening laboratory. To prevent the problem of delays, there may be a potential solution in using unmanned aerial systems, or drones, to deliver specimens. RTI International was tasked with reviewing challenges that occur with drone use such as flight distance, time, and pilot training and developing models to ensure a timely response.

With 20% of Rwandan youth being unemployed, Feed the Future-funded USAID/Rwanda Private Sector Driven Agricultural Growth (PSDAG) program partnered with the Rwandan Ministry of Agriculture and Animal Resources (MINAGRI) and the Rwanda Youth in Agribusiness Forum (RYAF) to launch a one-year paid internship program for youth in the agriculture sector. Through the program, young graduates with degrees and diplomas in agronomy, finance, food processing, and other relevant areas have been placed among 12 small agri-businesses and 48 cooperatives to complete their internships. RTI International is tasked with placing graduates in businesses and cooperatives that will lead them to full-time employment by helping to develop their professional skills and networking throughout the project.

RTI International and Room to Read created the Early Grade Reading Assessment (EGRA) to measure the reading performance levels in early grade readers globally to track improvements needed to education systems. These benchmarks give policymakers goals to better school systems which in turn empower students to pursue their education.

The Pelvic Floor Disorders (PFDs)  Network has conducted research to improve the clinical care of women, but their data is only accessible for users within the network. This data is needed by researchers to explore the safety and efficacy of surgeries using transvaginal mesh. RTI aims to create public datasets for studies, facilitate analyses that allow the use of the datasets, and share the datasets through the NICHD, allowing researchers to evaluate surgical procedures to treat PFDs with and without mesh devices, use abdominal and vaginal approaches.

New York State's Department of Health, Community Health Car Association of NY State, and IPRO developed and implemented a cancer screening registry within the Center for Primary Care Informatics (CPCI), a data warehouse that serves New York Federally Qualified Health Centers (FQHC). The registry aims to support quality improvement interventions to promote quality care for breast, cervical, and colorectal cancer screenings. RTI was tasking with interviewing key informants to understand the ongoing use of the CPCI in improving cancer screening, perceptions of the CPCI among clinical and administrative staff who participated in interventions at FQHC practices and assess the sustainability of spreading the use of CPCI for clinical use.

The Adolescent Pregnancy Prevention Program funds RTI to provide training and technical assistance support to grant recipients who are researching programming to learn more about teen pregnancy prevention. The project aims to provides planning and support for annual conferences, provides recommendations to grantees for speakers at conferences, monitors grantees program performance, and disseminates knowledge through a web-based resource center and technical assistance to ensure appropriate program implementation.

In this project, RTI International and Ogilvy work together to increase the impact of The Crisis Next Door campaign that aims to reduce the stigma associated with opioid addiction. RTI conducts formative research to develop key messages, evaluate the reach of the campaign, and assess how the stories affect people's knowledge, attitudes, and beliefs about opioid use disorder and those who have it. By confronting the opioid epidemic with a gender-focused lense, this project uses relatable stories of opioid misuse to start a nationwide conversation.

This type 3 hybrid cluster randomized trial evaluates a theory-driven implementation strategy relative to the standard implementation strategy used by the Addiction Technology Transfer Center as a means of promoting the uptake of contingency management in comprehensive opioid treatment centers.

RTI is working to combat wildlife trafficking in Tanzania with USAID by reducing poaching at the village level and by building capacity at higher levels with law enforcement to improve the rate of successful prosecutions of wildlife traffickers. By raising awareness of the effects of wildlife trafficking, lobbying decision makers, and building capacity with law enforcement, this project increases decreases transnational crime and creates economic opportunities for all. Often times, women and youth help to amplify the message that conversation is needed to change behavior and alter practices.

The Gender Integration Technical Assistance (GITA) task order under the Advancing the Agenda of Gender Equality (ADVANTAGE) indefinite delivery/indefinite quantity (IDIQ) contract provides technical assistance to the United States Agency for International Development (USAID). The program aims to reduce gender and economic gaps that inhibit the development of USAID projects, strategies, and activities. USAID Bureaus or Missions may use GITA to conduct gender and social inclusion analyses and assessments develop gender-responsive solicitations and procurements, facilitates staff and partner gender training, and provides research for drafting papers, case studies, and background briefings.

This project is a randomized trial that assesses whether the provision of multiple oral-fluid based HIV self-test kits to HIV-negative women at high risk of acquiring HIV in western Kenya is an approach that promotes HIV testing among women's sexual partners, facilitates better sexual decision making, and reduces women's risk of acquiring HIV. The study will determine the intervention's effect on the uptake of HIV testing and identification of HIV infection among partners, will assess safety perception of participants and their partners, and will assess the cost-effectiveness of the intervention and obtain information necessary to promote the intervention in other locations.

Waves for Change is a surf therapy program in South Africa that aims to develop emotional support programs to combat the emotional and psychological disorders due to exposure to violence that many young South Africans experiences. Surfing sessions can improve mental health and promote positive behavior changes for students. RTI supports this project by designing ways for the organization to identify gender biases, norms, and practices, to influence outcomes associated with their risk-reduction program.

The National Longitudinal Survey of Adolescent Health aims to determine what social, economic, and biological factors during adolescence and young adulthood can lead to chronic disease and poor health outcomes later in life. The Sexual Minorities add on collects information on the socioeconomic and developmental factors contributing to life-course stress and implications for sexual and gender minority health, enriching over 20 years of prospective data from a unique population-based sample of survey respondents.

The U.S. Department of State’s Bureau of International Narcotics and Law Enforcement (INL) in Costa Rica is strengthening the data collection efforts from Costa Rican national and local government entities, specifically within the criminal justice system. The project aims to consolidate statistics to better control Costa Rican gender violence, organized crime, and citizen security.

Adverse experiences during sensitive developmental windows—the time of conception, late pregnancy, infancy, and early childhood—can have long-lasting effects on children’s health. The purpose of this research is to better understand the effects of physical, chemical, and biological exposures, social and behavioral factors, and the natural and built environments on child health and development. This program is focused on five different health outcomes: pre-, peri-, and postnatal outcomes; obesity and its consequences; upper and lower airway conditions; domains of neurodevelopment; and positive attributes of healthy growth.

This project aims to develop and test methodology for collecting valid data on sexual assault and other dimensions of campus climate among college students. The study involved surveying approximately 23,000 undergraduate students at nine institutions of higher education through a confidential web-based survey. Using standardized and methodologically rigorous data collection procedures enables meaningful comparisons of victimization rates across schools and, for a given school, over time. This allows for a greater understanding of why some schools have higher rates than others, and what can be done to make campuses safer for all students. As a result of the CCSVS, a valid survey instrument and methodology for measuring sexual assault and campus climate related to sexual assault can now be used on a larger scale to understand and begin to address the issue of campus sexual assault.

The Water for Women Fund aims to strengthen collaboration between community, civil society networks, local authorities, service providers, and national stakeholders, to build a consensus on design, planning, and delivery of water, sanitation, and hygiene (WASH) programs. The project ensures gender equality and social inclusion in all WASH activities and helps to build recognition for policymakers to implement these practices.

In this systematic review on the benefits and harms of different treatment options for early-stage prostate cancer, this project will be used to build evidence maps for patients and clinicians to use while discussing treatment options.

Through a survey funded by the Arthritis Foundation, this project aims to research women of reproductive age who have rheumatoid arthritis and other autoimmune diseases to explore their information needs related to pregnancy and their health condition.

The Science, Technology, Research, and Innovation for Development Program is a program implemented by RTI in partnership with the United States Agency for International Development (USAID) that aims to activate innovation and entrepreneurship to eliminate poverty in the Philipines. STRIDE has created networking partnerships that awards scholars and grants to Filipino scientists and researchers, promoting diversity in initiatives to innovate the country.

Over the last two decades, NC has experienced one of the fastest rates of Latino population growth in the nation, resulting in rapidly changing behavioral health needs. Higher rates of trauma and different cultural understandings create an urgent demand for adapted behavioral health approaches. Too often providers face a research-to-practice gap based on several contributing factors: lack of access to up-to-date information in a specific practice field, lack of awareness of patient-centered outcomes research (PCOR) or a conceptual framework for uptake of PCOR findings, and lack of capacity to implement new practices based on those PCOR findings. Through research in partnership with RTI, El Futuro aims to develop a toolkit to assess unmet mental health services needs that can have devastating economic and social consequences for the Latino community. The project addresses challenges through patient-centered research that benefits both children and adults.

Improving Family Services Study (IFSS) collects data from families that have been involved with the child welfare system and develops designs of effectively created and deployed electronic consent form management systems, tracking systems integration, and data quality reporting to improve the quality of life for children.

The purpose of this workshop is to equip young Southeast Asian leaders to address noncommunicable diseases (NCDs) and mental health issues in their communities, providing opportunities for relationships with regional and global businesses, institutions, experts and peers to create positive change in their communities in countries.

Sponsored by the Centers for Disease Control and Prevention (CDC), the third round of NISVS collects valid and reliable information on the magnitude and trends in intimate partner violence, sexual violence, and stalking. The NISVS is a dual-frame national telephone survey of men and women drawn from a list-assisted RDD sample and a cell phone sample stratified by four U.S. Census regions and includes a nonresponse follow-up. In 2016-2017, 12,500 interviews were completed for the base year and 15,000 interviews were completed for the option year. Approximately 12,500 interviews will be conducted each year for option years 2 and 3. The base year (2017) includes a telephone survey of a random sample of 8,500 active-duty personnel (female and male) and 2,300 wives of married male service members.

Teens who are pregnant or parenting experience high rates of intimate partner violence (IPV). IPV can threaten the health and well-being of teen parents and their children. The purpose of this study is to adapt the evidence-based Safe Dates IPV prevention program to address the unique needs of teen girls who are pregnant or parenting.

In partnership with the Bill & Melinda Gates Foundation, this grant develops a biodegradable implant with TAF, a tenofivr pro-drug, that could provide sustained protection against HIV for 6 months to 1 year.

The overarching goal of this project is to develop a comprehensive and standardized platform to effectively evaluate the efforts of SAMHSA’s Center for Substance Abuse Prevention and its grantees to prevent and reduce substance use and related consequences. As the major task of the PEP-C project, RTI is evaluating the effectiveness of the Strategic Prevention Framework–Partnerships for Success (SPF-PFS) program, which aims to (1) prevent the onset and reduce the progression of substance abuse, prioritizing underage drinking among persons aged 12–20 and prescription drug misuse and abuse among persons aged 12–25; (2) reduce substance abuse-related consequences; (3) strengthen prevention capacity and infrastructure at the state and community levels; and (4) leverage, redirect, and align statewide funding streams and BUBEN, 2 resources for prevention. Coordinates with grantees and their subrecipients to improve quantitative data quality, conducts analyses for manuscripts and cross-site evaluation reports, and serves as project coordinator for the Data Collection and Analysis task orders in the SPF-PFS evaluation.

RTI supported the development of guidelines on microscopic hematuria and counseling for urinary incontinence in obese women for the American Urogynecological Society.

Through a grant awarded by the Jacob's Foundation, this project examines the available evidence for the effectiveness of psychosocial intervention for promoting well-being following children's exposure to intimate partner violence.

The Partnership for HIV-Free Survival is funded by USAID’s President’s Emergency Plan for AIDS Relief program and uses a quality improvement approach to scale up prevention of mother-to-child HIV transmission (PMTCT) programs in six sub-Saharan African countries. The evaluation uses a mixed methods approach to measure if health facilities implementing quality improvements have a greater impact on HIV-free survival of HIV-exposed children at 18 months of age than health facilities offering the standard of care. Using facility data collected throughout the period of implementation in PHFS and non-PHFS sites, we are applying a multivariable time series analysis to identify the factors that contribute to HIV-free survival.

For this nationwide study of over 10,000 women at eight academic clinical sites across the United States, manages data and provides statistical support for the goal of identifying maternal, placental, and fetal growth parameters associated with preterm birth, most specifically related to the adverse pregnancy outcomes of hypertensive disease of pregnancy, intrauterine growth restriction, and spontaneous preterm labor.

The purpose of this project is to design and plan a Regional Center of Research Excellence for NCDs in India. The consortium is led by the Public Health Foundation of India, RTI International‒India, and Emory University. RTI will implement the community engagement plan to develop consensus on research priorities for NCD prevention and control in India. RTI also will conduct a mixed methods study to describe the prevalence and correlates of cancer-related perceived stigma and investigate cancer- and diabetes-related knowledge and psychosocial barriers to diagnosis and treatment, including fear, stigma, anxiety, and depression.

This Development and Implementation Project (DIP) funded by the National Science Foundation's Cyberlearning and Future Technologies applies an interactive design-based research process to design a new form of virtual knowledge building community that enables co-created citizen science investigations around local impacts of weather and climate on coastal communities.

This project aims to increase HPV vaccination rates for 11 and 12-year-old patients at Federally Qualified Health Centers (FQHCs) and Community Health Centers across the nation. RTI evaluated a pilot program at 11 FQHCs to provide technical support and create a manuscript.

RTI works collaboratively with USAID to establish an economic observatory that strengthens civil society engagement at national and local levels for a more effective advocacy role to advance public policies and programs that foster sustainable economic and social development. The project focuses on the following development themes: rural development and food security, agricultural sector growth, the environment, including climate change resilience and biodiversity conservation, and competitiveness and the business enabling environment.

Provides expertise in infectious disease surveillance and outbreak investigation, statistical analyses, and state and local health department operations and serves as primary liaison with state and local public health officials. We are assessing prevention and treatment resources for opioid users in western NC and identifying ways to improve capacity over time by evaluating the gender differences of addiction with injection drugs. This includes training health care providers to provide hepatitis C virus care and other services to people who inject opioids; employing bridge counselors to link people who use opioids to services across different settings; and establishing syringe service programs to reduce opioid-related morbidity and mortality.

This multiyear, multisite research project supports the U.S. Department of Defense HIV/AIDS Prevention Program (DHAPP) in successfully implementing HIV research with foreign militaries in President’s Emergency Plan for AIDS Relief (PEPFAR) countries. The project collaborates with national Armed Forces to complete data collection and quality assurance.

The purpose of the survey is to investigate the prevalence and severity of sexual harassment within NIH and its impact on people’s careers and decision to stay in science.

With the Bureau of Justice Statistics, this project seeks to combine its law enforcement data collections into a cohesive law enforcement collection program and reshape its
content to focus on agency performance and measures needed to better describe contemporary topics related to agency staffing, regulations, and policies. By redesigning the data collection components, BJS will be able to provide detailed information about law enforcement agency performance that aligns these data with an ongoing national debate about the need for new measures and metrics for law enforcement agencies in relation to its impact on various genders.

Research and Evaluation Survey for the Public Education Campaign on Tobacco among LGBT (RESPECT LGBT) is an important research study, sponsored by The Food and Drug Administration’s Center for Tobacco Products (CTP). RESPECT evaluates the effectiveness of media campaigns in local bars and nightclubs designed to reduce tobacco use among young adults, ages 18-24 within the LGBT network. Data Collectors work with their team to help bar patrons complete a short screening using a hand-held tablet. This project is the continuation of RTI's evaluation of FDA CTP's LGBT-targeted media campaign "This Free Life." This study will provide the FDA's, policymakers, and researchers with critical information about awareness and exposure to This Free Life messages on preventing and reducing tobacco use. The information this study collects will also improve our understanding of how campaigns affect the target audience’s attitudes, beliefs, and behaviors toward tobacco use.

No studies report whether improvements to commercial weight-loss programs affect retention and weight loss. Similarly, no studies report whether enrolling in a program through work (with a corporate partner) affects retention and weight loss. This study aims to determine whether improvements to a commercial program and enrolling through a corporate partner are associated with greater weight loss that is because of improved retention.

As a growing number of governments in low- and middle-income countries take on the provision of early childhood education (ECE), they face the challenge of building a capable workforce of ECE teachers who can provide high-quality, developmentally appropriate instruction to learners at a critical period in their cognitive and social-emotional development. This project implements a pilot kindergarten program by taking teachers beyond traditional, lecture-based instruction to play-based, student-centered approaches for teaching oral language skills and emergent literacy.

Every year, 40 million people around the world die from noncommunicable diseases (NCDs), including heart and respiratory ailments, diabetes, and cancer. Major NCD risk factors, such as tobacco smoking, harmful alcohol use, and obesity are increasing worldwide, including among adolescents. We conducted an economic analysis to determine the potential costs and return on investment for the implementation of interventions for adolescent NCD risk reduction globally. Our findings show that full implementation of all six of the evidence-based interventions we reviewed would reduce premature mortality among today’s adolescents by almost 10 percent. This translates into 21 million avoided premature deaths from NCDs over the next 50 years and about US$400 billion in cumulative economic benefits. By intervening now and implementing these policies, low and middle-income countries can significantly reduce premature mortality from NCDs at reasonable costs, contributing to their country’s productivity and longevity.

Mucopolysaccharidosis Type I (MPS I) is a rare genetic condition that affects about one in every 100,000 newborns nationwide. This disease causes a buildup of a specific kind of sugar in the lysosomes of cells, and in its most severe form—known as Hurler’s Syndrome—usually causes death before the age of 10. This study will demonstrate that screening for MPS I can be done as successfully and as reliably as screening for other newborn diseases. The fact that we were able to identify one infant with severe MPS I, and facilitate the proper medical intervention, shows the potential benefits of screening for this rare disease on a nationwide basis.

One-sixth of the worldwide population–more than 1 billion people—suffer from one or more neglected tropical diseases (NTDs). These diseases devastate the world’s most vulnerable populations, striking the poor and people in rural areas and urban slums in low-income countries. Many NTDs cause severe disfigurement and disability and come hand-in-hand with poverty because they thrive where access to clean water and sanitation is limited. This project sets out to improve the evidence base for determining and assessing action to control and eliminate targeted NTDs, increase drug administration coverage for at-risk communities, and strengthen capacity for implementing NTD control and elimination programs. We target the hardest-to-reach and most vulnerable communities, conduct surveys to assess impact, and help countries complete the World Health Organization’s certification process, which confirms the successful elimination of these diseases.

RTI International and project investigator Mary Muth partnered with researchers at the U.S. Department of Agriculture’s Economic Research Service to determine the extent to which reformulation of foods frequently consumed by children and adolescents could improve the healthfulness of those foods and, subsequently, diet quality. Because reformulation could raise the costs of manufacturing foods, we also assessed whether healthier foods have higher average prices than less healthy foods. Our results show it is possible to improve dietary quality for households with children and adolescents by reformulating just 12 frequently-consumed foods using nutrition standards that already exist. The impact on diet quality can be achieved by changing the food supply, which benefits all consumers—not just those who are nutritionally aware—and can complement efforts to change eating behavior. These results are particularly encouraging given the interest some governments have shown in using reformulation as a tool to reduce childhood obesity, food companies’ increasing interest in participating in voluntary industry initiatives aimed at improving the healthfulness of foods, and upcoming changes to the Nutrition Facts label set to take effect in 2020. However, if reformulation leads to substantial changes in the taste or price of foods, improvements to dietary quality may be more limited.

Menstrual hygiene management (MHM) aims to fill a gap in the water, sanitation, and hygiene (WASH) sector by bringing a focus specifically on menstrual hygiene safe disposal in low- and middle-income countries (LMIC). RTI International and project investigator Myles Elledge found that the disposal of used absorbents cannot be understood and carried out in isolation, requiring user-centered design thinking to consider socio-cultural norms regarding menstruation, product availability, quality and use, and existing sanitation systems. In institutional and community settings, the design of sanitation systems needs to be responsive to and plan for disposal of menstrual waste, incorporating it into both the sanitation and solid waste management parts of a WASH program, providing appropriate, discrete and sound solutions that minimize adverse health impacts on girls and women, sanitation workers, and broader environmental consequences.

In response to the need for national-level, representative data on early childhood development before the start of formal schooling, the Measuring Early Learning Quality & Outcomes (MELQO) project was founded by three United Nations organizations and one non-governmental organization, UNESCO, UNICEF, the World Bank, and the Brookings Institution. In partnership with RTI International and Project Investigator Maria Dzula, this study examines the development and learning of 684 Tanzanian children starting school, averaging 7 years of age. A primary goal was to evaluate the psychometric properties of a globally-informed measure of school readiness. Using multiple measures including newly-developed direct assessment, and teacher and parent reports of child development, we hypothesized that children's development and learning would demonstrate expected constructs of academic and social/emotional skills and associations with family and child characteristics. Children's direct assessment scores factored into five domains measuring pre-mathematics, pre-literacy, executive functioning, fine motor skills, and socioemotional knowledge. Teachers' reports of children's social/emotional abilities factored into three domains measuring children's social competence, attention/self-regulatory abilities, and problem behaviors. Structural analyses indicated that children's attentional/self-regulatory abilities were associated with their direct assessment scores. Future research should examine these constructs in other countries, with additional methodologies to examine cultural fit and relevance.

