Our Studies

Our Work and Findings

The research focus of the Crawford Lab on Race and Equity (CORE) takes a multifaceted approach that encompasses rigorous scientific investigation, targeted interventions, and community-centered mentorship. At the core of our endeavors is the commitment to unravel the social and structural determinants influencing health outcomes and to develop innovative strategies that promote equity. From advancing pre-exposure prophylaxis (PrEP) access within community pharmacies to examining how social factors influence the health of our communities our research spans diverse projects, all aimed at reshaping population health paradigms.

Publications

Our Current Funded Research

  • Title: Advancing pre-exposure prophylaxis (PrEP) access in pharmacies to improve PrEP uptake in disadvantaged areas (PrEP UP)

    Summary: Optimizing the reach of pre-exposure prophylaxis (PrEP) access for black men who have sex with men (BMSM) is critical to reduce racial inequities in HIV. The overall objective of this R34 application is to develop a culturally appropriate pharmacy PrEP delivery model and examine its feasibility, acceptability, and safety for BMSM who live in high poverty, racial minority neighborhoods. Cohen’s structural theory supports our central hypothesis that increased availability of PrEP screening and prescribing in neighborhoods where BMSM are most impacted by HIV will facilitate PrEP uptake. Findings from the proposed pilot study will support the long-term goal of this program of research, which is to implement an R01 cluster randomized efficacy trial in high poverty, racial minority neighborhoods to increase PrEP uptake among BMSM and reduce racial inequities in HIV.

    Aim 1: Develop a pharmacy PrEP delivery model by evaluating the barriers to and facilitators of integrating PrEP into existing pharmacy practice among 40 key stakeholders (pharmacists, technicians, PrEP-prescribing physicians and BMSM) and

    Aim 2: Pilot test the pharmacy PrEP delivery model and examine its feasibility, acceptability and safety, and gather early evidence of its impact and cost with respect to PrEP uptake at baseline and in 3-months among BMSM.

  • Title: Strengthening the HIV prevention care continuum in pharmacies using policy and implementation science (Prep For PrEp)

    Summary: The purpose of this study is to understand the multi-level components that influence the pharmacy work system to bolster sustainable HIV prevention services in pharmacies. Thus, this proposal will consider the policy-, pharmacy-, and staff-level influences that shape HIV prevention service implementation in the pharmacy.

    Aim 1: Examine the policy-, pharmacy-, and staff-level barriers and facilitators of adopting HIV prevention services (e.g., HIV testing, PrEP referral and prescribing, HIV treatment referral) in community pharmacies.

  • Title: Strengthening the HIV Prevention Continuum Using Pharmacies

    Short Title: Pharmacy-base Access to Testing for HIV” (PATH)

    Summary: Our work has shown that HIV testing uptake in community pharmacies can be increased if it is offered with less stigmatized non-HIV-related services (e.g., COVID19, blood pressure, glucose, and cholesterol screening). But many community pharmacy staff report inadequate training as barriers to integrating HIV testing into the pharmacy work system. The goal of this project is to evaluate the implementation and effectiveness of HIV testing and prevention services within community pharmacies.

    Aim 1: Examine the policy-, pharmacy- and pharmacy staff- barriers and facilitators of adopting HIV prevention services (e.g., HIV testing, PrEP referral, HIV treatment referral) in community pharmacies.

    Aim 2: Develop and implement pharmacy staff HIV prevention service (e.g., HIV testing and counseling, PrEP referral, HIV treatment referral) trainings.

    Aim 3: Test the effects of integrating HIV prevention services in community pharmacies with existing non-HIV-related screenings versus those without on effectiveness and implementation outcomes.

  • Title: Advancing Pharmacy-based PrEP Starts and Care Linkage Using Collaborative Practice Agreements

    Short Title: Collaborative Agreement-based PrEP Using Pharmacists” (CAP-UP)

    Summary: We propose increasing formalized linkages between pharmacists and clinicians, and expanding the reach of current pharmacy-based PrEP models using collaborative practice agreements (CPAs). Models for CPAs for PrEP services have been successfully implemented in other states, but little is known about the willingness to establish CPAs and the implementation of CPAs for PrEP starts and care linkage in the US Southeast. Therefore the goal of this study is to evaluate the implementation barriers of establishing CPAs for PrEP services in Southeastern pharmacies, as well as develop and test a CPA adaptable to varying pharmacy and clinic settings to address those barriers.

    Aim 1: Evaluate the barriers to and facilitators of establishing CPAs between pharmacists and PrEP-prescribing clinicians among key stakeholders.

    Aim 2: Develop a publicly available, adaptable pharmacist-clinician CPA template and training for pharmacy-based PrEP start and care linkage.

    Aim 3: Test the integration of the pharmacist-clinician CPAs in community pharmacies on effectiveness and implementation outcomes (e.g., acceptability, feasibility, effective linkage) among pharmacists and clinicians.