In partnership with the Bill and Melinda Gates Foundation, RTI International and project investigator Linda Squiers worked together to analyze the Gender-based violence (GBV), particularly violence against women and girls (VAWG), that is deeply
rooted in India’s patriarchal social fabric. In addressing GBV and VAWG in India, the Population Foundation of India (PFI) developed a
communication intervention delivered through various digital and social media platforms. The
Bas Ab Bahut Ho Gaya (‘Enough is Enough’) campaign, as it was titled, was designed to engage
youth 15 to 24 years of age, on the issue of GBV and VAWG, with the centerpiece of the
intervention being a series of six short films featuring a range of topics related to GBV and
VAWG. Additionally, three of the six films featured Indian celebrities. The stated goal of this campaign was to positively influence youth knowledge, attitude, and
perceptions related to GBV, particularly VAWG, through sustained digital media interventions
and engagement.

 

In 2014, we were contracted by the Medtronic Foundation to implement HeartRescue Global, an extension of an already existing HeartRescue program in the United States, in selected cities in China, India, and Brazil. The goal of HeartRescue is to create an effective STEMI response program, geared to the unique needs of the local community, that speeds time to effective treatment and improves access to quality health care—in other words, to ensure that all of the medical and EMS infrastructure is on hand to enable effective reperfusion treatment and increase STEMI survival rates. With cardiological issues being the leading cause of death for women, RTI International's Global Gender Center became involved along with project investigator Michael Trissolini. Vitória da Conquista, Brazil, serves as an important regional center for health care, including several smaller cities in its surrounding region of Bahia and Minas Gerais. Our program here is less advanced than in Suzhou or Bangalore; we originally had planned a HeartRescue effort in Sao Paolo, which was discontinued. As an example of the challenges, Vitoria da Conquista faces, the only publicly funded reperfusion strategy currently available for STEMI patients in the public health care system is through thrombolytic medications in the General Hospital—that is when thrombolytic drugs are available. We believe that the development of a multi-faceted intervention in Vitória da Conquista, including the community, EMS, and public and private hospitals, along with expanding access to thrombolytic medications and privately funded PCI services, will enable improvements in care for STEMI patients. As in China and India, we are developing a systematic STEMI patient registry data-collection system that focuses on the quality measures standardized for the HeartRescue Global program, which will enable tracking of patient access, reducing time to effective reperfusion treatment, and continuous quality improvement of STEMI interventions. In June 2018 we began the fourth year of our five-year HeartRescue Project in China, India, and Brazil. We are hopeful that the comprehensive approach to interventions across the community, EMS, and hospitals, and the progress we have made in treating STEMI in a more timely fashion, will provide a model for other cities in these countries.

In partnership with the nonprofit organization ZERO TO THREE, RTI International and Cecilia Casanueva are creating a system to protect children from harm and ensure safety, permanency, and well-being. The process, though, is complicated, involving families, courts, public and private agencies, schools and child care providers, nonprofit groups, and more. ZERO TO THREE designed a new approach for supporting the health, mental health, and developmental needs of young children in the child welfare system and expediting safe and nurturing permanency outcomes. Known as Safe Babies Court Team^TM (SBCT), this approach is a collaborative, problem-solving systems-change innovation focused on supporting the health, mental health, and developmental needs of babies and toddlers under the court’s jurisdiction and expediting safe, nurturing permanency outcomes.

International Cohort Study of Children Born to Women Infected with Zika Virus During Pregnancy (ZIP 2.0) RTI and will serve as Data Coordinating Center (DCC) for the ZIP 2.0 Study, titled "International Cohort Study of Children Born to Women Infected with Zika Virus during Pregnancy". RTI and Project Developer Brittany Goode will support the development of case report fonns (CRFs), study definitions, and the data management system (OMS) in REDCap, available as both a central and distributed system in English, Spanish and Portuguese, for 6 sites in Latin America. In addition, RTI will develop and implement data edits for key variables, produce monitoring reports and respond to ad hoc requests for data reports. RTI will facilitate routine conference calls and site visits required to carry out the implementation and governance of the ZIP 2.0 protocol. The ZIP 2.0 database will meet FISMA IT security requirements as outlined in Task Order 6. ZIP 2.0 is an extension of the Zika in Infants and Pregnancy (ZIP) study protocol that will continue the longitudinal follow-up of up to 400 children. Of the 400 children, approximately 200 were born to women with documented Zika virus infection during their pregnancy and 200 were born to women without documented Zika virus infection during their pregnancy. Participants enrolled will be followed for up to 3.5 years of age. The primary aims of the ZIP 2.0 study are to (1) determine the long-term neurodevelopmental outcomes among children born to women with documented Zika virus infection during their pregnancy, and (2) compare growth, vision, hearing, and neurodevelopment among children exposed to Zika virus in utero compared with unexposed children.

Under the East Africa Energy Program, RTI and Project Investigator Randall Wood will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade.  We will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. We will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

RTI assisted USAID in expanding affordable and reliable electricity services in East Africa, with the ultimate goal of supporting development priorities, including inclusive economic growth, security, and improved health and education outcomes. Under the East Africa Energy Program, RTI will work to optimize the region’s power supply, increase grid-based power connections, strengthen utilities, and increase the region’s power trade. The project will deploy an adaptive management approach, consistent with USAID’s collaborating, learning and adapting (CLA) approach, to program design, implementation, and management. RTI will also build on our previous work to increase gender equity in the power sector by promoting women’s leadership, adopting a gender-balanced approach to training, and providing mentoring and coaching to female leaders across the region.

This project will complete intervention development and tablet programming and conduct a randomized control trial to assess the effectiveness of tailored tablet-based Sexual Assault Prevention Interventions.

This study plans to increase uptake and adherence of preexposure prophylaxis (PrEP) for HIV prevention among vulnerable HIV-negative adolescent girls and young women, aged 16-24 who engage in high-risk sex, through a multilevel HIV prevention strategy that addresses stigma and discrimination in accessing health care, social support, and individual risk behaviors.

As an ancillary study to the BMGF-funded trial on preconception maternal nutrition (The Women First Trial), UCD did a comparison of the infant outcomes, comparing assessment using the traditional evaluation (Bayley Scales of Infant Development) vs. the Inter-NDA. The Inter-NDA is a new tool to assess neurodevelopment, which requires less time and resources to administer than the BSID and thus may be advantageous to use in low-middle income countries. RTI provided support for the data collection and analyses of the outcomes of infants who are tested for this study.

 

RTI served as a data coordinating center for a case-control study of approximately 7,500 - 10,000 pregnant women with Zika and develop the data management system, monitoring study enrollment and data quality as well as providing statistical analyses of outcomes of interest.

The evaluation of this breast cancer screening media campaign is to gauge reactions to the campaign, assess its effectiveness, and inform future iterations of the campaign.

The purpose of the survey is to evaluate a cancer fertility intervention in TX and to gather national data about cancer patients' unmet needs.

The study scope included review of extent on which women in science, engineering, and medicine are victimized by sexual harassment on college and university campuses, in research labs and field sites; at hospitals/medical centers; and in other academic environments. RTI also examined existing information on the extent to which sexual harassment in academia negatively impacts the recruitment, retention, and advancement of women pursuing scientific, engineering, technical, and medical careers, with comparative evidence drawn from other sectors, such as the military, government, and the private sector. And lastly, RTI identified and analyzed policies, strategies and practices that have been the most successful in preventing and addressing sexual harassment in these settings.

The proposed study is designed to (1) identify specific neurodevelopmental precursors of varying levels of alcohol use; (2) track the developmental progression of neurocognitive functions in users, heavy episodic drinkers, and nonusers; and (3) isolate the potential neurodevelopmental consequences of varying levels of alcohol use from precursor conditions.

This study examines the processes that drive effective translation of an evidence-based parent-child interaction therapeutic treatment into the novel context of the court system, to intervene early and promote emotional wellness in cases of infant/toddler maltreatment.

The objective of the National Intimate Partner and Sexual Violence Survey (NISVS) is is to build a national surveillance system by using a rigorous approach to maximize the completeness and quality of the data, which will allow the interagency team of CDC in collaboration with the National Institute of Justice and the Department of Defense to provide regularly updated, accurate, reliable, and representative data on the prevalence of IPV, SV, and stalking.

This project is a preeclinical development of a new silicone-based female condom. RTI conducted the feasibility and preliminary functional performance/acceptability components of the project.

This project funded by the UNC CFAR adapted an HIV prevention intervention for Black and Coloured couples in South Africa for use with Hispanic couples in North Carolina. The project will be conducted in two phases. The formative phase will use focus groups with Hispanic couples and with local services providers to inform the adaptation of the couples' intervention that was originally developed for use with couples in South Africa. The pilot phase of the project will use a single group pre-test post-test design to assess the feasibility and acceptability of the intervention with Hispanic couples in North Carolina. Findings from this study provided preliminary data for an R34 proposal to further refine the intervention and test it in a small randomized trial.

The goal of MANDATE is to provide an evidence-based framework for the global community to prioritize technology development to reduce maternal, fetal, and neonatal mortality. During the first year of the MANDATE supplemental award, MANDATE has focused on augmenting three key outcomes: (1) developing models that predict lives saved for priority maternal and neonatal conditions, (2) expanding relevant technology briefs for existing and emerging technologies, and (3) improving the user interface and experience for users who wish to access MANDATE's model via a Web interface.

This project had four main aims: (1) To characterize the types of drinking venues, their immediate context, and surrounding neighborhood characteristics in the sampled neighborhood blocks in several large Black/African and Coloured communities in Cape Town, South Africa; (2) To refine through qualitative methods the proposed interventions in relation to skills-building to address gender-role expectations, sexual partnering, gender and power, violence, and environments where drinking and sexual risk behaviors occur; (3) To conduct a randomized group trial to compare the relative efficacy of a comprehensive intervention to the gender-focused intervention on reducing AOD use, sexual risk behavior, and GBV at 6- and 12-month follow-ups; and (4) To assess the mechanisms through which the intervention effects may occur and to identify groups for whom the interventions have the greatest effect on study outcomes of AOD use, sexual risk, and GBV.

This study compared the costs and benefits of personalized medicine to identify the approaches that will be the most cost-effective to screen younger women to identify those at increased risk of developing breast cancer. This modeling study assessed the cost-effectiveness of breast cancer prevention/screening activities directed at younger women. Specifically, it can identify which current and future technologies when targeted at a specific cohort of young women will be the most cost-effective. This study is critical for the establishment of prevention/screening programs for young women as guidelines and coverage decisions are now largely based on long-term impacts identified through modeling studies.

This project developed and tested an interactive, multimedia, Web-based Family Planning Counseling Aid (FPCA). The FPCA was designed to be a low-cost tool that will improve clinic efficiency by enhancing the quality of family planning (FP) services without increasing the providers' counseling workload. The implementation of the FPCA will help patients to be better informed and more engaged in the counseling process and to make more realistic contraceptive choices. The tool will also help clinicians to make their counseling more patient-centered and to feel more satisfied that contraceptive decisions are right for each client.  Specific aims of the project were to develop the FPCA, assess the feasibility of integrating the FPCA into FP clinics' workflow and the usability of the tool by both clients and providers, and assess the impact of the FPCA on the quality and content of counseling. Study sites were two FP clinics--a county health department and a Planned Parenthood clinic. To develop the FPCA, RTI International reviewed existing counseling and decision support tools and sought input from an expert panel. To ensure that the FPCA meets the needs of both patients and clinicians, RTI conducted pretests using interactive mock-ups of the tool and getting reactions through focus groups with clients and interviews with clinicians. RTI then developed a prototype of the FPCA and pilot tested it with clients and clinicians.

RTI International conducted a participatory process evaluation with three programs [Standing Against Global Exploitation (SAGE) Project, Inc., The Salvation Army Trafficking Outreach Program and Intervention Techniques (STOP-IT), and The Streetwork Project at Safe Horizon] that provided comprehensive services to male, female, and transgender domestic minor victims of human trafficking. The service programs were funded by the U.S. Department of Justice, Office for Victims of Crime (OVC) and collectively served 201 young people during the study period (January 2011 through June 2013). The process evaluation focused on describing program operations and implementation experiences as the groundwork for refinement of program models and evaluation strategies. The goal of this project was to generate much-needed information on the trafficking of minors, including the characteristics and needs of youths who are victims of sex and labor trafficking. Findings from the evaluation identified promising practices in the delivery of comprehensive services to best meet the needs of trafficked youths.

The Zimbabwe AIDS Prevention Project (ZAPP), on behalf of the Zimbabwe National AIDS Council (NAC), operates a program that provides health care for sex workers at 16 sites around Zimbabwe. Over 6,500 women have attended the program to date, with over half attending on multiple occasions. Eight mobile health care workers currently manage patient records for these 16 sites. Data are collected using two forms: demography and encounter. ZAPP would like to replace the existing paper-first data collection system with an electronic-first system. This project will develop an electronic system based on RTI's Coconut mobile application platform for use on tablet computers. 8-10 nurse counselors will use tablet computers to collect and manage case data offline. Data will be synchronized with a shared cloud database from 6 Internet-connected hub locations.

The objective of this project is to provide CDC with the highest quality health marketing materials that will resonate with their target audience and that will further CDC's goals in the areas of HIV testing and prevention.

Recent surveillance data indicate that HIV prevention and testing efforts aimed at reducing the risk of acquiring or transmitting HIV infection among men who have sex with men (MSM) must be expanded. The overall increase in HIV diagnoses among MSM is also coupled with racial and age disparities. To address this issue, RTI conducted a series of formative, process, and outcome evaluation tasks for the HIV testing campaign, which targeted African American MSM, and for the HIV prevention and testing campaigns, which target African American, Caucasian, and Latino MSM. Some of the tasks performed at RTI included: developing and submitting Institutional Review Board (IRB) protocols and Office of Management and Budget (OMB) packages for formative research, evaluation planning for the HIV prevention and testing campaigns that target all three segments of MSM, conducting formative research, and the execution of evaluation plans developed for the HIV prevention and testing campaigns for all three racial/ethnic segments of MSM.

RTI International conducted a project for the Centers for Disease Control and Prevention (CDC) that involved expanding a dynamic, compartmental model of HIV that was developed by CDC using Stella software and that contained a single risk group: men who have sex with men (MSM). Under this project, the project team modified the Stella model to add heterosexuals, intravenous drug users (IDUs), and women. However, even after this modification, the Stella model was still unable to easily handle additional model complexity, such as differences in HIV risk across racial/ethnic groups and mixing of HIV risk subpopulations. So, RTI, reconstructed the Stella model using MATLAB to include racial/ethnic differences and incorporate methods that capture the infection risk of each subpopulation and mixing of the modeled subpopulations. The MATLAB model included an optimization component so that strategies to minimize the number of new HIV infections could be identified. RTI also trained CDC's Prevention Modeling and Economics Team (PMET) on the MATLAB model so that PMET staff could run the model and refine it over time.

RTI worked with CDC to conduct project tasks targeting various audiences, including women and men of reproductive age, parents, early educators, and health care providers. The team conducted research to understand what these various audiences know about behaviors that could help or harm the healthy development of babies and children. The main research focus areas included preconception health among women and couples and the prevention of birth defects, such as fetal alcohol syndrome and cleft lip and palate. Other research areas included understanding perceptions about Down syndrome and finding out what pregnant women could and would be willing to do to protect themselves and their families during pandemic influenza.

There is a need for health communication research among African Americans in order to develop effective prevention messages that connect with their everyday realities and that speak to them with relevance. In an effort to address this need the Centers for Disease Control and Prevention (CDC) contracted RTI to complete four tasks: (1) Conduct a comprehensive literature review to inform the development of effective prevention messages for African American audiences; (2) Develop a screening instrument, a moderator guide, and institutional review board (IRB) protocols for CDC and RTI; (3) Conduct four rounds of exploratory research, which included exploring topics such as stigma, social determinants of health, and message bundling, facilitating focus groups with African American men and women across five locations in the United States, hosting group discussions with professionals from health, legal, media, business, and law enforcement, and pretesting messages with a small sample of the target audience prior to implementing them in the pilot project; and (4) Develop a pilot project to test the efficacy of the recommended intervention developed in Task 3 within one African American community located in a High Morbidity Area (HMA).

RTI International staff brought together behavioral scientists, engineers, medical scientists, epidemiologists, and health economists to create a new audio computer-assisted self-interview (ACASI), interactive counseling and self-testing computer tool (CARE-India) to support HIV prevention research. The aims were the following: (1) Culturally adapt the CARE tool for Southern India and add functionality for fingerprint recognition and confidential linking of longitudinal risk data and automated computer interpretation of rapid HIV test results and (2) Field test the CARE-India tool among 300 participants to determine the accuracy of fingerprint identification and the accuracy of computer-assisted self-testing for HIV, and to measure the acceptability of staff assessment and testing versus the acceptability of optional ACASI assessment and computer-assisted self-testing when delivered in a general health assessment and offered with diabetes testing. CARE-India could have a large impact in this region by providing the option of HIV self-testing methodology, with improved accuracy of interpretation and documentation, and enhancing participation in HIV-related research studies.

This study examined the relationship between social position (e.g., gender, socioeconomic status, race/ethnicity) and gender roles in predicting partner selection patterns and unsafe sexual behaviors among a longitudinal cohort of socioeconomically and racially diverse adolescents and young adults. As a sub grantee to Johns Hopkins University on this study, RTI International advised on the sampling methodology, prepared the sampling frame of the proposed target population, and assigned analytical weights to adjust for the unequal probability of selection of youths in households and enable design-consistent estimation of population parameters.

Legacy for ChildrenTM is a group-based intervention aimed at improving child outcomes by fostering positive parenting among low-income mothers of infants and young children. The Legacy approach is unique in its emphasis on the group context as a contained, small-community venue for guided learning, mutual aid, reinforcement of new ideas and skills, and an expanded social network. The Centers for Disease Control and Prevention (CDC) entered into an agreement with the Administration for Children and Families (ACF) to collaboratively explore the feasibility of implementing the Legacy model within the Early Head Start (EHS) infrastructure. To do this, CDC contracted RTI International to provide Legacy program training and technical assistance. RTI’s role in this project involved (1) participating in the Legacy train-the-trainer workshop, (2) conducting training of EHS-Legacy staff, (3) providing ongoing technical assistance to EHS-Legacy staff, and (4) providing post-implementation training. Findings from the training evaluation suggested that reactions to the training were mostly positive.

The longer lifespan of HIV-positive persons receiving highly active antiretroviral therapy (HAART) and the side effects of HAART therapy have created the need for research into new or modified manifestations of HIV infection and AIDS and clinical outcomes in patients on long-term HAART treatment. Moreover, responses to HAART and its toxic effects, lipodystrophy, cardiovascular disease, neuropsychiatric complications, may be affected by gender and race. So, to initiate this necessary research RTI led the Central African regional data center (Region 9). In this role RTI was responsible for various study activities including: (1) identification of critical HIV/AIDS-related questions or interest in the region that cannot be answered by one site alone; (2) training on data collection, processing, and cleaning to ensure quality data was collected at the local sites; (3) assistance to research units in order to obtain institutional review board (IRB) approval at their institutions; and (4) development of AIDS-related cancer research activities, including the development of an active surveillance system in Cameroon and improved cervical cancer screening in Rwanda.

The literature on HIV risk and alcohol use among Latino labor migrants documents numerous risk factors, such as multiple sex partners, sex with female sex workers, sex between men, low condom use, high rates of sexually transmitted diseases (STDs), and high alcohol use that co-occurs with sexual activities. Although no studies document the high prevalence of HIV among this population, documented risk behaviors and environmental conditions suggest that if HIV enters Latino migrant day laborer (LMDL) networks, there is a high likelihood of an epidemic. Also, existing studies focus almost exclusively on behavioral risk with little consideration of the context of such risk. The aim of this study was to explore the structural-environmental factors associated with alcohol-related sexual HIV risk in LMDLs. A main objective was to develop and test a theoretical model of risk and prevention in LMDLs coping frequently with alcohol-related situations in which safer sex is difficult to practice. Results informed recommendations for developing structural-environmental prevention interventions to decrease alcohol-related sexual HIV risk in LMDLs.

To better understand the circumstances, motivations, and social environments of injection initiation later in life (after turning 30 years old), RTI International conducted a quantitative and qualitative study of late initiation to injection drugs. The study had the following three aims: (1) To explore attributes of drugs and drug injection among late initiates using life course theory (LCT) constructs; (2) To describe individual characteristics, drug use histories, and key life events of late initiates as compared with typical initiates using LCT constructs; and (3) To explore the interpersonal, social, and structural environments of late initiates compared with typical initiates using LCT constructs.

This study examined the space-time patterns of HIV risk behaviors among injection drug users (IDUs) and HIV prevention services in the San Francisco Bay Area from 1987 to 2005. The project team modeled the relationship among neighborhood characteristics, neighborhood HIV prevention services, and individual HIV risk behavior outcomes among IDUs. Research on HIV and illicit substance use has traditionally focused solely on individual-level characteristics that confer risk. Emerging research in the areas of HIV and illicit substance use has identified the importance of considering social environmental factors, including access to health care services, when studying individual health behaviors. This study involved applying newly emergent spatial analytical methods to secondary data sets to refine the knowledge regarding how neighborhood characteristics might be associated with access to HIV prevention services and HIV risk among street-based IDUs. RTI's work adapted the well-known Behavioral Model of Vulnerable Populations (BMVP) to incorporate a well-developed conceptualization of the spatial interaction between contextual variables and individual behavior.

This project involved developing adaptation packages to accompany school and family based interventions to prevent dating violence in high-risk inner-city settings and developing interactive web-based resources to assess capacity and readiness for the implementation and evaluation of violence prevention strategies.

Girls' Improved Learning Outcomes (GILO) in close collaboration with the Ministry of Education (MOE) improved the quality of teaching and learning and expanded girls' access to quality education across Egypt. During 2007-2013, RTI helped the MOE decentralize GOE funds and key roles/responsibilities around finance, budgeting/planning, procurement, and accountability. As a result, billions of Egyptian pounds (EGP) have been and continue to be devolved by the center to schools and lower level jurisdictions along with the decision-making authority to use them in ways they feel best address their educational needs. Moreover, RTI support during Phase 2 (2011-2013) assisted the MOE to begin to institutionalize a number the early grade reading components to ensure that they become a more permanent aspect of the educational landscape. This occurred by the establishment by decree of Early Grade Learning Teams (EGLTs) within the MOE, muderiyas, idaras, and schools, revised grade 1 Arabic curriculum, revised grade 1-2 Arabic textbooks; and PAT certification of the EGR training program, workbooks, and trainers.

HealthGov aims to strengthen LGUs' commitment to health and enhance their capacity to sustainably provide, finance, and manage quality health services, particularly for such programs as family planning, maternal and child health, and control of diseases such as tuberculosis, avian influenza, severe acute respiratory syndrome (SARS), A(H1N1), and other emerging infectious diseases.

The purpose of this project was to increase an effective regional response to prevent and mitigate HIV/AIDS, malaria, tuberculosis (TB), avian influenza and other emerging infectious diseases among men, women, and children. To achieve this objective, USAID/ the Regional Development Mission for Asia (RDMA) set the following intermediate results: (1) Improved access to prevention, care, and treatment to reduce and mitigate the impact of infectious diseases, (2) Strategic information collected and used for program improvement monitoring and documenting outputs, outcomes, and impact, and (3) Provision of technical assistance and capacity building linked to scale-up of effective models.

RTI partnered with the Uganda People's Defense Force-HIV/AIDS Control Program to implement comprehensive HIV-related services for military personnel and their families, helping soldiers and their dependents through HIV counselling and testing, prevention of mother-to-child transmission of HIV, better care and treatment of the infected, improved diagnosis and management of tuberculosis, and programs that mitigate the effects of HIV on orphans and vulnerable children (OVC). With a focus on providing quality services to this underserved and hard-to- reach population, the project has provided clinical mentorship on the diagnosis and treatment of AIDS syndromes and treatment of pediatric patients, monitored patients through diaries, appointment cards, files, and re-organizing clinic flow, provided support networks within the military for PLHIV, conducted training on counseling and testing, family planning, drug provision, referral for specified care for HIV-positive pregnant women, and early infant diagnosis, held dialogue meetings promoting male involvement, conducted proficiency testing and sitting-in support sessions for trained health workers, provided facilities with technical support in patient management, procurement, and records keeping, and identified critical interventions for OVC.

The Supporting Public sector workplaces to Expand Action and Responses against HIV and AIDS, (SPEAR) project was a five-year USAID/PEPFAR funded initiative for supporting the Ministries of Internal Affairs (MoIA) Local Government (MoLG) and Education and Sports (MoES) to enhance HIV/AIDS prevention, care and treatment of male and female public sector workers for selected workplaces in Uganda. RTI had four distinct responsibilities: (1) developing contextualized sectoral workplace HIV/AIDS policies in the Ministries of Education, Local Government, and International Affairs, as well as in the major semi-autonomous departments such as the Uganda Police, Prisons and Districts; (2) building institutional and technical capacity of each Ministry and Department to disseminate and enforce these policies; (3) strengthening the evidence base of programming across all thematic areas of the project, including design implementation and analysis of all baseline and sectoral assessments, and operations research; and (4) linking health facilities within the Uganda Police and Prison services to other USG implementing partners carrying out Safe Medical Circumcision throughout Uganda.

This project aimed to increase the inclusivity of citizen participation, particularly ensuring that planning procedures were based on open and coordinated debate and that they reflected the realities of various social groups. The overall objective was to promote effective and accountable local governance and to formalize citizen participation in the decision-making and oversight processes. RTI International was also coordinating closely with national-level institutions and assisting in the implementation of policies and processes related to local governance. The team supported the development of models for citizen participation, such as participatory strategic planning, and promoted transparency mechanisms through annual accountability reports and clear public procurement procedures. Among PROMUNI's anticipated results were to have a minimum percentage of decision-making positions in citizen oversight committees held by women and vulnerable groups and to ensure that 50% of female leaders were trained by the Association of Ecuadorean Women Municipal Leaders (Asociación de Mujeres Municipalistas Ecuatorianas, AMUME) and 75% of project municipalities had an active Council Commission on Equality and Gender.

RTI worked with the National Prosecuting Authority (NPA) of South Africa, to improve care for rape survivors and the ability of the NPA to manage associated legal cases and improve prosecution rates. The resulting Thuthuzela Information Management System (TIMS) combines medical data, psycho-social information, and legal case information on survivors. TIMS was based on the existing holistic Monitoring and Evaluation (M&E) system and complies with the National Protocol for Post-exposure Prophylaxis (PEP) for HIV/AIDS. TIMS enables clinicians and case managers to maintain patient records and legal case records. It is used in Thuthuzela Care Clinics (TCC) to manage patient records and is also used by mobile case managers who must also be present in court. The software helps TCC staff to track and improve adherence to the PEP regimen, which is critical to preventing the spread of HIV/AIDS. The system provides a list of clients for whom there is not a record of contact for the week. It also provides convenient access to a large number of health care and case management reports. Lastly, the program connects to the NPA Sexual Offences and Community Affairs (SOCA) Unit computer network and is integrated with the SOCA case management system.

This project seeks to advance knowledge about how non-financial incentive structures can be designed to generate improvements in the allocation of resources devoted to primary and secondary prevention, with the overall goals of improving population health and reducing health system costs. Sue Mavedzenge, representing RTI, is an infectious disease epidemiologist, who has lived and worked in Zimbabwe for many years. Sue will play a critical role in the study design, trial implementation and monitoring, and analysis and interpretation of study results.

Postnatal gestational age dating methods have been needed in low and middle income settings because ultrasound is often unavailable, last menstrual dates are uncertain, and physical and neurological scoring is complex. The disappearance of anterior lens capsule vascularity (ALCV), a normal embryological process, has a high correlation with gestational age at delivery among preterm neonates. So, the primary aim of this project was to establish the validity of smartphone ophthalmoscope ALCV gestational age estimates among preterm neonates at delivery compared with the referent standard of ultrasound gestational age. To carry out this aim RTI used a smartphone ophthalmoscope to capture images of ALCV in preterm neonates, developed an ALCV biomarker dataset using image analysis software, and developed and validated a predictive algorithm for gestational age using ALCV image biomarkers.

This projects aims to establish the validity of smartphone ophthalmoscope ALCV gestational age estimates among preterm neonates at delivery compared with the referent standard of ultrasound gestational age.

This project aims to raise awareness and build individual and collective responsibilities to reduce gender inequalities, violence, alcohol abuse, and HIV vulnerabilities in the context of sexual and reproductive health amongst the target population. RTI conceptualized the theoretical underpinnings of the research aspects; designed, implemented, and analyzed the quantitative baseline survey; and evaluated the project.

This RTI study was grounded in social-cognitive theory and aimed to develop and initially evaluate an intervention, Sex and Female Empowerment (SAFE), designed to increase acceptance of and adherence to contraceptive practices among opioid-agonist-maintained women of childbearing age. The intervention was developed and efficacy was compared between two different formats: face-to-face and novel computer-adaptive platform. SAFE has the potential to reduce the number of unintended pregnancies and consequently decrease the need for and the costs of child protective services. Improving women’s ability to make and adhere to contraceptive choices and better time their pregnancies while also decreasing risky sexual behavior that can lead to HIV and other sexually transmitted infections (STIs) add to the promise of this intervention's potential overall public health impact.

The objective of the study was to determine whether concomitant administration of TFV vaginal microbicide gel and a nonmicrobicide vaginal product (antifungal cream, antimicrobial gel, or the combination contraceptive vaginal ring) changed local and/or systemic exposure compared with TFV alone or vaginal product alone. Dr. Ariane van der Straten served as the RTI site principal investigator for this study and the team at RTI had overall responsibility for the recruitment and follow-up of 27 healthy female volunteers. Additionally, RTI was responsible for risk reduction counseling of participants after HIV/sexually transmitted infection (STI) testing, management of all case report forms, and quality control of all data collected.

This project builds on a gender-specific intervention that focuses on sexual safety to address the unique circumstances of incarcerated women with IV. The purposes of this R34 Exploratory Research proposal are to (a) integrate strategies for affect management and increased social support/access to community resources into the Woman-focused HIV prevention intervention and tailor the integrated intervention for incarcerated women and (b) to collect preliminary data on its feasibility, acceptability, and initial efficacy with community therapists. We collected preliminary information to explore potential treatment differences and likely effect size ranges.

RTI assisted in designing and evaluating Women’s Health and Mindfulness—a group-based intervention addressing mindfulness, healthy eating, and physical activity to reduce chronic disease risk among overweight and obese lesbian and bisexual women ages 40 years and older.

This project collected data in communities participating in the Start Strong Initiative, a program to prevent teen dating violence and abuse by teaching 11- to- 14-year-old boys and girls about healthy relationships. Because all Start Strong communities implement a school-based EBP, they represent an ideal laboratory to examine adaptation issues. The study assessed how local context influences adaptation, how practitioners made adaptation decisions, how practitioner characteristics influenced adaptation, and how site and process characteristics related to the types of adaptations made. Findings will contribute to adaptation and implementation science by drawing on the experiential knowledge of expert practitioners.

The multifaceted purposes of this project are to : 1) examine geographic disparities in breast cancer screening among Medicaid insured women aged 40 to 64 years; 2) describe factors (personal, county, and state level) associated with low breast cancer screening rates among this population; 3) develop benchmarks to evaluate county level screening compliance ; 4) identify counties (or regions) that might benefit from coordinated interventions to increase breast cancer screening; and 5) provide recommendations- on addressing area-based screening disparities and promoting regional collaboration - to organizations and programs (including Comprehensive Cancer Control) that support breast cancer screening in vulnerable populations.

RTI International and the Urban Institute (UI) to estimated the impact of the ACA on children's health coverage and to analyze how expanded children's coverage, discontinuities in coverage, and gaps in covered benefits will affect the need for Title V MCH block grant services, with a particular focus on CSHCN.

RTI International has worked closely with the Centers for Disease Control and Prevention (CDC) and the Consumer Work Group (CWG) over the past 4 years to both conduct consumer-focused research on PCH (Formative Research on Preconception Health Issues and Formative Research Among Couples about Reproductive Life Planning) and design a social marketing plan (Development of a Preconception Health Social Marketing Plan) to promote awareness of PCH among women and men in the childbearing age.

RTI developed a new cost-effectiveness analysis of repeat HIV testing during pregnancy to inform updated guidelines for repeat HIV testing during pregnancy. The team constructed a decision tree model to evaluate the cost-effectiveness of universal, voluntary repeat HIV testing during the third trimester of pregnancy. Using a societal perspective, RTI estimated the incremental costs and benefits of a second HIV test during the third trimester relative to the status quo of a single HIV test early in pregnancy for all women. The team also reported on the costs and benefits of early HIV detection in pregnant women and averted transmissions for their sexual partners resulting from repeat testing during pregnancy. RTI staff conducted sensitivity analyses to determine the impact of uncertainty in parameter values on the cost-effectiveness ratio and performed a threshold analysis to determine the HIV incidence rate at which costs per life-year saved reached $100,000.

This project will provide information on continuity of insurance, employment status, out-of-pocket medical costs faced by young breast cancer survivors; and will identify factors impacting their access to comprehensive care. The results from this study will lay a foundation for designing and implementing interventions/organizational policies aimed at reducing the financial constraints faced by young breast cancer survivors and increasing their health and quality of life. The specific objectives of this project are to: 1) provide information on continuity of insurance coverage, employment status, and copayment/deductibles faced by young women (18-39 years) diagnosed with breast cancer; and 2) identify factors impacting the access of young breast cancer survivors to comprehensive high quality medical care.

The objective of this RTI study was to assess, via focus groups, the awareness, attitudes, and perceptions, particularly health risk perceptions to self and to fetus, of pregnant women and women of childbearing age (18 to 40 years) who smoke or recently quit due to pregnancy regarding smokeless tobacco products and nicotine replacement therapy (NRT). RTI also examined factors that might influence this population to change products (especially from cigarettes to smokeless tobacco products) and/or resume tobacco use with a new product. Knowing how smokeless products are viewed by pregnant women and women intending to become pregnant merits attention in order to help shape intervention and policy strategies to prevent smokeless tobacco use in pregnant women and women of reproductive age. The goal of this study was also to provide the Federal Drug Administration (FDA) with information regarding whether and how different populations of female smokers of childbearing age may be influenced by marketing messages related to smokeless tobacco products.

The Prevention IS Care campaign is part of the Act Against AIDS (AAA) program, CDC’s national communication initiative to raise awareness about HIV/AIDS in the United States and to reduce the risk of infection among the hardest hit populations – gay and bisexual men, African Americans, and Latinos.

The HSSC campaign targets primary care physicians (general practitioners and internal medicine physicians without a subspecialty) and provides them with tools to help administer and offer HIV screening to patients. The campaign expanded in 2013 to target providers who manage racial and ethnic minority patients.

This project entailed the phase of the campaign where RTI and PNPS focused on a refresh of the campaign's creative elements, while conducting targeted online media buys, social media activities, and partner engagement and outreach. The overarching goal for TCTT was to increase HIV testing and decrease HIV transmission among African-American women in the United States. These behavioral goals were affected by achieving the following supporting communication goals: (1) Build awareness of HIV, including causes, prevention and treatment, and drive the audience to feel empowered to make informed choices to protect their health; (2) Increase share of voice for HIV testing and prevention with audience; and (3) Create virtual and online campaign ground war to empower audience to get tested and provide testing opportunities when possible.

RTI worked with the Centers for Disease Control and Prevention (CDC) to convene a consultation with experts on the use of the Internet and new media to deliver HIV prevention messaging to men who have sex with men (MSM). Experts participated in discussions to examine the strengths and weaknesses of specific channels, technologies, and Web sites for delivering HIV prevention messages and how the issues raised could inform the development of electronic materials to educate and support choices for different risk reduction strategies (Lewis, et al. 2011). The experts strongly recommended developing an interactive Web-based tool to inform, educate, and support MSM choices for different risk reduction strategies. So, the purpose of this project was to develop content and messages, conduct extensive formative research, and design and develop a tailored, Internet-based HIV-prevention decision-support tool. Although the original intent was to develop the tool specifically for MSM, the audience was later expanded to include all individuals seeking information about HIV risk reduction, including heterosexual men and women and transgender people.

The specific aims were as follows: (1) Conduct ethnographic research on the methamphetamine market in Ohio; (2) Enrich these data using Ecological Momentary Assessment (EMA), collecting self-report data on daily drug consumption, production, sales, decisions, strategies, etc.; (3) Inform simulation parameters using a panel survey of 204 active methamphetamine users; (4) Construct a computer lab of agent-based model (ABM) simulations to reproduce how the local methamphetamine market operates, integrating both social (i.e., health) and economic behaviors; and (5) Experiment with the ABM simulations to understand how the market operates and functions, create and test policy-based intervention scenarios (e.g. enforcement, treatment, and outreach) intended to impact outcomes, and model risk behaviors (e.g., needle sharing, trading drugs for sex) influencing the spread of HIV among men and women. Case Western University did the data collection, while RTI developed an ABM of methamphetamine consumption. The results eventually became a model to understand the dynamics of methamphetamine use.

The objectives of the SCRN are to do the following: (1) Determine the causes of stillbirth using a standardized stillbirth postmortem protocol, to include review of clinical history, protocols for autopsies and pathologic examinations of the fetus and placenta, as well as other postmortem tests to illuminate genetic, maternal, and other environmental influences; (2) Obtain a geographic population-based determination of the incidence of stillbirth, defined as fetal death at 20 weeks gestation or greater; and (3) Elucidate risk factors for stillbirth. A steering committee, comprised of the principal investigators from the clinical sites and from RTI and the project scientists from NICHD, was responsible for the overall design and implementation of the study. RTI also served as the Data Coordinating and Analysis Center (DCAC). Information from the study is expected to benefit families who have experienced a stillbirth, women who are pregnant or who are considering pregnancy, and their physicians.

This project is designed to assist the U.S. Naval Health Research Center Department of Defense HIV/AIDS Prevention Program (DHAPP) in developing and implementing an HIV Behavioral Health Surveillance Program for the armed forces in one participating DHAPP nation, Liberia. RTI International is supporting the military population of the Armed Forces of Liberia (AFL) in an HIV Behavioral and Seroprevalence survey with the following objectives: (1) Provide technical assistance and training for the design and implementation of an HIV seroprevalence and behavioral risk surveillance study within the AFL; (2) Assist DHAPP with the adaptation of an HIV behavioral risk surveillance questionnaire appropriate for the AFL; (3) Develop data collection and management tools; (4) Provide technical assistance to support the procurement of data collection supplies and the logistics necessary for field implementation; and (5) Facilitate the dissemination of findings to inform AFL policy for improving prevention, care, and treatment.

The Obstetric-Fetal Pharmacology Research Units (OPRU) Network carries out pharmacology research to enhance understanding of obstetrical pharmcokinetics and pharmcodynamics and improve appropriate therapeutics during pregnancy. RTI is serving as the data coordinating and analysis center (DCAC) for this network.

RTI International supported the MACDP and fetal alcohol syndrome (FAS) surveillance by providing RTI staff in client facilities who managed the following tasks: coordinating FAS surveillance and MACDP surveillance, identifying cases of birth defects and FAS and abstract records for them, and processing and analyzing data from these surveillance systems.

The Office on Violence Against Women (OVW) is focused on building the capacity of criminal justice and victim services organizations to respond effectively to sexual assault, domestic violence, dating violence and stalking and fostering partnerships among organizations that have not traditionally worked together to address violence against women. OVW's Technical Assistance Program provides training, expertise and problem-solving strategies to meet the challenges of addressing sexual assault, domestic violence, dating violence and stalking. Technical assistance projects offer in-person and online educational opportunities, peer-to-peer consultations, site visits and tailored assistance for OVW grantees and potential grantees. In more limited circumstances, OVW's technical assistance projects offer technical assistance to a small number of pilot sites as part of demonstration initiatives or assessments of newly developed training curricula or tools. The project team at RTI is providing training and technical assistance to institutions of higher education on assessment and evaluation strategies and tools to assist Campus Program technical assistance providers and grantees to strengthen their evaluation and assessment methods.

Working together with the HIV+ community, the team is making maps of where people go for care and how the places they live impact their health and their lives. The aims of the study are: (1) To examine spatial relationships between neighborhood characteristics and HIV treatment outcomes in San Francisco through the use of geographic information systems (GIS) software; (2) To identify locations of resources which facilitate engagement in HIV treatment by utilizing methods of public participatory GIS (PPGIS) with HIV positive individuals; and (3) To create an online mapping platform for the dissemination of thematic maps showing gaps in HIV treatment outcomes and resources using data collected in Aims 1 and 2. The scope of work for RTI's contribution consisted of Dr. Alex Kral providing scientific oversight and assisting with papers for publication in peer-reviewed journals.

This project is an illustration-based, computerized child report assessment for early manifestations and predictors of substance abuse and antisocial behavior. The ALEXSA was recently developed at RTI to fill the need for self-report assessments of problem behaviors, risk factors and outcomes for boys and girls. An ambitious project, the core “kernel” includes 350 items organized into 39 subscales and 9 factors. The ALEXSA could provide efficient child reports for research, needs assessment, and outcomes to support etiology and prevention of substance abuse and antisocial behavior.

This study tracks offenders released from prison in 2004 who were studied in a previous RTI project. For this project, researchers are examining the situational factors that impact offenders’ desistance from crime and violence. This consists of obtaining data from Indiana and South Carolina Departments of Corrections for record of life time incarcerations and conducting in-person interviews with men to collect information on demographics, attitudes, life events, and criminal activity. Long-term outcomes will help researchers better understand whether cognitive transformation is necessary as a prerequisite to desistance.

The purpose of this project was to provide training and technical assistance (T/TA) to support Dating Matters grantees in their efforts during the implementation of the Dating Matters Initiative. The Centers for Disease Control and Prevention (CDC) developed the Dating Matters Initiative, a highly innovative, comprehensive community approach to prevent teen dating violence (TDV). The Dating Matters Initiative includes preventive strategies for male and female peers, families, schools, and neighborhoods and includes local public health capacity building to implement prevention strategies and identification and validation of community-level indicators of TDV. To meet the T/TA goals, RTI created a team with experience in T/TA models, strong knowledge of and experience with Dating Matters, and diverse areas of expertise related to T/TA implementation.

The scope of work for this project was to continue assisting in the development, organization, and analysis of the qualitative data in conjunction with quantitative data for the study titled “Relationship Factors and HIV Treatment Adherence”. The specific aims of this study were as follows: (1) Explore longitudinal associations among relationship dynamics, partner support for adherence, and antiretroviral therapy (ART) adherence within a cohort of HIV serodiscordant and seroconcordant male couples and (2) Develop and pilot a Social Control Theory-informed couples-based adherence support intervention: Duo PACT (Partnership Adherence Commitment Therapy). Findings from this study were used to inform the analysis of quantitative data collected in the larger study. Research suggests that optimal couple functioning depends on adopting a “we” orientation to health.

Biocon Foundation is a corporate foundation based in Bangalore, India. The foundation focuses on reducing poverty and improving health through the provision of primary care. They are also committed to advancing gender equality. Biocon requested RTI to support their focus on gender equality by implementing a gender based violence response capacity building intervention in their primary care centers. RTI's model was supported through a U.S. Agency for International Development (USAID) grant for work in Bangalore. Replicating the Bangalore model (which was implemented in public primary care clinics) in a private sector setting (Biocon) positioned RTI to be able to further market this work to the private sector in India.

The initiative of this program is to prevent teen dating violence (TDV) by helping 11-to-14-year-old male and female youth develop healthy and safe relationship knowledge and skills.  RTI developed a rigorous, quasi-experimental evaluation design to evaluate whether this initiative has impacted TDV. The evaluation included two components: (1) an outcome evaluation to assess the effectiveness and implementation of the Start Strong TDV prevention initiative and (2) a policy evaluation to assess the adoption, implementation, and sustainability of policy efforts. As part of the outcome evaluation, RTI examined the effectiveness of the initiative through collection of student and teacher data on key outcomes (i.e., TDV perpetration and victimization), as well as critical mediators that may underlie hypothesized changes (i.e., conflict management skills, anger management skills, gender stereotyping, dating violence norms).

The World Health Organization (WHO) invited RTI Global India to gather and analyze peer-education initiatives directed at young people in India between 2000 and 2015, with a focus on adolescent sexual and reproductive health.

This project provided a means for parents—particularly mothers—to support their children’s literacy acquisition through the use of content delivered via mobile phone. In 2013, the implementing organization, Urban Planet, Inc., developed and delivered audio-enabled Short Message Service (SMS) messages to mobile phones of participants in the pilot program. The messages were designed to enable parents to engage in simple literacy-promoting activities with their children, such as practicing letter sounds, building words, and listening to stories. RTI measured the effects of the program by comparing pre- and post-test scores on a simple reading diagnostic with those of a control group (parents were only given verbal instructions once regarding actions they could take to help their child) and a group receiving the same content but in a printed booklet.

The project focused on teachers' understanding of the literacy needs of students, and their skills in applying effective techniques in the classroom. RTI designed and assessed teachers' skills in reading and math in order to determine program impact on teacher competencies. The project team at RTI also carried out EGRA and EGMA assessments of student performance.

This project aimed to increase the capacity of civil society organizations (CSOs), most-at-risk populations (MARPs), and people living with HIV (PLHIV) to deliver effective and efficient HIV services and engage in programming, decision-making, and policy advocacy efforts in the response to the HIV epidemic. The project helped CSOs contribute to the Government of Vietnam's (GVN's) National Strategic Plan for HIV/AIDS. The goal of this five-year project was to develop an empowered, effective, and efficient civil society that is providing a sustainable and significant impact, is accountable to its constituency, is engaged and valued by government programs, and is contributing to the national HIV/AIDS response.

This project aims to promote more effective and accountable local governance in Morocco by increasing citizen participation in local governance, enhancing local governments' performance, and encouraging increased accountability and transparency. Local Governance Program aims to enable elected women officials to act as full participants and responsible officials who contribute to the sound management of local affairs. To this end, the project carried out a participatory diagnostic on the status of the responsibilities of elected women and their participation in decision making in local management in two target regions. The study helped identify their specific needs, and develop an action plan to strengthen their capacities and leadership skills.

This program assisted health care providers in determining when and to whom antiretroviral (ARV) drugs should be prescribed for Pre-Exposure Prophylaxis (PrEP) or the non-occupational Post-Exposure Prophylaxis (PEP). The goal of this project was to help reduce new HIV infections and improve health outcomes among heterosexual males and females at greatest risk of HIV acquisition, men who have sex with men (MSM), transgender individuals, and other persons who experience non-occupational exposure that may lead to acquisition of HIV, by creating increased understanding of PrEP and PEP among health care providers, thereby encouraging them to recommend or prescribe the medications to all patients at high risk of HIV acquisition. RTI International provided the task support in the following areas: (1) Writing and web content development; (2) Digital medical education; (3) Social and digital media; (4) Conference exhibits panel; (5) Materials development; (6) Trade media advertising; (7) Earned trade media; (8) Account management; (9) Progress reports; and (10) Fulfillment and storage service.

This project developed and implemented HIV prevention activities for key populations; namely people who inject drugs and their sexual partners, men who have sex with men (MSM), female sex workers (FSW), and at-risk youth. GHPP worked closely with local nongovernmental organizations (NGOs) to strengthen the national response to HIV by delivering an expanded package of HIV prevention services to key populations, which included community and internet-based outreach, targeted information and education communication, condom distribution, HIV counseling and testing, hepatitis B and C virus counseling and testing, tuberculosis counseling, reproductive health/family planning counseling and referral to appropriate health services, engagement of Georgian families and communities to support key populations, and advocacy for sustainable HIV prevention policies, strategies, and programs in both the civil and penitentiary sectors.

RTI assisted the Government of Botswana to improve the quality and quantity of HIV prevention services for MARPs while building the capacity of civil society organizations (CSOs) to deliver these services. The project was located primarily in the towns of Gaborone, Francistown, Selebi-Phikwe, and Kasane, along the highly trafficked corridor. Interventions included preventive strategies, such as helping vulnerable women avoid the sex trade, teaching condom negotiation skills, and introducing methods to assist women in exiting sex work, as well as working to bring services, such as voluntary counseling and testing (VCT), closer to target populations.

The project contributed to the achievement of five main objectives: (1) Improve child survival, maternal health, and nutrition; (2) Reduce unintended pregnancy and improve healthy reproductive behavior; (3) Prevent and control infectious diseases of major importance; (4) Improve access to water and sanitation in target communes; and (5) Reduce transmission and impact of HIV/AIDS. After five years of implementation, Santénet2 has contributed to the success of the community health system process in Madagascar thanks to its strategies adjusted to a changing environment and entailing a mix of activities. These activities have developed ownership of health interventions among the communities that support healthcare provision at the community level and have generated a greater demand for health services and products.

The B-WELL-Mom Study is a pregnancy cohort designed to investigate changes in maternal asthma control related to immune function, inflammation, environment and lifestyle factors funded by National Institute of Child Health and Human Development (NICHD). This project's goal is to support the EMMES Corporation in collection of personal air monitoring measurements for the B-Well-Mom study, using three sensors for PM, NO2, and O3

RTI's goal for this investigation was to identify fetal genetic variation associated with the higher risk of preterm birth (PTB)-related outcomes and to identify cytokines that explain this association. By identifying high-risk neonates, the analyses will enhance understanding of the pathophysiology and biological mechanisms leading to PTB-associated outcomes and suggest intervention strategies.

The purpose of this project was to identify health literacy challenges related to accessing and using Medicaid among women on probation who were signed up since the Affordable Care Act (ACA). RTI used these findings to adapt and pilot a health literacy intervention, originally developed for women leaving jail, for women on probation with Medicaid.

This program supports efforts of the national government to provide access to better basic health services, with a focus on maternal, neonatal, and child healthcare. RTI International submitted a short concept paper with an indicative budget so that ADP can receive internal approval.

RTI International investigator, Dr. Ariane van der Straten, participated as an Investigator in the Behavioral Research Working Group (BRWG) of the Microbicide Trials Network (MTN). BRWG provides input and innovative ideas to enhance understanding of behaviors before, during and after microbicide use; and on ways for collecting accurate behavioral data. Dr. van der Straten participated in monthly conference calls of the BRWG, all communications related to the functioning of the BRWG, attending and conducting presentations at the MTN annual meetings, the regional meetings and other technical meetings of the MTN, as needed, as well as cross-network meetings. She is contributing to scientific discussions on study design and analyses, and more specifically, on the behavioral component of new MTN protocols, including feasibility of using different quantitative and qualitative behavioral assessment tools, and cultural appropriateness of different assessments and interventions.

The funding of these adolescent pregnancy prevention grantees allows states to replicate evidence-based effective program models or incorporate elements of effective programs to delay sexual activity, increase condom and/or contraceptive use for sexually active youths, and reduce pregnancy rates among youths, especially youth populations at the highest risk or vulnerable for pregnancies. In an effort to support FYSB, RTI International provides grantees with the following supportive services: (1) Training and resources to enhance service quality, ensure fidelity of program implementation and appropriateness of adaptations of evidence-based models, and enhance grantee skill sets to reduce teen pregnancy; (2) Knowledge and technical assistance on the latest developments in teen pregnancy prevention and related fields to increase competency in providing programmatic oversight of the grants; (3) Technical assistance provided individually and in small groups; (4) Monitoring of grantees' programmatic performance; and (5) Annual teen pregnancy prevention conference planning.

RTI International has provided support to the Justice Center at the University of Alaska Anchorage through annual random-digit-dialing telephone surveys of women in Alaska since 2010. The survey provides comprehensive statewide and regional data to guide planning and policy development and to evaluate the impact of prevention and intervention services. The 2015 survey of 3,027 adult women revealed that: (1) More than one in nine Alaskan women age 60+ experienced psychological or physical abuse in the past year; (2) One in four women in the Municipality of Anchorage have experienced stalking; (3) One in three women in Alaska have experienced stalking; and (4) There was a decline in intimate partner and sexual violence since 2010. These results have been used in planning and policy development, evaluating the impact of prevention and intervention services, and provide greater support for preventing violence against women.

The goal of this project is to help reduce HIV infections and improve health outcomes by increasing understanding and appropriate usage of the biomedical interventions of Pre-Exposure Prophylaxis (PrEP) and non-occupational Post-Exposure Prophylaxis (PEP) by health care providers for their patients of all genders at high risk for acquiring HIV infection. This project builds on materials and outreach programs created in the initial PrEP and PEP educational program launched in the fall of 2015. RTI International has provided support in the following areas: (1) Writing and web content development; (2) Digital medical education; (3) Social and digital media; (4) Materials development; (5) PrEP and PEP Slide Kit; (6) Trade media advertising; (7) Earned trade media; (8) Materials dissemination and storage services; (9) Core curriculum development; (10) Promotion to college health providers; (11) Account management; and (12) Evaluation.

RTI International developed a maternal and perinatal death database for the Zimbabwe Ministry of Health with support from the United Nations Population Fund (UNFPA). The system is hosted at the Zimbabwe Ministry of Health and Child Care (MoHCC) at the national level and is updated with data from Zimbabwe facilities every time a maternal or perinatal death occurs.

The Office of Violence Against Women in the Department of Justice (DOJ) invited RTI International social science researcher Tasseli McKay to develop a white paper on the selection of intimate partner violence (IPV) screening tools for use in DOJ-funded programs, participate in a roundtable on this topic, and prepare a summary of the proceedings.

The SUM II project provides targeted assistance in leadership and management, strategic planning, human resource development, mobilizing most-at-risk populations (MARPs) and people living with HIV (PLHIV) and resources, advocacy, and financial management. RTI International employed the Chief of Party and served as the major implementing partner providing technical leadership and management, as well as administrative oversight. RTI managed $6.5 million in small grants to civil society organizations (CSOs) to build their capacity and expand interventions in communities or "hotspots" where there is a high concentration of MARPs–specifically female sex workers (FSWs) and their clients, men who have sex with men (MSM), transgender individuals (Waria), and injecting drug users (IDUs), as well as PLHIV–and a likelihood of high-risk behavior. These small grants provided working capital to improve organizational performance and leverage funds from non-US government sources, including local government and other donors. SUM II's goal was to strengthen CSOs capacity and the local government’s ability to plan, budget, manage and monitor the HIV response to ensure comprehensive HIV and AIDS services were scaled up to cover at least 80% of MARPs by 2015.

RTI to conducted a rapid research study on post-conflict reintegration of “bush wives” in Northern Uganda – women who were kidnapped and forced to marry combatants. The purpose of the study was to draft a report with policy recommendations for the national government.

RTI International implemented a pilot study of its skills enhancement training guide that addresses the intersecting risks of contracting HIV/AIDS among women who experience intimate partner violence (IPV). The overall goal of the project was to improve service delivery for domestic violence victims/survivors at risk for HIV/AIDS. This goal was accomplished by cross-training HIV and domestic violence professionals on strategies to address the intersection between HIV and violence when working with their clients, which in turn improved skills, messaging, and services among professionals. The study included training, technical assistance and program evaluation at four HIV/AIDS and four IPV service organizations around the United States. Following the completion of training, RTI conducted a process evaluation to collect information about the training and its delivery. This process evaluation plan informed OWH on the successes and barriers of training implementation and informed future use of the skills enhancement training guide with HIV/AIDS and IPV service providers.

The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (NuMoM2b), which began in 2010, studied pregnant women who were delivering for the first time (nulliparous women). The “Longitudinal Study of Loss of Imprinting in the First Trimester CVS Samples Compared to Placental Samples at Delivery” evaluated the underlying, interrelated mechanisms of several common adverse pregnancy outcomes, which can be unpredictable in women who have little or no pregnancy history to help guide their treatment. This initiative has addressed a critical group of at-risk women who are currently understudied and represent 40% of the four million births in the United States each year. As the data coordination center for the NuMoM2b study, RTI International collected and analyzed the data for this study. This responsibility specifically included setting up additional tracking in the data management system for chorionic villus samples specific to this sub study, incorporating data from the sub study into the primary database, constructing analysis files for the sub study, and data analysis. The results of this study helped inform health care providers and their patients who are pregnant or considering pregnancy and will support future research to improve care and outcomes in this group of women.

The purpose of this project was to evaluate the U.S. Agency for International Development (USAID), Human Rights and Governance (DRG) program where USAID assists Zimbabweans of all genders to promote a more accountable and democratic system of governance. RTI International was responsible for assessing whether the portfolio design was appropriate. The goal of this performance evaluation was: (1) To ensure accountability by assessing the programmatic performance and results of the DRG portfolio and (2) To systematically generate and document lessons learned from the DRG program for use by USAID to inform potential future programs. The evaluation contributed to learning labs and knowledge banks of other missions operating in similar contexts.

This project is a secondary study to the Transfusion of Prematures (TOP). The TOP Trial hypothesizes that maintaining higher hemoglobin levels in extremely low birth weight (ELBW) infants by use of a high hemoglobin threshold for transfusion will lead to a higher rate of survival without neurodevelopmental impairment. This secondary proposal enhances the TOP trial through assessment of regional tissue oxygenation of the brain and gastrointestinal tract using bedside near-infrared spectroscopy (NIRS) monitoring.

The Feed the Future  (‘flourishing agriculture”) project is a four-year USAID-funded effort that began in 2015 with the primary objective of improving inclusive economic growth among vulnerable households through improved production, productivity, and marketing of select cereal crops. Feed the Future scales up techniques and technologies identified under its predecessor project with the goal of reaching more than 130,000 households (an estimated 45 percent of households in the Feed the Future zone of influence). The project works with farmers and other value chain actors such as women and children in facilitating systemic change of financial, contracting, and risk mitigation arrangements as well as increased access to stable and profitable markets. The project supports improvements in the irrigated rice, rain-fed rice, maize, and millet value chains across the Senegal River Valley, the Southern Groundnut Basin, and Casamance. A unique feature of the project is the way it uses simple, easily accessible digital tools to support locally owned and sustainable data collection and analysis.

This two-year NICHD-funded Pretreatment CoOp study adapted and determined the initial feasibility of a seek, test, treat and retain (STTR) model for HIV prevention and linkage to treatment for co-occurring substance use and victimization. Information gleaned from in-depth qualitative interviews and focus groups in the formative phase to adapt the evidence-based STTR model to include linkages to treatment for substance use and victimization for young women.

The goal of this NIDA-funded project was to develop and initially evaluate an efficacious, comprehensive, culturally sensitive, women-centered model of care for pregnant South African women by adapting and refining the Reinforcement-based Treatment (RBT) model, at the same time integrating into it the HIV prevention components of the WHC prevention model, yielding an integrated treatment and prevention model, RBT+WHC.

Since 2001, RTI International has adapted and conducted a comprehensive evidence-based intervention for women, the Women’s Health CoOp (WHC), that addresses alcohol and other drug (AOD) use, sexual risk, and gender-based violence. The Young Women’s CoOp (YWC) is an adaptation of the WHC that targets this vulnerable population of young women who use AOD. This project seeks to reach this population and overcome barriers to improved health for female adolescents who have dropped out of school by increasing the uptake of HIV testing and counselling (HTC) through a comprehensive gender-focused HTC intervention with trained peer co-facilitators and outreach workers from each community. The study findings may provide knowledge that could be used to increase the uptake of services and improve treatment adherence among female adolescents through the use of peer-driven intervention methods. This study has the following aims: (1) To train and evaluate adolescent peer role models to conduct community outreach with established outreach workers to recruit 500 out-of school, substance-using female adolescents aged 16 to 19 for HTC and to co-facilitate a gender-focused comprehensive HTC program and (2) To test the efficacy of a young women’s gender-focused comprehensive HTC program for reducing substance use, victimization, and sexual risk behavior and improving access to effective treatment and support services through linkages to care relative to standard HTC for young women.

This trial recruited men and their main female sex partners in Cape Town to participate in the Couples’ Health CoOp (CHC) intervention, aimed at reducing substance use, violence, and sexual risk behaviors among couples. Women in the CHC were less likely to be HIV positive at follow-up; men in the CHC were less likely to report heavy drinking and more likely to report condom use at follow-up than in other conditions.

This study tested the effectiveness of combining voluntary counseling and testing with the WHC among vulnerable women. This was the first trial in South Africa with women who use drugs to demonstrate that supplementing voluntary counseling and testing with a woman-focused intervention results in greater abstinence from drug use.

The Women’s Health CoOp (WHC) was adapted to reach sex workers and vulnerable women who use substances in Pretoria, South Africa. Sex workers in the WHC were significantly less likely to report physical abuse by a main partner and had a significant reduction in drug use compared to sex workers in the control. The WHC is listed in the USAID Compendium of Gender Studies in Africa and has been packaged for implementation in many settings.

This study adapted the WC to reach sexually active, vulnerable African American women aged 16–19 who were at risk for dropping out of school. The study focused on issues related to returning to school, pregnancy and parenting, social support, and healthy relationships. At 3-month follow-up, participants were significantly less likely to report sex without a condom at last sex compared to controls.

This study pilot tested the Women's CoOp intervention among pregnant African American women in substance abuse treatment in North Carolina. The study compared an adapted version of the
intervention tailored to pregnant women with standard services offered in substance abuse treatment programs.

This study determined the long-term effects of the Women's CoOp intervention and booster sessions to help sustain risk reduction. Women who had been in the WC were found to be in a low-risk group at long-term follow-up.

To address the impact of HIV among African American women who use crack cocaine, a culturally specific HIV intervention—the Women’s CoOp (WC)—was developed in North Carolina. This intervention was effective in reducing sexual risk and increasing self-sufficiency. It is listed as a “best-evidence” intervention by the Centers for Disease Control and Prevention (CDC).

The ADVANTAGE IDIQ is USAID's follow-on to the Women in Development IQC. It will provide technical assistance and training relating to gender, gender-based violence and trafficking in persons. RTI will work with Banyan Global to provide expertise regarding gender-based violence, particularly in Africa.

RTI International is on the brink of providing women with topical microbicide products that, when used consistently, prevent acquisition of HIV. The most important challenge, however, is transforming these revolutionary products that women should use into something that women value, desire and demand to use. To succeed, RTI is conducting a research continuum, which links a detailed understanding of barriers to and drivers for correct and consistent use of microbicides in different population segments, to implementation of changes in product design, packaging, and branding, objective evaluation of the impact of these changes on product acceptance and use, and final development of a marketing campaign based on the acquired knowledge of users’ preferences, motivations, barriers, influencers and lifestyles. These goals will be accomplished by an integrated team of experts from IDEO, RTI International, Abt Associates, CAPRISA and CONRAD.

This study continues a longitudinal investigation of the developmental cascade of effects due to exposure to cocaine in-utero. Prior to this study, participants were recruited while in-utero and have been followed through age 15. The present RTI International project extends the study through participants' age 20 investigating differences between youths who were exposed to cocaine in-utero versus youths who were exposed to substances other than cocaine in-utero. The specific aims are to: (1) assess effects of prenatally cocaine exposed (PCE) on substance use disorders, antisocial behavior and adaptive functioning in emerging adulthood (EA), (2) determine if cognitive problems previously identified in this cohort among PCE children persist into EA and to examine whether these pre-existing cognitive problems and early behavior problems mediate expected effects of PCE on substance use disorders, antisocial behavior and poor adaptive functioning, and (3) identify environmental and biologic factors that may moderate developmental outcomes in EA among prenatally cocaine/polydrug exposed individuals by examining gender, placement history, elevated blood lead, iron status and childhood adversity. The results of this study will assist in designing properly timed prevention and substance use treatment interventions for emerging adults who may be at risk for costly lifelong problems related to substance use disorders.

This RTI International project involves the University of California, San Francisco obstetrics/gynecology and bio-engineering departments for the development of a "smart diaphragm" device, that would detect early signs of pre-term labor through changes in collagen composition in the cervix. The first stages of the project involved iterations of various prototype devices. The team has developed a device version 3.0 that is ready for initial site evaluations. Qualitative and quantitative acceptability/feasibility study of device v3.0 will focus on the storage, placement and use of the diaphragm in conjunction with a cloud-based telemedicine solution in both the US and in Sub Saharan Africa. Key objectives include determining: (1) whether women are comfortable using a diaphragm-like device at home to lower their risk of preterm labor, (2) if there any cultural barriers to using this technology to assess maternal health during pregnancy, and (3) the acceptability of the monitoring and triage strategy among clinical providers. With the final iteration, each patient will be able to track the progression of her pregnancy at home without the need for clinical supervision. Data will be relayed daily to a server via a mobile app. If preterm birth risk elevates, an alert will be sent to both patient and clinician. The engineering team is also exploring the addition of pH and temperature sensors to detect infection-initiated preterm birth.

Population Foundation of India is a NGO that promotes and advocates for effective formulation and implementation of gender-sensitive population and development policies, strategies and programs. PFI has been shortlisted for a Gates Grand Challenges award focused on putting women and girls at the center of development. Their project focuses on leveraging digital media and celebrities to improve knowledge, attitudes and perceptions about Gender Based Violence, particularly among the youth. They have invited RTI Global India/RTI Main to be their evaluation partner.

RTI is conducting a systematic literature review on the effectiveness of programs to promote child well-being following exposure to intimate partner violence (IPV). This project will be an invaluable resource for research, practitioners and policymakers who seek to implement and recommend the most promising interventions to promote well-being among children exposed to IPV. RTI seeks to examine whether psychosocial interventions promote mental and behavioral health, and academic achievement. Additionally, RTI will examine whether interventions with particular characteristics (e.g. individual vs. family-based) are more effective than others at promoting child well-being following IPV exposure. The review will document and provide recommendations to research and practice on how to best protect this vulnerable popualtion and promote child well-being.

With a goal of increasing initiation and duration rates of breastfeeding throughout the state, ten Kansas organizations and agencies have received funding totaling approximately $1 million through the Kansas Breastfeeding Initiative, a partnership of the Kansas Health Foundation and the United Methodist Health Ministry Fund. Funding to these organizations has supported the implementation of strategies recommended by the Centers for Disease Control and Prevention in hospitals, workplaces and communities to support mothers in successful breastfeeding. RTI International is conducting a process evaluation to determine the extent to which these grantees were successful in implementing the strategies they selected related to increasing initiation and duration rates of breastfeeding in Kansas.

The purpose of this project was to provide support to the Centers for Disease Control and Prevention’s Prevention Communication Branch by conducting exploratory research on pre-exposure prophylaxis (PrEP). RTI International prepared materials and conducted approximately 20 interviews with male and female consumers at risk for HIV and approximately 10 interviews with health care providers treating at-risk individuals. The findings have been used to inform the development of messages and materials about PrEP for both consumers and health care providers.

Merck for Mothers is a 10-year $500 million initiative focused on improving the health and well-being of mothers during pregnancy and childbirth. Specifically, Merck for Mothers is interested in identifying what needs to be done to prepare for providing access to carbetocin, a drug used to control postpartum hemorrhage (bleeding after giving birth), in low resource settings. Part of that access – all under the rubric of product introduction activities – is ensuring that there is a clear value proposition for this drug. RTI assisted Merck for Mothers run a study to help develop a better value proposition.

As efforts to support legal redress for survivors of mass rape intensify in Central and East Africa, Physicians For Human Rights' (PHR) – in collaboration with a number of local partners in the region – is working to improve the abilities of the health and legal communities to build prosecutions of sexual violence crimes. PHR’s goal is to dramatically increase local capacity for the collection of court-admissible forensic evidence of sexual violence to support prosecutions for these crimes. The Program on Sexual Violence in Conflict Zones draws on PHR’s extensive expertise in documenting war crimes and providing forensic training to professionals in regions of conflict where mass crimes have been committed. Specifically, the program includes a series of cross-sectoral, collaborative training workshops for members of the health care, law enforcement, and legal communities. To assist with this project RTI International: (1) worked with PHR to revise pre/post training assessments, (2) continued analysis of pre/post training assessments, (3) worked with PHR to revise follow-up assessments of participants, and (4) analyzed follow-up assessment data.

The American Cancer Society with Merck, UICC, Women Deliver, PSI India and Global Health Strategies launched a campaign to advance comprehensive cervical cancer (CaCx) prevention and control in Sikkim and Tamil Nadu, India. These were the two most favorable Indian states to work in, especially because both states offer CaCx screening and treatment for women. RTI India conducted formative research surrounding the two issues of prevention and control and offered recommendations for strategic communication and health systems strengthening.

The goal of the Nanofabric Pilot Study at RTI International is to assess the perceptions and acceptability of a new intravaginal drug delivery system for HIV prevention and contraception in the form of drug-eluting fibers fabricated by electrospinning and woven into a fabric. The project is taking place in Kampala, Uganda, Harare, Zimbabwe, and Durban, South Africa among up to 60 female participants of reproductive age who will join a focus group discussion. The intention of this study is to obtain general reactions (likes/dislikes, perceptions, possible use, etc.), and to probe a few key attributes (application, feel, geometry, etc.) about the intended fiber-based fabric as multipurpose technologies that can be explored in greater depth in future studies.

This study examines the impact of an intervention (COMBIND) on uptake of the four major components of the prevention of mother-to-child transmission (PMTCT) program, using a cluster- randomized trial design in four HIV high-burden districts of Maharashtra, India. A total of 117 Integrated Counseling and Testing Centers (ICTCs) were included in the study, randomized equally to either the Standard of Care (Arm 1) or to the COMBIND intervention (Arm 2). Each arm was stratified equally to rural or urban ICTCs. There were 900 HIV-positive pregnant and breastfeeding women recruited over a period of six to nine months at the participating ICTCs. After delivery, each participant and infant was followed for 24 weeks. The RTI International team performed quality assurance (QA) visits to verify regulatory adherence and protocol fidelity and to validate data integrity for the COMBIND study.

This project related to the Neonatal Research Network INS-3 protocol. The INS-3 was a phase 3, randomized, double-masked, placebo-controlled study designed to determine the effectiveness of myo-Inositol 5% Injection to increase survival in premature infants <28 0/7 weeks' gestation. Following this trial, RTI International supported the preparation of the Clinical Study Report (CSR). This support included retrieving, assessing, assembling, and reporting information generated by the Eunice Kennedy Shriver National Institute of Child Health and Human Development or by RTI during the course of the study that was relevant to the CSRs.

The National Institute of Justice seeks better understand the social context of violent victimization among at-risk and understudied groups. This study uses longitudinal, couples-based quantitative and qualitative data from 3,473 participants in the Multi-site Family Study on Incarceration, Parenting and Partnering to understand the context, types, and predictors of intimate partner violence (IPV) victimization in a population of reentering men and their partners in which 43% experienced physical partner violence victimization in a recent 6-month period.

 

Automated DOT (a-DOT), a smartphone app that uses facial recognition software and advanced features to detect non-ingestion, combines the accuracy of in-person DOT with the convenience of real-time centralized data collection and monitoring. Adding a daily sexual diary will allow precise tracking of the timing of both tenofovir/emtricitabine (TDF/FTC) ingestion and sexual risk episodes for evaluation of intermittent regimens. So, the project team is building and evaluating a new adherence measurement technology, DOT Diary (D2) that integrates a-DOT and a daily sexual diary on a smartphone platform. This adherence tool meets all four criteria of an optimal adherence measure: (1) provides evidence of medication ingestion, (2) precisely tracks longitudinal patterns of adherence, (3) provides real-time adherence monitoring, and (4) allows for individual feedback on adherence performance and tailored adherence support interventions. This adherence measurement and potential adherence intervention tool is being tested in young men who have sex with men in Atlanta and San Francisco. RTI International has been involved with the formative research and qualitative data collection and analyses activities at the San Francisco site.

The goal of this project is to conduct a review of HIV testing and linkage to post-test services among key populations in six Eastern and Southern African countries. Specifically, RTI  is reviewing the published and gray literature and existing governmental and international policies, as well as review ongoing research and programming, focusing on female sex workers, men who have sex with men, people who inject drugs, adolescent women, and male-specific interventions.

This study provided an estimate of the economic benefits of reduced alcohol consumption through its impact on breast cancer in younger women. It supported the Centers for Disease Control and Prevention’s (CDC's) strategies to educate young women on the risk factors for breast cancer. Additionally, the project complemented the other work CDC has been conducting, including several studies with RTI International, to develop a comprehensive set of economic analyses of breast cancer among women aged 18 to 44.

The Transfusion of Prematures (TOP) study is a randomized clinical trial designed to determine whether the primary outcome of death or significant neurodevelopmental impairment (NDI) in survivors at 22 to 26 months is less common among preterm infants maintained at a higher hemoglobin level. This trial provides an opportunity to conduct a secondary study on near-infrared spectroscopy (NIRS), a noninvasive bedside technology able to reliably measure regional tissue oxygenation of both cerebral and mesenteric tissues. RTI International is working to determine whether abnormal cerebral NIRS measures are a better predictor of NDI than hemoglobin alone and whether abnormal mesenteric NIRS measures are associated with the development of NEC within the 48 hours following a transfusion. Additionally, as the data coordinating center for the NIRS study, RTI collaborates with the study's clinical investigators in developing and implementing the study and disseminating results, providing leadership in statistical design and analysis, and providing data management and logistical support.

The National Human Trafficking Hotline (NHTH) serves victims and survivors of human trafficking and the anti-trafficking community in the United States. The program’s mission is to provide human trafficking victims and survivors with access to critical support and services to get help and stay safe, and to equip the anti-trafficking community with the tools to effectively combat all forms of human trafficking. RTI is supporting the Administration for Children and Families (ACF) on its efforts to: (1) describe the activities, procedures, and organization of the NHTH Program, including staff training, staff capacity, and service delivery; (2) describe the customer service of the NHTH, for example who contacts the NHTH, and what information or assistance do they seek; (3) describe the immediate outcomes of the NHTH, specifically with regard to callers and users; and (4) explore the creation of one or more new performance measures, to enable NHTH to explain its activities and accomplishments in an ongoing way to stakeholders.

The POWER (Prevention Options for Women Evaluation Research) study aims to develop and evaluate effective, scalable strategies that are context specific and gender responsive and that address critical gaps in microbicide and oral pre-exposure prophylaxis (PrEP) delivery for African women in high-HIV-incidence settings. To achieve these aims, RTI International has been working to: (1) conduct formative research among young African women, African men, and key informants, focusing on motivators and obstacles for initiation of and adherence to microbicides and PrEP, to inform development of effective communications, decision tools, and delivery strategies that meet women’s needs and are integrated with established programs, including regular HIV testing, (2) establish open cohorts of women for delivery of microbicides and PrEP; (3) Pilot optimized and scalable microbicide and PrEP adherence support and delivery strategies; (4) analyze cost-effectiveness and modeling delivery approaches; and (5) translate successful approaches to other programmatic settings.

In this study, RTI will conduct a medium systematic review of breastfeeding and maternal and infant health outcomes in developed countries.

Trafficking of male and female minor victims for sex or labor is a problem of growing concern, but there are insufficient data on the topic. Better information about the number and characteristics of trafficked minors is needed to support effective strategies to prevent trafficking, provide services to its victims, and prosecute its perpetrators. In this study, funded by the U.S. Department of Justice, National Institute of Justice (NIJ), RTI researchers are addressing this knowledge gap through analyses of statewide administrative data in Florida. Since implementation of its Safe Harbor Act, Florida has received more than 5,000 allegations of human trafficking involving minor victims. Analyses will address the presumed underreporting of minor victim trafficking by describing the number and characteristics of identified victims and statistically modeling the extent of unidentified victimization within the child welfare population. Findings will support empirically informed recommendations for service development, program planning, and policymaking within the fields of criminal justice, child welfare, and juvenile justice at federal, state, local, and tribal levels.

Researchers have been studying birth, growth, and development for decades, but most of the data they have collected are stored on hard drives or in file cabinets where no one has access to them. The Healthy Birth, Growth, and Development (HBGD) knowledge integration (HBGDki) initiative has brought a lot of these data together into a large and diverse knowledge base. The HBGDki initiative aims to facilitate collaboration between researchers, quantitative experts, and policy makers in fields related to HBGD, with a focus on reducing the global burden associated with three complex and interrelated outcomes: preterm birth, stunting, and impaired neurocognitive development. The goal is to enable broader impact of insights from past and ongoing studies by incorporating individual study data into larger pooled analyses. To assist with this project, RTI International identified and procured publicly available U.S. datasets that covered health topics related to preterm birth and maternal, newborn, and child health. Data curation tasks involved mapping variables to HBGDki domains and identifying variables that were consistent across datasets in efforts to harmonize data to address questions that single datasets were unable to address. These findings will be used for strategy development within the Bill & Melinda Gates Foundation and with its partners, including the World Health Organization and World Bank.

The Democracy, Human Rights, and Governance (DRG) Center for Excellence within the United States Agency for International Development (USAID) engaged in a series of initiatives to gather information on Agency efforts to integrate DRG principles and approaches into strategy development, project design, and program implementation. RTI International assisted the DRG Center in the promotion of cross-sectoral programming through targeted research as to what constitutes and supports more DRG integration, identifying ways to encourage more collaborative design and activity, and creating an evidence-base documenting the effects of DRG integration. To accomplish the project goal, RTI researchers helped to conduct and write six case study reports of DRG integration at USAID Missions in Ethiopia, Rwanda, Indonesia, Malawi, Guatemala, and Nepal. RTI staff provided technical expertise to organize a series of roundtable discussions in collaboration with USAID on Civil Society Engagement and Capacity Development 2.0, Public Financial Management, Strengthening Local Governance and Accountability Roundtable, and Policy Reform. Additionally, RTI staff took the lead in writing a synthesis report summarizing the results of the six case studies.

To assist the Ohio Department of Health (ODH) in monitoring maternal and infant health (MIH), the Ohio Colleges of Medicine Government Resource Center (GRC) developed and administered the 2016 Ohio Pregnancy Assessment Survey (OPAS), with the assistance of RTI International. The OPAS was modeled on the Centers for Disease Control and Prevention (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS). The PRAMS is a national state-level, ongoing, targeted population-based survey that collects information and attitudes on residential women who give birth. The PRAMS supplements birth certificate data by collecting information on women's attitudes, experiences, and behaviors before, during, and after they deliver a live infant. Using this model, the 2016 OPAS was administered to assist ODH and its Ohio partner agencies in assessing MIH in survey form in order to provide data to improve the health of mothers and infants.

RTI works with the US Department of Justice National Institute of Justice (NIJ) to study human trafficking. RTI takes a highly interactive and collaborative approach, incorporating our extensive evaluation experience, survivors' knowledge and perspectives, and task force expertise in responding to people who have experienced trafficking. Project activities began with developing in-depth knowledge for each task force (leadership structure, formal/informal partner agencies, existing protocols, service provision plans, task force objectives). During the implementation phase, RTI works closely with each task force on data collection, analysis, and task force refinement prior to disseminating results.

 

As a partner in the President's Emergency Plan for AIDS Relief (PEPFAR), the Department of Defense HIV/AIDS Prevention Program (DHAPP) assists countries in establishing HIV/AIDS prevention, care, and treatment programs or strengthening their capabilities to combat HIV. Targeted prevention efforts are important for young men and women serving in national militaries, who often report high rates of risky sexual behaviors and low condom use. RTI supported the military population of the Republic of Sierra Leone Armed Forces (RSLAF) in a HIV Behavioral and Seroprevalence survey with the following objectives: (1) provide technical assistance and training for the design and implementation of an HIV seroprevalence and behavioral risk surveillance study within RSLAF, (2) assist DHAPP with the adaptation of an HIV behavioral risk surveillance questionnaire appropriate for RSLAF, (3) develop data collection and management tools, (4) provide technical assistance to support the procurement of data collection supplies and the logistics necessary for field implementation, and (5) facilitate the dissemination of findings to inform RSLAF policy for improving prevention, care, and treatment. Essentially, behavioral and serological surveillance is important to determine the burden of the problem and to implement targeted prevention programs and clinical services.

This project is an extension of analyses RTI International has been conducting for the Centers for Disease Control and Prevention (CDC) since 2012. RTI has programmed a national compartmental model for HIV/AIDS, so the purpose of this project is to broaden the scope of the modeling effort by (1) incorporating uncertainty analyses, (2) investigating how new cases of HIV are generated based on calibration of the model’s mixing matrix, (3) calculating cost-effectiveness of pre-exposure prophylaxis for men who have sex with men compared with improvements to the test and treat continuum, and (4) allocating optimal, national HIV prevention resources from a societal perspective and consideration of the role of public health.

This cooperative agreement with March of Dimes is funded by the Centers for Disease Control and Prevention’s (CDC’s) National Center on Birth Defects and Developmental Disabilities (NCBDDD) to conduct formative research to understand clinician's and pregnant women's understanding of the use of over-the-counter medications early in pregnancy. The project builds on previous contract work RTI International has done for NCBDDD, and a successful collaboration RTI had with March of Dimes via a national consumer workgroup via RTI’s previous CDC NCBDDD work.

RTI International developed a novel, highly automated method of gestational age estimation at delivery combining anterior lens capsule vascularity (ALCV) and biophysical parameters appropriate for use in low-income countries. The specific aims of the study are: (1) to develop an algorithm to predict gestational age at delivery from 26 to 42 weeks’ gestation with ALCV and key biophysical parameters and (2) to evaluate the performance of gestational age estimates based on ALCV and biophysical parameters. RTI accomplished this through a multi-site, cross-sectional study among newborn children in the United States and internationally to measure ALCV and key biophysical measures of gestational age, and, via modern statistical approaches, to develop a robust predictive algorithm for gestational age. The combination of domestic sites allowed the project team to test and refine the algorithm in U.S. research universities, while the international sites allowed the team to explore feasibility and performance in low-resource settings.

This study will evaluate ongoing gender-based violence programming under the DREAMS Initiative in Kenya, as well as develop and pilot test an intervention to improve PrEP uptake and adherence among women exposed to violence.

MindanaoHealth improves the health of Filipino families in targeted provinces by expanding their access to high-quality, integrated MNCHN and FP services at household level, in communities, and at both public and private facilities. Working with Centers for Health Development (CHD), Provincial/Municipal/City Health Offices and local government unit counterparts, the project addresses the distinct service delivery needs of priority populations, which include men and women of reproductive age, youth, including adolescent boys and girls, children under five years of age, and poor families covered by the Government of the Philippines' National Household Targeting System for Poverty Reduction. RTI's core focus is working with local partners and government counterparts focusing on the systems strengthening aspects of the project including: operationalization of FP/MNCHN policies, improving access and utilization of central government grants, and providing direct support to CHDs in the following areas: date analysis and use, mobilizing and managing financial resources, logistics management and investment planning.

The goal of this project was to help reduce new HIV infections and improve health outcomes among heterosexual males and females at greatest risk of HIV acquisition, men who have sex with men, transgender individuals, and other persons who experience non-occupational exposure that may lead to acquisition of HIV, by creating increased understanding of PrEP and PEP among health care providers, thereby encouraging them to recommend or prescribe the medications to all patients at high risk of HIV acquisition. Sponsored by the Centers for Disease Control and Prevention (CDC) and the National Center for Health Marketing (NCHM), this contract builds on materials and outreach programs created in the initial PrEP and PEP educational program launched in the fall of 2015.RTI International has provided support in the following areas: (1) writing and web content development, (2) digital medical education, (3) social and digital media, (4) conference exhibits panel, (5) materials development, (6) trade media advertising, (7) earned trade media, (8) account management, (9) progress reports, and (10) fulfillment and storage service.

 

The study will develop a framework that links drinking patterns and a range of alcohol consequences to address questions about the effectiveness and cost-effectiveness of evidence-based alcohol dependence treatment approaches and to explore whether some approaches could lead to better quality of life and reduction in alcohol-related costs in the long-term.
The study aims to: (1) develop a dynamic simulation model to link drinking patterns, long-term alcohol consequences, alcohol treatment effectiveness and cost-effectiveness, and (2) use the model to estimate the long-term costs and outcomes of the nine treatment arms examined in COMBINE under scenarios of recurrent treatment episodes throughout lifetime, and the impact of COMBINE therapies on different age, ethnic and gender cohorts, hence producing long-term cost-effectiveness estimates for different subgroups.  To date, no study has estimated the long-term cost-effectiveness of alcohol treatments. This project will address this research gap by applying established dynamic modeling methods which take into account the long-term range of effects of problematic alcohol consumption to achieve better estimates of the costs and benefits of alcohol treatment.

Research on maternal nutrition before conception remains very limited, despite evidence of its importance during this period and throughout the first trimester of pregnancy. This project aims to determine the benefits to the children of women in poor, food-insecure environments of taking a daily comprehensive maternal nutrition supplement (with additional balanced calorie/protein supplement for underweight participants) at least three months prior to conception versus the benefits of the same supplement at 12-14 week gestation, compared to a third group who receive no supplement.

This research aims to comprehensively evaluate a multi-component HIV prevention project in Zimbabwe targeting young female sex workers (FSW) under 25 years of age, to determine methods of delivery that result in the highest uptake, retention, and compliance. Young FSW are a vulnerable population at greater risk for HIV acquisition than their older counterparts, yet their engagement in HIV services remains low. Funding has been secured to implement an evidence-based, HIV prevention pilot project for young FSW, integrated within Zimbabwe's National Sex Worker Programme (NSWP) clinics. This project will comprehensively evaluate the pilot project at 8 NSWP clinics, benefiting from the infrastructure, resources, and wealth of programmatic data available from all 36 NSWP sites nationally. The specific aims are to: (1) determine barriers and facilitators to implementation and uptake of the HIV prevention pilot project, (2) implement and evaluate the pilot project using a randomized stepped wedge design, and (3) estimate the cost and cost-effectiveness of the different HIV prevention components. This study will provide quantitative and qualitative evidence to determine if a future trial to scale up and evaluate the intervention's effectiveness/cost-effectiveness is warranted.

The Center for Weight and Health (CWH) is a national leader in research to develop and evaluate programs in the fields of obesity, healthful eating, and active living. In partnership with the California Department of Public Health (CDPH) Nutrition Education and Obesity Prevention Branch (NEOPB), CWH oversees the Obesity Prevention Evaluation Research Unit. The unit conducts evaluation research to inform and improve programs and policies related to nutrition and physical activity behaviors of low-income Californians of all genders. The facility also conducts evaluation and tracking specifically focused on the process, impacts, and obesity-related outcomes of Supplemental Nutrition Assistance Program Education (SNAP-Ed) interventions. One of the SNAP-Ed interventions is the Champions for Healthy Change media campaign that promotes healthy eating, physical activity, and community engagement. The Nutrition Education and Obesity Prevention Branch Champions for Change Media Campaign included four different campaigns: Join the Movement, Legacy of Health, Not My Kids (A Mis Hijos No), and Traditions. The purpose of the survey was to assess associations between levels of exposure to the 2015 advertisements and self-reported outcomes. RTI International worked with CWH to conduct the California Champions for Change Media Campaign evaluation.

This project aims to improve services for victims of human trafficking in the United States by supporting the Administration for Children and Families (ACF) through evaluations, working with grantees to improve performance measurement, and informing ACF's decisions regarding future evaluation activities. In 2014, ACF's Family and Youth Services Bureau (FYSB) provided coordinated case management and comprehensive direct victim assistance to domestic victims of severe forms of human trafficking through demonstration projects. The demonstration projects continued through 2015, to build and sustain coordinated service systems and partnerships with allied professionals in community-based organizations (CBOs). These CBOs work with populations such as runaway and homeless youth, and domestic violence, sexual assault, and human trafficking victims.

Uterine prolapse, or the dropping or sagging of the uterus (and perhaps other organs like the bladder) into the vagina is, unfortunately, a fairly common problem in women. The investigators of the Pelvic Floor Disorders Network have been very interested in comparing various treatments for prolapse in order to provide information that will help doctors develop the best treatment plan for their patients. Often, repair of uterine prolapse includes removal of the uterus (hysterectomy). An alternative procedure is one that supports the prolapsing uterus (hysteropexy) and pelvic organs. In this study, the investigators, including a RTI researcher, are comparing these two prolapse procedures. Women in this study have been randomly assigned to one of the two vaginal prolapse procedures. All participating women will complete questionnaires and a physical examination before and then for up to five years after surgery. This study began in March, 2013, and is expected to continue until about 2018. Recruitment and surgical procedures will occur over the first two years, and women enrolled in the study will continue to be followed afterwards for the additional three years.

With the changing HIV prevention landscape, the Centers for Disease Control and Prevention (CDC) Prevention Communication Branch (PCB) changed its messaging to include information about both HIV risk factors and evidence-based strategies for reducing risk that include the newer prevention strategies. Since 2009, RTI International has been working with PCB to address these challenges through two projects: (1) the development of a comprehensive, online, tailored, interactive HIV Risk Reduction Educational Tool (HRRET) to communicate accurate information about HIV, HIV risk, and ways to prevent both HIV acquisition and transmission and (2) the implementation of the Message Testing for High Impact Prevention project to expeditiously test messages on timely HIV prevention topics. The HRRET originally was intended to be developed specifically for sexual risk reduction among men who have sex with men (MSM). However, PCB later expanded the scope to include HIV risk reduction more broadly as well as information for heterosexual men, women, transgender persons, and injection drug users. The goal of the Message Testing for High Impact Prevention project is to combine evidence-based, scalable, and cost-effective interventions in ways that reach people most at risk for HIV, including MSM, Latinos, African Americans, injection drug users, transgender persons, youth, and people living in high prevalence areas.

Sub-Saharan Africa experiences an enormous burden from cervical cancer, but lessons learned from successful programs have not been synthesized and disseminated to foster scale-up of cost-effective implementation strategies in the region. To address this gap, RTI International performed a process evaluation of the successful Cervical Cancer Prevention Program in Zambia (CCPPZ), undertook a comprehensive assessment of stakeholder perspectives and funding options, and developed an innovative model to assess cost and effectiveness under real-world conditions. This study will provide evidence-based implementation guidelines on the optimal selection of prevention and screening interventions that can be scaled up in sub-Saharan Africa to reduce mortality from cervical cancer.

Studies have shown that males and females differ in their susceptibility to nicotine dependence (ND) and other cigarette smoking behaviors.  With regard to genetics, heritability of ND is estimated at 50%, and specific variants in the nicotinic acetylcholine receptor (nAChR) genes are known to increase risk of ND. These associations were discovered from genome-wide association studies (GWAS) of ND and other smoking behaviors, yet no prior studies have evaluated differences in genetic associations by sex. This study aims to: (1) conduct a genome-wide joint 2df meta-analysis of ND accounting for interaction with sex and (2) test SNPs with the most significant meta-analysis results, when accounting for interaction with sex, for independent replication.
 

In order to keep people living with HIV (PLWH) in care and assist clinicians who serve them, innovative and engaging communication strategies are needed. This project, funded by the Centers for Disease Control and Prevention, National Center for Health Marketing, aimed to develop a computer-based tool—Positive Health Check—to deliver prevention messages to patients and signal important information to providers, a strategy that has shown promise in changing HIV risk and adherence behaviors.

The Birth Defects - Study to Evaluate Pregnancy Exposures (BD-STEPS) was a retrospective collection of data that sought to identify modifiable maternal exposures in early pregnancy. This study was built on the foundation of the Centers for Disease Control and Prevention (CDC) National Birth Defects Prevention Study that assessed a variety of exposures for their potential association with specific birth defects. BD-STEPS provided critical data to support the goals of the CDC's National Center for Birth Defects and Developmental Disabilities by identifying the causes of key birth defects and modifiable risk factors and promoting health and well-being among people of all ages who are affected by disabilities. RTI International offered CDC scientific expertise in pregnancy research, technical expertise in data collection, experienced project management, and seamless integration with the Metropolitan Atlanta Congenital Defects Program, which RTI has been supporting since 2008.

Men who have sex with men (MSM) continue to be the population most affected by HIV. Although they represent about 4% of the U.S. male population, they continue to account for more than half of the new HIV infections annually. African Americans and Latinos are also disproportionately affected by HIV. Other high-risk groups for HIV infection include HIV-negative partners in mixed-status relationships, sex workers, transgender communities, and injection drug users. Although, more prevention strategies are available today than ever before, research has shown that there are significant gaps in the HIV continuum of care (CoC) that may hamper national efforts to stem the tide of infection. In 2013, the White House implemented the CoC initiative to help focus future prevention efforts to meet the primary goals of the newly revised National HIV/AIDS Strategy and direct funding where it is needed most. RTI International is assisting the Centers for Disease Control and Prevention with this initiative by completing the following tasks: (1) quantitative data collection and analysis, (2) qualitative data collection and analysis, (3) secondary data review and analysis, (4) social media and web metrics monitoring, (5) message, concept, and materials testing for transgender populations and health care providers who treat them, (6) planning and reporting activities, and (7) supplemental and administrative tasks.

The Centers for Disease Control and Prevention (CDC) and the White House launched Act Against AIDS (AAA), a 5-year national campaign to combat complacency with HIV and AIDS in the United States. The campaign focused on raising awareness among all Americans and reducing the risk of infection among the populations disproportionately affected by HIV—gay and bisexual men, African Americans, Latinos, other communities at increased risk, and health care providers who provide medical services to those at risk. During the campaign, RTI International planned and conducted formative research, message testing, concept testing, and materials testing on new components of the AAA campaigns, as well as process and outcome evaluations on existing AAA campaigns. AAA consisted of several concurrent HIV prevention and testing campaigns and used mass media and community outreach to deliver important HIV prevention and messages.

Fragile X syndrome is a genetic condition that causes a range of developmental problems including learning disabilities and cognitive impairment. We are working with The John Merck Fund to include fragile X as part of our Early Check newborn screening project.

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Program provides  nutrition assistance, nutrition education, breastfeeding promotion and support, and referrals to health and social services for low-income and nutritionally at-risk pregnant, breastfeeding, and postpartum women, as well as to infants and young children up to age five. The 2013 WIC Vendor Management Study examined the management of retail delivery systems and determined the extent to which WIC vendors follow program rules and the factors associated with any violations. As subcontractor to Altarum, RTI International provided support in numerous ways, which included constructing a sample frame of WIC vendors, selecting a nationally representative sample of vendors, developing and pretesting field data collection instruments and procedures, and assisting Altarum in analyzing and reporting study findings. One significant finding from the study was that the rate at which vendors allow buyers to substitute items for traditional WIC benefits has declined but is disproportionately high for benefits with a cash value.

RTI’s project team conducted a multi-country cluster randomized trial to assess the impact of antenatal ultrasound screening performed by community physician and non-physician health care staff on a composite outcome consisting of maternal mortality and near-miss maternal mortality, stillbirth, and neonatal mortality in low-resource community settings. This trial took place in India, Pakistan, Guatemala, Kenya, and Zambia. The study aimed to evaluate whether use of ultrasound in community health centers: (1) increases antenatal care attendance, (2)  increases the use of delivery facilities by women with pregnancy complications, and (3) reduces a composite outcome of maternal mortality and near-miss mortality, stillbirth, and neonatal mortality. RTI served as the data coordinating center  for this project, providing oversight and overall study management, developing data collection tools, developing the data management system, maintaining the IT system for data transmission, conducting statistical analyses, and ensuring data quality.

 

This project seeks to develop a model that uses pharmacodynamic data from prior studies with Carbon-60, a naturally occurring molecule of carbon, and carbon nanotubes in pregnant and lactating women and pharmacodynamic data from cardio-, pulmonary-, and other -cell based in vitro and ex vivo studies. Pregnancy that is compromised by both obesity and heart disease particles is of considerable importance in understanding risk to the mother, fetus, and child. This study will observe how differences in distribution of particles to the lungs and reproductive tissues relates to risks of heart and lung/airway diseases, and risks to the developing fetus or developing offspring are areas of interests.

RTI International provides training and technical assistance support for the Administration for Children and Families’ Adolescent Pregnancy Prevention (APP) Program. Specifically, this project seeks to: (1) provide training and resources to enhance service quality, ensure fidelity of program implementation and appropriateness of adaptations of evidence-based models, and enhance grantee skill sets to reduce adolescent pregnancy, (2) disseminate knowledge and technical assistance, (3) provide technical assistance individually and in small groups, (4) monitor grantees’ programmatic performance, (5) identify the APP needs of the grantees and provide recommendations for approaches and speakers to be incorporated at the APP grantee conference, (6) provide planning and logistical support for annual grantee conferences, and (7) support a web-based resource center entitled The Exchange.

The purpose of this project is to support development and optimization of HIV prevention techniques, such as systemic microbicide or multipurpose prevention technologies (e.g. products that combine prevention of HIV with prevention of pregnancy).

The purpose of this project at RTI International is to support an evaluation of three discretionary grant programs for the Substance Abuse and Mental Health Services Administration (SAMHSA) – the State Adolescent Treatment Enhancement and Dissemination grants (SAT-ED), the State Adolescent and Transitional Aged Youth Treatment Enhancement and Dissemination grants (SYT), and the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women (PPW) programs. Key objectives are to: (1) perform separate cross-site evaluations for SAT-ED and SYT, which are newer Center for Substance Abuse programs and have never been evaluated, (2) provide a report on pregnant/post-partum women in each of the 3 programs; (3) provide ad hoc reports for the three programs; and (4) provide analysis for examining the feasibility, utility, and sustainability of future adolescent and PPW cohorts.

Recent epidemiologic studies suggest that women with adverse pregnancy outcomes (APOs), such as preeclampsia, are at increased risk for subsequent cardiovascular diseases. However, prospective data to elucidate the precise relationship between adverse pregnancy outcomes and subsequent cardiovascular disease are lacking. To address this critical knowledge gap, the National Heart, Lung, and Blood Institute (NHLBI), in collaboration with the Eunice Kennedy Shriver Kennedy National Institute of Child Health and Human Development, funded a follow-up study of expectant mothers to evaluate the association between APOs and maternal health approximately two years postpartum using prospectively and rigorously collected data and bio-specimens. This multicenter group is utilizing an ethnically, racially, socioeconomically and geographically diverse cohort of 10,000 nulliparous women enrolled in the NICHD-funded Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be. During the initial months of the project, RTI International helped develop the study protocol, consent forms, case report forms, study brochures, and other supporting documentation. RTI staff also developed data capture and data management systems during this same time period in preparation for enrollment.

The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Nulliparous Research Network to study women for whom the current pregnancy will lead to their first delivery (nulliparas). In this study the Network enrolled a cohort of a racially/ethnically/geographically diverse population of 10,000 nulliparous women to undergo intensive research assessments during the course of their pregnancies to study the prediction and prevention of adverse pregnancy outcomes such as preterm birth, preeclampsia, fetal growth restriction, and stillbirth. RTI has served as the Data Coordinating and Analysis Center (DCAC) for the project and has established a scientific partnership with Steering Committee membership to transform the research agenda into operationally sound protocols, developed study materials, developed and implemented data collection and management systems at the DCAC and the clinical sites, provided quality assurance for Network operations, and developed procedures for and conducted data analysis. The information gained from the Nulliparous Research Network will benefit women who are pregnant or who are considering pregnancy and their physicians. In addition, the knowledge will support future research aimed at improving a critical group of at-risk women who are currently understudied.

The RTI team is working closely with HHS/CDC Zimbabwe, the Ministry of Health, and other local organizations to improve their capacity to disseminate and utilize systems-generated health data at national, provincial, district, and clinic levels.

To fully implement the Prison Rape Elimination Act (PREA) of 2003, the Bureau of Justice Statistics (BJS) has developed a multiple-measure, multiple-method data collection strategy. One of these data collection activities, the National Inmate Survey (NIS), involves obtaining information directly from male and female adult inmates on their experiences with sexual assault. Building on the knowledge gained from the first two years of the NIS, RTI's role in this project is to prepare a touch-screen audio computer-assisted self-interviewing instrument to measure the incidence and effects of sexual assault in correctional facilities and to determine the common characteristics of both the victims and the perpetrators of these crimes. RTI's responsibilities also include data collection, data processing, data analysis, and reporting of this study conducted in approximately 650 correctional facilities. Results allow BJS to report valid yearly estimates of the incidence and effects of sexual assault among inmates. The major challenge arises from the fact that victimization, particularly sexual assault by a same-sex perpetrator, is an extremely sensitive and taboo subject that introduces complexities for collecting self-report data. However, RTI's extensive experience developing and managing complex surveys on sensitive matters makes it uniquely positioned to successfully meet the challenging demands of this project.

This project is a cooperative agreement for RTI International to serve as the data coordinating center (DCC) for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network (NRN). The network includes a cooperative group of 15 U.S. hospital clusters that conduct clinical research to investigate persistent unanswered questions regarding the safety and efficacy of treatment and management strategies for newborn infants. These hospitals enroll mostly premature babies into clinical trials and observational studies that test the efficacy and safety of various treatments, with several protocols active at any given time. The specific aims for RTI as the DCC are: (1) to play a pivotal role in data management and analysis and (2) to provide statistical expertise and logistical services required for the NRN in support of its mission to investigate the safety and efficacy of treatment and management strategies for newborn infants.

RTI International’s study of small businesses in STEM fields looks specifically at gaps in business performance and commercialization outcomes among minority entrepreneurs (e.g. non-white minorities, women). This study uses data from firms receiving Phase II funding from federal Small Business Innovation Research (SBIR) programs to understand gaps in innovative behaviors of minority-owned and female-owned businesses. Given that the goal of the SBIR program is commercialization of a funded technology, commercialization is the focal outcome variable of this study. The research design incorporated uses an econometric model of the probability of commercialization as a function of the minority/gender ownership of the business, in addition to other owner and business characteristics.

The Committee on Women in Science, Engineering, and Medicine (CWSEM) of the National Academies is studying the influence of sexual harassment on the career advancement of women in science, engineering, and medicine, particularly in the higher education and medical settings. They reached out to RTI to conduct focus groups with various academic stakeholders, with a goal of learning about potential strategies and policies that might enable a broad range of institutions to identify what works and what does not in terms of reducing sexual harassment. We are working with sexual harassment experts on their Committee to develop a protocol and conduct the focus groups.

Together with patients and key stakeholders, such as healthcare providers, we have designed a study to address the gap in evidence on how best to deliver evidence-based behavioral lifestyle interventions to obese Latino men. We propose to compare the effectiveness of MyCHOICE (Men Making Healthy Lifestyle Choices) with a minimal intensity behavioral lifestyle intervention for promoting sustainable weight loss. MyCHOICE is a 12-month primary care-based lifestyle intervention tailored specifically for Latino men that has strong potential to lead to clinically significant weight loss.

Driven by the fact that “women are driving economic growth” in Latin America and the Caribbean, Citi Foundation and Junior Achievements Americas led an initiative focusing on young women between the ages of 18 and 25 to train them on practical business skills and financial acumen in Argentina, Costa Rica, Dominican Republic, Paraguay, and Ecuador. RTI International used a mixed-methods approach to evaluate the impact of this program using a combination of retrospective and prospective evaluation strategies for meta-analysis. The results of this rigorous impact evaluation will support decision making toward improving the program and ensuring its sustainability.

RTI International has worked to ensure that the Show Your Love mobile application is developed, providing value, and meets the health needs of the target demographic (women between the ages of 18 and 44 who indicate that they intend to become pregnant in the next year or two) through strategic planning, program development, evaluation, and promotion. This preconception health (PCH) mobile app will help the CDC Foundation support healthy pregnancies by providing evidence-based content that makes women who are planning a pregnancy feel energized, supported, and equipped to maintain PCH behaviors and tackle everyday barriers to those behaviors.

The overall goal of this RTI International project was to increase the use of quality family planning (FP) services among Uganda People’s Defense Forces (UPDF) uniformed personnel, their spouses, and populations surrounding UPDF establishments and facilities. The primary target population was HIV-infected and HIV-uninfected men and women of childbearing age, and their partners, who were receiving HIV-related and sexual and reproductive health services at the 15 project-supported UPDF facilities. Objectives were to: (1) increase availability and access of all modern FP methods; (2) increase demand for FP services; (3) improve infrastructure for the delivery of quality FP services; (4) strengthen the supply chain for FP commodities and supplies; and (5) improve the quality of FP services. Special attention was paid to strengthening the FP component of the Option B+ package for prevention of mother-to-child transmission and linking FP services with other maternal and child health services that are part of the Uganda Ministry of Health’s Saving Mothers initiative.

The Impact Research and Development Organization (IRDO) study developed strategies to increase uptake of voluntary medical male circumcision (VMMC) in men aged 25 to 39 years based on feedback provided by uncircumcised men in this age group and information provided by their wives and partners. One of the major barriers identified in preliminary research is loss of income during the recovery period, which remains an issue even when cultural and personal concerns are addressed through counseling. Alleviating this barrier may require reimbursements to men; however, compensation brings its own controversies. RTI International supported this study by performing quality assurance visits to verify regulatory adherence and protocol fidelity and to validate data integrity for the study. Results from the study have provided important data on the effectiveness of increasing VMMC rates through counseling and improved environments for provision of services to older men without direct monetary compensation.

Both experimental and correlational evidence demonstrate that alcohol consumption can increase the risk of intimate partner violence (IPV). In addition, experts have developed interventions that effectively reduce alcohol consumption. Together, these bodies of work suggest a promising avenue for reducing IPV, an issue of critical relevance globally and in India. Despite the high rates of alcohol use and IPV in developing countries, previous efforts to design, implement and evaluate interventions to reduce alcohol use have mainly been based in developed countries despite the high need elsewhere. Given this gap, we are working together with a stellar multi-disciplinary team made up of MIT, the University of Maryland, and led by Ideas42. This team brings expertise in incentives and commitment based approaches to reduce drinking, cognitive behavioral therapy for alcohol and IPV reduction, and violence against women intervention research.

The purpose of the Quatro Study, sponsored by CONRAD is to assess the acceptability, preferences, user experience, and effect on sexual behavior of four different vaginal microbicide or multipurpose technology  (combining HIV and pregnancy prevention) delivery forms, using placebo products in 18- to 30-year-old African women: rapidly disintegrating vaginal insert, intravaginal ring (IVR), film, and gel. The study also examines adherence to the dosage forms through objective markers, developed for each dosage form prior to the commencement of the study. Furthermore, the study assesses acceptability, preferences, and potential barriers to uptake by conducting qualitative interviews and focus group discussions with male partners of women who used the Quatro products and health providers and key stakeholders. RTI International's role is to oversee the study activities, develop research instruments, manage funding, handle logistical issues, and lead analysis and publication. Additionally, the fieldwork is implemented by RTI’s collaborating clinical research sites in Harare, Zimbabwe, and Durban, South Africa. Information gathered in the Quatro Study will lay the foundation for improved, female-initiated HIV-prevention and multipurpose technology products and provide early assessment to modify products, packages, and messages with the goal of increasing product uptake and use.

RTI International is helping to expand and advance the scientific knowledge base of violence prevention by rigorously evaluating prevention strategies, programs, and policies to address specific gaps in the prevention of teen dating violence, intimate partner violence, sexual violence, and youth violence. Men Can Stop Rape (MCSR) is a non-profit community-based violence prevention organization that has developed a theoretically-based 22-week curriculum that is delivered in high schools as an after school program called Men of Strength (MOST) Club. RTI is working with MCSR to rigorously evaluate the impact of the MOST Club curriculum on perpetration of physical and sexual violence and on bystander behavior. Additionally, the MOST Club curriculum is unique as its primary mechanism of change is to shift the narrative of masculinity among high school men who can serve as peer leaders. Combining a traditional randomized control trial based evaluation with social network referrals will allow examination of program effects on both Club participants and male and female peers with whom participants regularly come in contact.

The purpose of this study is to examine the extent of criminal justice involvement and its association with unmet healthcare needs among African American women who use illicit drugs. Previous research has determined that there are significant disparities in health and healthcare which disadvantage African American women. However, the role that criminal justice involvement plays in contributing to or reducing these disparities is largely unexplored. The health-related needs of criminal justice involved women appear to be distinct from those of the men, who make up the majority of the criminal justice population. The specific aims are: (1) to characterize the range and accumulation of criminal justice involvement (no involvement, arrest, community supervision, incarceration) in a community-based sample of African American women who use illicit drugs and (2) to examine the association of unmet healthcare needs with the range and accumulation of criminal justice involvement, while controlling for predisposing, enabling/impeding and need factors.

Funded by the U.S. Department of State, Office to Monitor and Combat Trafficking, this project aims to strengthen Tanzania’s national criminal justice system’s response to trafficking in persons (TIP) and to ensure access to justice and fair treatment for all TIP victims. In doing this, RTI International is conducting a review of current TIP regulations and laws in Tanzania and comparing them with international standards, proposing any rewrites or amendments of the current laws or drafting new laws to better protect victims and enhance national and international coordination. The results of the project are expected to lead to stronger laws and implementing procedures, better victim and witness protections, strengthened capacity within the government entities responsible for implementing the Anti-TIP law, and ultimately, the dismantling and deterrence of traffickers through more effective prosecution.

Adequate nutrition during their first 1,000 days is necessary for children to grow and develop to their full potential. Alive & Thrive (A&T), a study sponsored by the Bill & Melinda Gates Foundation, contributes to better nutrition during the first 1,000 days by promoting improved infant and young child feeding (IYCF) practices. In its first 5 years, A&T successfully delivered high-impact IYCF interventions at scale in three countries. During the second phase, A&T will expand its effort to several new countries, including Nigeria. The target states in Nigeria are Lagos and Kaduna. As part of A&T’s efforts in Nigeria, an external evaluation will be conducted to rigorously measure the impact of two different A&T intervention models as adapted in Kaduna and Lagos states. These interventions will use different types of communication strategies, including interpersonal communication, community mobilization, and mass media communication. The two intervention models will include community mobilization and will differ in the interpersonal communication strategy. The two strategies are (1) an intensive interpersonal communication intervention with a full array of messages on IYCF and multiple interactions with women in the target group, and (2) a streamlined interpersonal communication approach with a more targeted set of messages and fewer interactions. These two interventions will be compared with mass media communication on infant and young child feeding, which will be provided throughout the two states. RTI will assist in conducting the impact evaluation of A&T.

In response to the Zika Virus outbreak, the Centers for Disease Control and Prevention (CDC) and the CDC foundation have been developing a campaign to promote awareness, knowledge, dialogue, and prevention behaviors against Zika. The project pays special attention to pregnant women as the primary audience with secondary audiences being community influencers, health care providers, and potentially family and friends of pregnant women, women of childbearing age, and community members. The campaign also focuses on Puerto Rico, US Virgin Islands, and American Samoa with emphasis on Puerto Rico given the status of the outbreak. Central to the campaign is the acceptability and uptake of Zika prevention kits which are being deployed for use among pregnant women. The campaign is integrating the kits into communication efforts and is assessing dissemination opportunities with private partnerships. Phase one of the campaign will inform phase two activities which are targeting the Caribbean and Latina American Region and being led by the Pan American Health Organization. RTI has been responsible for pre-strategy development, formative research, development of campaign strategy, community engagement and mobilization, campaign products, media buys, media events, and process and outcome evaluations.

Attention to human trafficking has surged over the past decade, particularly with regard to the child trafficking for sex or labor, due in part to the passage of the Trafficking Victims Protection Act  in 2000. In this study sponsored by the U.S. Department of Health and Human Services, Administration for Children and Families (ACF), RTI International is compiling existing information and conducting new data collection to document existing efforts and explore shared risk factors and overlapping trajectories that connect child maltreatment and child trafficking victimization. The Domestic Human Trafficking and the Child Welfare Population study will provide immediate support and long-term guidance for these efforts by compiling existing research, policy, and practice; developing a research agenda and plan for near-term efforts; and conducting studies that can immediately guide practice.

RTI expanded the project to activities that include youth who run from foster care and are at risk for human trafficking. The investigation provides a look at the intersection between foster care episodes and HT. Evidence from this large cohort of youth suggests that stabilizing foster care placements may impact both runaway behavior and human trafficking victimization experienced while on runaway status. With greater understanding, more effective interventions aimed at preventing the onset and reoccurrence of both runaway behaviors and human trafficking victimization can be developed.

In an effort to understand how to best identify and address intimate partner violence (IPV) in the context of healthy marriage and relationship education programming, the Administration for Children and Families (ACF) is conducting the Responding to Intimate Violence in Relationship Programs (RIViR) project. The RIViR project involves (1) synthesizing information on IPV experiences across healthy relationship grantee populations; (2) assessing IPV protocol approaches among current healthy relationship grantees; (3) building an evidence-informed framework for understanding IPV in healthy relationship programs; (4) developing parameters for IPV screening tools and surrounding protocols; and (5) identifying and testing IPV screeners and surrounding protocols in healthy relationship programs. The purpose of this project is to help healthy relationship programs realize their full potential to prevent IPV, ensure victim safety, and connect victims and perpetrators with support. RTI is providing support by building a practical, evidence-informed theoretical framework and parameters for addressing IPV in healthy relationship programs, selecting and validating IPV screening tools and protocols, describing IPV experiences and service needs among healthy relationship participants, and summarizing healthy relationship program approaches to IPV. RTI will also work collaboratively and responsively with the Office of Planning, Research, and Evaluation.

The Office for Victims of Crime (OVC) and the Office of Juvenile Justice and Delinquency Prevention (OJJDP) intend to fund up to eight demonstration sites that will implement trauma-informed, comprehensive services for male survivors of violence. OVC and OJJDP also fund training and technical assistance (TTA) providers to assist the demonstration sites with outreach efforts aimed at educating stakeholders and communities where projects operate on adverse effects of trauma and violence. RTI is implementing a mixed-methods evaluation design to determine demonstration sites' fidelity to implementation strategies with the goal of improving services for male survivors of violence and their families.

The Office of Victims of Crime funded RTI to design and implement a cross-site evaluation of a demonstration initiative, which seeks to provide timely and culturally relevant victim and trauma-related services to young men and boys of color who have experienced violence. The evaluation includes an assessment of existing partnerships of each demonstration site strategy, focusing on the roles and responsibilities are of partners that contribute to the success of the project.

Studies have shown that women and men differ in their patterns of substance abuse and dependence. Gender differences in the effects of THC, the primary psychoactive substituent of marijuana, have been reported in humans, but the mechanisms responsible for these differences are unclear and are the focus of this research at RTI International. This study aims to determine whether gender differences in the antinociceptive and dependence-related effects of THC, respectively, are modulated by gonadal hormones, estradiol, and progesterone in females and testosterone in males. Gender differences in tolerance to the pain relieving effects of THC, one of the potential therapeutic indications of cannabinoid-based medications, will also be evaluated. Understanding these basic mechanisms underlying sex differences will facilitate development of gender-specific approaches to treat marijuana dependence and to use cannabinoid-based medications therapeutically, specifically in the treatment of pain.

The purpose of the Girls' Education Challenge (GEC) is to help up to a million of the world’s poorest girls improve their lives through education and find better ways of getting girls in school and ensuring they receive a quality of education to transform their future. RTI International is part of the Evaluation Manager, led by Coffey International. In this role, RTI is responsible for developing and conducting the learning assessments associated with the evaluation for quality assurance on sampling frameworks and for providing the design of a longitudinal study. The purpose of this study is to establish the impact of the education of marginalized girls on a range of economic, social, health, and societal outcomes.

The goal of this project, funded by the Bill & Melinda Gates Foundation, is to evaluate the acceptability of three multipurpose prevention technology (MPT) delivery forms for the prevention of HIV and unintended pregnancy among young women in Kenya and South Africa: a vaginal ring, an injectable, and a co-formulated daily oral tablet (all placebos). RTI International designed data collection activities to inform the development of a culturally appropriate MPT communication strategy and educational messages tailored for young women in these sub-Saharan African settings. Additionally, the fieldwork for this study is implemented by RTI’s collaborating clinical research sites in Kisumu, Kenya, and Pretoria, South Africa. Other aspects of RTI's role are to oversee the study activities, develop research instruments, manage funding, handle logistical issues, and lead analysis and publication. This research will help identify how products and their attributes are viewed by young women at dual risk of HIV and unintended pregnancy and how messaging about the products can be appropriately tailored to increase adoption of these methods. Moreover, the findings will enhance the potential public health impact of MPTs in addressing two critical women’s health issues.

This study uses mixed methods to identify health literacy challenges related to accessing and using Medicaid among women on probation who were signed up since the Affordable Care Act. From these findings, researchers will adapt and pilot a health literacy intervention, originally developed for women leaving jail, for women on probation with Medicaid.

The Dominican Republic At-Risk Youth Initiative (DRARYI) project provides young people with the opportunity to develop their talents and values, integrate into society through educational and technical training programs, and become productive and positive contributors to society. The main beneficiaries are vulnerable young people who have dropped out of school, committed crimes, been in gangs, teen or young single mothers, young people with disabilities, and other similar groups seeking opportunities to re-invent their lives and start over. The project is also helping HIV-positive youth. Specifically, the project seeks to improve opportunities for youth through better policies, systems, and services in education, health, workforce development, and crime and violence prevention. RTI is a subcontractor to ENTRENA, and provides monitoring and evaluation services as well as technical assistance related to youth at-risk including: health (physical, mental, reproductive/sexual, substance abuse), education (truancy, reinsertion, retention, improved literacy), criminal justice (delinquency and violence prevention, recidivism, reintegration from secure detention, gang involvement), and civic engagement (community participation, volunteerism, mentoring, mediation and conflict resolution, public policy) activities related to youth. RTI has developed a screening process that assigns youth to evidence-based programming based on their identified risks. Additionally, RTI provides technical assistance at the community level to community leaders, private sector businesses, educators, parents, and other civic leaders to promote collective efficacy and to generally mobilize efforts to address the issues of at-risk youth.

The purpose of this project—Training and Technical Assistance to Support Implementation of the Dating Matters: Strategies to Promote Healthy Teen Relationships Initiative (Dating Matters Initiative)—was to provide training and technical assistance (T/TA) to support Dating Matters grantees in their efforts during the implementation of the Dating Matters Initiative. The Centers for Disease Control and Prevention (CDC) developed the Dating Matters Initiative, a highly innovative, comprehensive community approach to prevent teen dating violence (TDV). The Dating Matters Initiative includes preventive strategies for male and female peers, families, schools, and neighborhoods and includes local public health capacity building to implement prevention strategies and identification and validation of community-level indicators of TDV. To meet the T/TA goals, RTI created a team with experience in T/TA models, strong knowledge of and experience with Dating Matters, and diverse areas of expertise related to T/TA implementation.

The goal of this project is to prevent sexual assault perpetration, primary victimization, and revictimization among men and women in the United States Air Force. To achieve this goal, RTI is evaluating empirically-based interventions, conducting formative research, developing screening measures to identify persons who experienced sexual abuse or assault prior to service entry, developing empirically-based tablet interventions to be delivered during initial basic military training (BMT), designing evaluation to assess the impact at each stage of intervention. The interventions are as follows: revictimization prevention among males, revictimization prevention among women, primary victimization prevention among men, primary victimization prevention among women, and perpetration prevention and accompanying classroom content to prevent sexual assault victimization and perpetration. Additionally, RTI is conducting a survey with the Air Force Reserve Officers' Training Corps (ROTC) cadets to inform potential applicability of this BMT intervention to young officers. If successful, these interventions will prevent initial and repeat incidents of sexual assault to ensure safety, well-being, military readiness, strong morale, workplace productivity, and retention among Airmen.

This project explores the relationship between structural factors and reproductive health among youth in Monterey County, CA and identify factors that influence these relationships that could be the focus of future public health intervention. The primary focus is to examine different sources of community violence exposure (e.g., gang involvement, having a partner in a gang, family members in gangs, witnessing neighborhood violence) and their effects on reproductive health behaviors and outcomes in youth. These questions are being evaluated in a prospective cohort study of male and female youth aged 15-21 followed for two years, completing study visits every six months. The quantitative study will be complemented by qualitative research activities in the formative research period and at the conclusion of the study.

Positive Health Check (PHC) is a tailored video counseling intervention developed by RTI International and the Centers for Disease Control and Prevention (CDC). This video aims to address the urgent challenge in the United States of decreasing HIV transmission risk by increasing antiretroviral therapy (ART) adherence and retention in HIV primary care for people living with HIV (PLWH). PHC uses best practices in tailored communication, social, and behavioral science theory for motivating HIV-related behavior change and digital communication strategies to deliver highly relevant and engaging messages to PLWH. Users of all genders select tips and questions for their provider, and PHC automatically generates printed handouts that users can bring to their appointment. The Extra Info section provides additional information on a range of HIV prevention topics, wellness, and healthy lifestyles. The project aims to: 1) test the impact of PHC on achieving better clinical outcomes (i.e., viral load suppression, ART prescription refills, clinic appointment attendance) and reducing HIV risk, 2) examine PHC implementation longitudinally to assess change over time in the perceived “fit” of PHC, the context for PHC implementation, the feasibility of PHC implementation, and patient-provider communication, 3) document costs associated with PHC implementation, and (4) describe the standards of care used in each clinic that are related to risk reduction, adherence, and retention in care.

The project is designed to address the gap between research and practice. Over the course of the project, RTI staff has developed, tested, and refined marketing and implementation strategies for integrating the Women’s Health CoOp (WHC) into clinics that provide HIV counseling and testing (HCT) and antenatal care, as well as into rehab programs. WHC is a woman-focused, behavioral prevention intervention for vulnerable women who use alcohol or drugs. The specific aims of this study include the following: (1) Develop, implement, and assess the appropriateness of a marketing plan to facilitate entry into health and rehab clinics for the implementation of the WHC; (2) Deliver the WHC via a stepped-wedge design across health and rehab clinics to evaluate implementation (acceptability, adoption, cost, fidelity, penetration, and sustainability) and service outcomes (comprehensive services and timely service linkages); and (3) Assess WHC patient outcomes (effectiveness, satisfaction) at 6-month follow-up. Implementing an evidence-based intervention in usual care settings to reach more vulnerable AOD-using women who are HIV+ has potentially high public health impact if it can be implemented successfully and shown to be effective and sustainable in these new settings.

In a partnership with the Altina Ventura Foundation, this project established a longitudinal study of infant and early childhood development, health, functional abilities, and family adaptation in a sample of children with congenital Zika syndrome in Recife, Brazil.

RTI researchers found that by addressing substance use and sexual risk behaviors, we can reduce the risk of experiencing violence, and further the risk for acquiring HIV among women in vulnerable settings. These findings are especially significant in South Africa, where substance use, violence, and HIV are highly prevalent, particularly among women of reproductive age.

The study, conducted in Pretoria, South Africa, combined a seek, test, treat, and retain approach with an adapted version of the Women’s Health CoOp (WHC). The WHC, which was developed by Dr. Wendee Wechsberg, is a woman-focused, enhanced HIV prevention strategy that has been adapted for use with various key populations around the world and was found to be a "best-evidence" HIV behavioral intervention by the Centers for Disease Control and Prevention. This combination approach is designed to improve the quality of life and reduce HIV infectiousness among women who are HIV positive and reduce HIV risk behaviors among women regardless of their HIV status.

Going forward, RTI is implementing an evidence-informed women’s intervention with support from the U.S. National Institute on Alcohol Abuse and Alcoholism and will assess its adoption, cost-effectiveness, and sustainability as an HIV prevention intervention for women.

The North Carolina Young Women’s CoOp (NC YWC) seeks to reach young, sexually active, African-American women aged 18 to 25 who use alcohol and other drugs (AODs) in low-resource communities who have not recently tested for HIV. Many of these young women are at high risk for HIV due to a lack of protective skills and other contextual conditions. The NC YWC is an adapted version of the Women’s CoOp, a gender-focused, empowerment-based HIV prevention program in North Carolina, that focuses on the needs of younger women, such as reproductive health care, educational and skills goals, and linkage to substance use treatment. This study is testing the YWC intervention conducted in two formats, face-to-face and mHealth via tablets, within HIV clinics in three counties in North Carolina. If found to be efficacious in clinics or through mobile devices, the intervention could be an important tool for health departments and treatment programs to reduce health disparities and a new way to empower young women for a healthier lifestyle and independence.

The Indonesia Expanding Maternal and Neonatal Survival (EMAS) Project is a cooperative agreement funded by USAID and implemented by Jhpiego Corporation in partnership with RTI International. RTI supports the integration of cross-cutting interventions in governance and information and communication technology (ICT). The project supports the Government of Indonesia by improving the quality of basic and comprehensive emergency obstetric care and neonatal care services in hospitals and health care centers to reduce maternal and neonatal mortality overall by 25%. During the course of implementation, the EMAS Project has improved quality of emergency care and contributed to more equitable access to emergency services by expanding access to and utilization of maternal and neonatal health care to Indonesia's poor and most vulnerable populations. Partnering with Indonesian government agencies (national, provincial and local), civil society organizations (also called civic forums), public and private health facilities, hospital associations, professional organizations, and the private sector, the EMAS team works to accelerate progress toward achieving Millennium Development Goals (MDGs) 4 and 5 (reduced under-five child and maternal mortality rates).

Current approaches to secondary school are producing high numbers of dropouts and low numbers of students well prepared for college and careers. Given the likelihood that the post- 2015 global development agenda will focus on education quality and relevance, with an emphasis on applied skills for work, a successful reform movement in the United States that blends rigorous academic learning, applied technical study, and work-based learning may be of global interest. Transporting a successful approach from one country to another must be carefully considered and implemented, paying attention to variables in local political economies and education systems. RTI International is developing approaches for adapting the successful U.S.-based approach, called Linked Learning, to other countries’ contexts. Of particular interest are questions of equity—exploring the effects that neighborhoods, parental influence, gender, and peers have on pathways selection and on performance.

The Community Health Clinic Model for Agency in Relationships and Safer Microbicide Adherence (CHARISMA) project, conducted by RTI International, intends to increase women’s agency to consistently and safely use microbicides, biomedical products used to protect people from becoming infected with HIV during sex, and mitigate intimate partner violence (IPV). This will be achieved through three specific aims: (1) identifying improved approaches to measure and address the beneficial impacts and harmful social effects—particularly IPV—of microbicide use, (2) developing and pilot testing the CHARISMA intervention, which has clinic- and community-based components, and (3) disseminating knowledge generated and promote uptake of promising practices for future microbicide and multipurpose prevention technology implementation projects.

RTI will evaluate the school-based mental health (SBMH) program in 24 elementary and middle schools in Charlotte-Mecklenburg, North Carolina. Researchers will compare schools receiving two versions of the enhanced SBMH model with comparable schools that continue to operate with their current approaches to mental health. Researchers will determine benefits for male and female students receiving mental health services, as well as additional student-level outcomes such as violence and bullying perpetration, victimization, and witnessing violence at school. Additionally, researchers will examine school-level outcomes such as school climate, perceptions of school safety, and disciplinary infractions. Implementation science principles will inform process evaluation, sophisticated statistical modeling will be used for outcome evaluation, and the cost-effectiveness evaluation will offer practitioners and policymakers practical, research-based information for making school safety decisions.

RTI is providing support to the Microbicide Trials Network (MTN) in the areas of behavioral and social sciences as members of the MTN Behavioral Research Committee and Behavioral Research Working Group. This includes attending regular conference calls and meetings, providing scientific input on behavioral and adherence issues in several of the MTN protocols including the MTN 001 and MTN 003 (VOICE) trials, taking leadership and being responsible for developing and testing the behavioral and adherence instruments for these trials, including development, pretesting and implementation of the Audio-Computer Assisted Self Interviewing (ACASI) component of the VOICE trial.

The Community Roots Project seeks to address the key underlying causes of migration of under-aged Guatemalans through holistic violence prevention approaches. This project is designed to reduce crime and violence levels, and levels of attempted immigration to the US. Centered in community-based interventions, and to empower communities to develop crime and violence prevention plans, and implement those plans through small grants. Lack of employment opportunities, particularly among vulnerable populations such as women and young women, is a key driver of crime, violence and immigration. Given this, Community Roots looks to integrate the private sector into the solution process through a variety of inputs that will lead to greater educational and employment opportunities for vulnerable populations. Community Roots also focuses additionally on secondary prevention strategies that target youth.

Health Policy Plus (HP+) works to strengthen and advance health policy priorities at global, national, and subnational levels. The project aims to achieve equitable and sustainable health services, supplies, and delivery systems through policy design, implementation, and financing. Evidence-based inclusive policies, more sustainable health financing, improved governance, and stronger global leadership and advocacy will lead to improved health outcomes worldwide. Critical to HP+’s work is a clear understanding of how gender influences policy environments, the development and implementation of health programs, and health outcomes. As a cross-cutting issue, gender equality is incorporated into all aspects of HP+ activities, both to facilitate achievement of positive results and to ensure that all people—regardless of gender identity or sexual preference—enjoy equal human rights and socially valued goods, opportunities, and resources. RTI International has been working with a team led by Palladium to assist in the implementation of this program.

The National Crime Victimization Survey (NCVS) collects information about the gender of victims for non-fatal violent crimes. RTI assists the Bureau of Justice Statistics (BJS) to redesign the to render it more productive, informative, and relevant. These improvements will ultimately build overall unity of NCVS, increase user satisfaction, and create a larger and more diverse group of users and consumers who can support, access, and benefit from the NCVS and its byproducts. The goals of this project are to (1) better understand and address key substantive issues in criminal victimization to enhance NCVS capabilities, (2) enhance BJS capacity to use NCVS and other statistical collections to report on key policy issues in criminal victimization, and (2) enhance use of NCVS by broader research and stakeholder communities.

RTI International is developing an on-site waste treatment and toilet system designed for communal or shared applications as part of the Bill and Melinda Gates Foundation’s Reinvent the Toilet Challenge. RTI’s reinvented toilet system is designed to be a self-contained unit that collects human waste through a squat plate designed for low water quantity flush, and then separates and treats the waste within the same unit. RTI constructed the second prototype in Ahmedabad, India. Primary research objectives for data collection were to conduct qualitative assessments of current behaviors, beliefs, and preferences regarding sanitation, with a focus on water reuse in the RTI system, women’s menstrual hygiene management, and men’s practices and preferences. Data revealed a desire for gender-separated stalls based on social norms and safety concerns. The gender segregation of public facilities led to minimal stated concerns regarding privacy or safety. Participants also noted some behaviors, which may be “pre-emptive” behaviors to secure their safety; women tended to switch to informal in-home washing stations, for urination at night instead of traveling outside to public facilities. Women felt some lack of privacy, or did not feel welcome to use public facilities, during menstruation. Findings will directly affect decisions made regarding adjustments to the user interface for RTI’s beta prototype and will inform system development in the long term through identifying important features that may affect user adoption.

The goal of the Sexual Assault Kit Initiative (SAKI) is to create a coordinated community response that ensures just resolution to these cases through a comprehensive and victim-centered approach, as well as to build jurisdictions’ capacity to prevent high numbers of unsubmitted sexual assault kits (SAKs) in the future. This program provides jurisdictions with resources to address their unsubmitted SAK issue, including support to inventory, test, and track SAKs; create and report performance metrics; access necessary training to increase effectiveness in addressing the complex issues associated with these cases and engage in multidisciplinary policy development, implementation, and coordination; and improve practices related to investigation, prosecution, and victim engagement, advocacy, and support in connection with evidence and cases resulting from the testing process. In 2015, the Bureau of Justice Assistance selected RTI to provide training and technical assistance for its SAKI program. The SAKI Training and Technical Assistance (TTA) program support coordinated teams of police officers, prosecutors, crime laboratory professionals, sexual assault nurse examiners (SANEs), forensic medical personnel, and victim services agency members. SAKI TTA provides evidence-based, victim-centered, and sustainable practices; these practices help with collecting and processing forensic evidence, investigating and prosecuting sexual assault cases, and supporting sexual assault survivors. SAKI TTA offers the support that jurisdictions need to navigate the unique challenges associated with cold case sexual assault. As of October 2018, we have conducted more than 40 webinars, produced more than 30 briefs, and provided more than 70 in-person TTA events. Additionally, we created the SAKI Toolkit and SAKI Virtual Academy, which are web-based resources designed to create customized curriculum supporting the SAKI holistic approach to sexual assault response reform. The SAKI Toolkit offers hands-on resources tailored for the community of practitioners working to respond to cold case sexual assault. Toolkit users can explore key categories of sexual assault response reform, browse topics centered around skill development, and save tools to a customizable dashboard known as the briefcase. The SAKI Virtual Academy, an online learning platform, offers five e-learning curricula covering the key steps to sexual assault response reform. The curricula are broken out into a total of 24 separate e-learning modules to allow learners to complete courses at their own pace. Throughout each course, learners complete knowledge checks and case study challenges to assess their comprehension of the course content.

To date, pre-exposure prophylaxis (PrEP) trials have been plagued by poor adherence to both orally and vaginally administered pre/peri-coital and daily product regimens. Low adherence not only complicates  results, but also undermines the effectiveness of products brought to market. RTI is developing a highly innovative approach to providing sustained delivery of an antiretroviral (ARV) agent for PrEP through the use of a thin-film polymer device (TFPD) that is subcutaneously injected and biodegradable but remains retrievable before therapeutic depletion. This anti-HIV product offers many improvements over existing microbicide delivery systems. The TFPD is user-independent and will offer long-term protection (three months or more) against HIV. The TFPD also provides maximum discretion of use, thus overcoming several of the social and logistical adherence challenges associated with user-dependent methods such as tablets and gels. Preliminary discussion with the U.S. Food and Drug Administration (FDA) suggests that the TFPD is likely to be considered a delivery system only and not an investigational device, so RTI International is developing this concept using an Investigational New Drug (IND) pathway, which should simplify regulatory approval.

The Multi-site Family Study on Incarceration, Parenting and Partnering (MFS-IP) was an evaluation of federal family strengthening programs for incarcerated and reentering fathers and their partners, which has produced the field’s richest quantitative dataset for understanding the experiences of these families. In 2006, the U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF), funded an initiative to support healthy marriage and responsible fatherhood. Thirteen grantees in 12 different states received five-year grants from the ACF's Office of Family Assistance to implement multiple activities to support and sustain marriages and families of fathers during and after incarceration. To evaluate the overall effectiveness of the 13 MFS-IP grantees, RTI conducted an implementation evaluation and a multi-site, longitudinal, impact evaluation of selected grantees. The evaluation was designed to add to research, policy, and practice by helping to determine what types of programs work best for those involved in the criminal justice system, what does not work, and what effects these programs may have on fostering healthy relationships, families, and children. The study team was also able to generate a stronger understanding of the experiences of justice-involved families before, during, and after a father's incarceration.

The West Bank Early Grade Reading Activity supports the Palestinian Ministry of Education and Higher Education (MOEHE) to enhance learning outcomes for Palestinian children at the primary level by improving Arabic reading instruction, policies and practices at the government, community and school levels. The project includes interventions to: 1) Improve early grade reading and introduce targeted learning materials that are integrated into grades 1-4 in public school classrooms in the West Bank, 2) Prepare MOEHE teachers and administrators to provide effective reading instruction through in service, induction and pre-service training, mentoring and supervision, 3) Encourage community engagement and participation to support increased student reading outcomes and school accountability, and 4) Support MOEHE efforts to institutionalize early grade reading policies, standards and assessments.

RTI International provided technical assistance and training support to the Government of Egypt’s Ministry of Education (MOE) for the implementation of the Egypt Primary Learning Program (PLP), a nationwide early grade learning program for young girls and boys in primary school. RTI collaborated with MOE to: (1) Strengthen early grade and remedial reading instruction, learning materials, and instructional approaches; (2) Improve early grade mathematics teaching, learning materials, and instructional approaches; (3) Develop cost-effective national assessments for reading and mathematics; (4) Institutionalize sustainable pre-service and in-service professional development systems for early grade teachers and supervisors; and (5) Improve the education delivery system and build the capacity of Governorate and Idara (district) teams to develop and implement education plans that include budgets for early grade learning, incentives, and needed human resources.

The President’s Malaria Initiative Program Component (StopPalu) is a three-year project with the goal of assisting the Government of Guinea to achieve the PMI target of reducing malaria morbidity and mortality through prevention, diagnosis and treatment interventions, and capacity building of the Ministry of Health (MOH) and the National Malaria Control Program (NMCP).  The program has three intermediate result areas: 1) Improved malaria prevention in support of the National Malaria Strategy, 2) Diagnostic testing and malaria treatment capacity improved, 3) National Malaria Control Program’s technical capacity to plan, design, manage, and coordinate a comprehensive malaria control program enhanced. RTI International is implementing StopPalu, supported by the sub-partners Jhpiego, the American Society for Microbiology (ASM), and Centre Africain de Formation pour le Développement (CENAFOD). The project covers 14 districts and the 5 communes of Conakry, known as the “PMI zone” for malaria control.

The purpose of Kenya Youth Employment and Skills Program is to enhance employment opportunities, whether wage employment or self-employment, for underemployed youth (ages 18-35) with primary or some secondary education, in focus geographic areas and sectors. The objectives include: (1) Improved technical and vocational skills of youth participants; (2) Business skills; (3) Improved effectiveness of market and employment information, career counseling, mentoring, and job placement for youth participants in target areas/sectors; (4) Influence youth to expand interests; (5) Increased rates of national ID registration; (6) Youth awareness and utilization of financial services; and (7) Gender equity. RTI International has been exploring and implementing a range of measures to sustain workforce development initiatives and employment outcomes. They are achieving this by decisively and methodically building partnerships that lead to host country and private sector leadership of the workforce models. RTI is also promoting sustainability by partnering with and leveraging private sector expertise and funding.

The Excellence in Higher Education for Liberian Development (EHELD) project works to develop the capacity of faculty and staff at the University of Liberia's Engineering Department and Cutting University's Agricultural Sciences Department. The goal is to equip top-performing young Liberian women and men for professional careers as researchers, teachers, managers, extension agents, and small business owners in the two most critical current development sectors in the country: agriculture and engineering. After almost two decades of conflict that nearly destroyed the education system, company managers, farmers, government officials, and donor representatives point to Liberia's critical need for improved education, skills, and labor force capacity as the principal challenge to sustaining the momentum of development. The EHELD team, working with U.S. university partners from the University of Michigan, Rutgers, and North Carolina State University, have completed revisions to the engineering and agriculture curricula and are working on urgent institutional needs such as intensive faculty development, as well as better university-employer connections resulting in more practical and relevant training, employment readiness, and job placement.

LuzonHealth is a health service strengthening project implemented by RTI in the Philipines. The project aims to improve the health of families in the Philippines by expanding access to high-quality, integrated family planning and maternal, neonatal, child health and nutrition services (FP/MNCHN). Through LuzonHealth, we enhance the role of hospitals in FP/MNCHN training and service delivery, modeling adolescent health interventions, increasing collaboration with the private sector, and replicating and scaling up best practices and innovations. Partnering with public health and local government officials, and with private sector and civil society groups, LuzonHealth worked to accelerate progress toward Millennium Development Goals (MDG) 4 and 5 (reduced under-five child and maternal mortality).

Health for Life (H4L) is a health system strengthening project in Nepal implemented by RTI International, in partnership with Jhpiego Corporation and the Integrated Rural Health Development Training Center Nepal . The project aims to strengthen the Ministry of Health and Population's capacity to plan, manage and deliver high-quality family planning and maternal, newborn and child health services. H4L activities directly address key health system constrains in the following areas: local health systems governance, data for decision making and evidence-based policy development, human resources management, quality improvement systems, and knowledge and behavior change. Addressing these constrains is being achieved through support at the national level and by providing technical assistance to 14 districts to improve the delivery of Family Planning/Maternal Newborn and Child Health services in a range of areas. Concurrently, H4L is also engaging in efforts to increase demand for services, focusing specifically on populations that have historically been underrepresented in health service utilization.

Uganda Literacy Achievement and Retention Activity (LARA) is a five-year initiative implemented by RTI International in collaboration with World Vision. The overarching purpose of the LARA is to improve the reading skills of primary-grade learners in Ugandan government schools through the scale-up of the Early Grade Reading methodology and ensure retention in early grades through prevention of school-related and gender-based violence. LARA aims to improve literacy by supporting interventions that (1) Improve key aspects of reading skills in both English and three of the 12 selected local languages in the primary grades and (2) Improve the year-to-year retention of learners in the primary grades by ensuring that the school environment for learners of all genders is safe from any form of abuse.

The Global Network for Women's and Children's Health Research established an innovative and flexible research network that has been responsive to the most critical existing and emerging health needs and public health problems of women and children globally. International, multidisciplinary teams of investigators (research units) have worked collaboratively to answer scientific and public health questions to help improve health and to prevent premature disease and death among women and children, primarily in developing countries. Initial efforts focused on safe pregnancy and birth outcomes within the broader context of women's and young children's health. Strategies to sustain proven interventions after funding is withdrawn have been developed and implemented. RTI International served as the data coordinating center  for the Global Network and was responsible for central training in research methods, statistical leadership, data collection, and management, including tracking systems, study communications and logistics, and assistance with materials development. Additionally, RTI staff members functioned as active participants of the steering committee, workgroups, and protocol teams.

The Health Policy Project is a 5-year cooperative agreement funded by USAID that seeks to improve health through strengthening the efficiency, effectiveness, and equity of health programs and systems. The project has three funded core health areas: Family Planning/Reproductive Health, HIV and AIDS, and Maternal and Child Health. HPP also has four cross-cutting issues: Gender, Health Equity, Stigma and Discrimination (S&D), and Monitoring and Evaluation. RTI’s role is to contribute expertise in health governance and bolster the HIV portfolio, with specific expertise in S&D, capacity building for People Living with HIV (PLHIV), and other key populations. The objective of this project is to strengthen developing countries’ national and subnational policy, advocacy, and governance for strategic, equitable, and sustainable health programming.

USAID's Kinerja Program strengthens government service delivery unit management so it will be more transparent, accountable and provide access for community participation. Kinerja works directly with local governments to improve public service delivery by identifying, testing, and replicating innovative interventions to improve measurable performance. RTI International leads the Kinerja program, which uses accountability and performance-based incentives to motivate local Indonesian governments to improve service delivery. As the lead implementer, RTI tests and replicates interventions that produce measurable performance enhancements in the three sectors: health, education, and the business-enabling environment. Kinerja supports efforts of the national government to provide access to better basic health services, with a focus on maternal, neonatal, and child healthcare. To achieve this improvement, it works with three types of interventions in mind: (1) Incentives – strengthen the demand side for better services; (2) Innovations – build on existing innovative practices and support local government to test and adopt promising service delivery approaches; and (3) Replication – expand successful innovations nationally and support Indonesian intermediary institutions to deliver and disseminate improved services to local government.

The Egypt Higher Education Partnership Program (HEPP) is a 5-year, United States Agency for International Development (USAID)-funded project. The program—part of the larger U.S.-Egypt Higher Education Initiative—develops the long-term institutional capacity of Egyptian universities and technical colleges to generate the human capital needed to sustain Egypt’s economic growth and competitiveness. HEPP has three main objectives: (1) Improving the quality and relevance of tertiary education creating a critical mass of youth and women with hands-on experience and expertise in defined areas related to private-sector needs and Egypt’s development challenges.; (2) Promoting Research, Development, and Innovation (RDI) in national priority development areas; and (3) Improving institutional governance and management of the Egyptian higher education System through targeted activities. Through HEPP, RTI International worked with USAID, the Ministry of Higher Education (MOHE), and a coalition of Egyptian and U.S. universities and private sector partners to provide thousands of Egyptians of all genders with access to higher education opportunities in both Egypt and the U.S. as well as facilitate strategic partnerships in key fields to strengthen Egypt’s economy.

This is a systems level project aimed at improving early grade reading in mother tongue with a transition to English, improving HIV/AIDS and health outcomes for students and teachers, and making improvements to EMIS systems.

Inform Asia helps generate and apply strategic, scientifically sound data in health programming in the region. Malaria, HIV, tuberculosis, pandemic influenza and other emerging infectious diseases pose a significant public health threat throughout Asia, and in particular, the Greater Mekong Sub-region. Headquartered in Bangkok, Inform Asia, implemented by RTI International, is a five-year program that works with the research community and program implementers to conduct research focused on strengthening health systems and promoting the use of science in that research in Thailand and in the Lao People’s Democratic Republic (Lao PDR). The program currently focuses on malaria and HIV. The purpose of this project is to: (1) Provide technical assistance to the Thai Bureau of Vector Borne Disease Control (VBDC) in order to assure the timely, high quality completion of Thailand Therapeutic Efficacy Survey in provinces; (2) Conduct an assessment of monitoring, evaluation and surveillance needs to inform capacity building needs within the VBDC; (3) Conduct an evaluation of malaria elimination models implemented in Thailand; and (4) Provide technical assistance to Lao PDR malaria program in the areas of program monitoring, evaluation, and surveillance. Inform Asia works to continually put forward evidence that can lead to better health outcomes and supportive health policy.

The goal of this research project is to bring the voices of young men and women to the product development process. The iPrevent study is exploring new ways to include at-risk communities at an earlier stage in the design process for HIV prevention methods. Through inviting youths “into the lab” during interactive focus groups in which prototypes of implants are handled and discussed, they are encouraged to contribute their ideas for improved design as fellow scientists and experts from their communities. Specifically, RTI will explore the characteristics of products and health care services that affect young people’s ability to consistently use an injectable HIV prevention method and to investigate their preferences for these products. This project is a collaboration between the Women’s Global Health Imperative, a group within RTI International based in San Francisco, California, and the Desmond Tutu HIV Foundation, a research institute in Cape Town, South Africa. The project has two aims: (1) To identify influences on uptake of and adherence to sustained-release injectables and implants among PrEP-experienced youth in South Africa and (2) To determine the key attributes of a sustained-release injectable and/or implantable HIV-prevention product that may improve uptake and adherence among PrEP-naïve South African youths.

This study plans to increase uptake and adherence of preexposure prophylaxis (PrEP) for HIV prevention among vulnerable HIV-negative adolescent girls and young women (AGYW) aged 16-24 who engage in high-risk sex, through a multilevel HIV prevention strategy that addresses stigma and discrimination (S&D) in AGYW accessing healthcare, social support, and individual risk behaviors. The randomized controlled trial (RCT) phase of the study will be conducted across 6 geographically mapped zones and 12 clinics in Pretoria, South Africa. Three zones will be randomized to receive S&D clinic training and three zones will be randomized to standard of care. Clinics located in zones randomized to S&D clinic training will participate in workshops aimed to reduce healthcare staff’s stigmatizing attitudes and behaviors toward AGYW. Within each set of zones (S&D training vs. standard of care), clinics will then be randomized to one of three arms: Arm 1: provision of PrEP by the clinics only; Arm 2: provision of PrEP by the clinics with addition of a PrEP club for social support to increase adherence; and Arm 3: provision of PrEP by the clinics with addition of a PrEP club as well as a women-focused behavioral intervention, the Women’s Health CoOp (WHC). This randomization scheme will result in 6 arms based on the zone and clinic. The overarching goal of the study is to reduce AGYW’s healthcare-related barriers to access PrEP, improve PrEP uptake and adherence, and reduce HIV risk behaviors.