C4™ was extensively studied in multi-site research trial investigating its association with HIV/STI risk reduction, including PrEP initiation and adherence.

The C4™ approach can be used in research for other health domains—contact us if you are interested in using this approach in your research.

research

• Wheeler DP, Lucas J, Wilton L, Nelson LE, Hucks‐Ortiz C, Watson CC, Hutchinson C, Mayer KH, Kuo I, Magnus M, Beauchamp G, Shoptaw S, Emel LM, Chen YQ, Hightow‐Weidman L, Fields SD. Building effective multilevel HIV prevention partnerships with Black men who have sex with men: experience from HPTN 073, a pre‐exposure prophylaxis study in three US cities. J Int AIDS Soc. 2018; 21(S7):e25181
• Wilton L, Nelson LE, Beauchamp G, Magnus M. Shoptaw S, Hightow-Weidman L, Chen Y, Lucas J, Piwowar-Manning E, Hendrix C, Marzinke M, Hucks-Ortiz C, Mayer KH, Fields SD, Wheeler DP. Structural barriers, mental health and PrEP initiation/non-initiation and adherence among Black MSM in 3 US cities. HPTN 073 study. 2017 International AIDS Conference, Paris, France.
• Wheeler DP, Fields SD, Nelson LE, Wilton L. Hightow-Weidman L, Shoptaw S, Magnus M, Beauchamp G, Watkins P, Mayer KH. HPTN 073: PrEP uptake and use by Black men who have sex with men in 3 US cities. 2016 Conference on Retroviruses & Opportunistic Infections, Boston, United States of America.
• Hightow-Weidman L, Magnus M, Shoptaw S, Emel L, Beauchamp G, Piwowar-Manning E, Mayer KH, Nelson LE, Watkins P, Fields SD, Wheeler DP. Significant health comorbidities in Black men who have sex with men presenting for a US PrEP study. 2016 International AIDS Conference, Durban, South Africa.
• Hucks-Ortiz C, Lucas JP, Wheeler DP, Fields SD, The HPTN Black Caucus for the HPTN 073 Protocol Team. HPTN 073: Successful engagement of Black MSM into a culturally relevant clinical trial for pre-exposure prophylaxis (PrEP). 2016 International AIDS Conference, Durban, South Africa.

related publications

• Desrosiers A, Levy M, Dright A et al. A Randomized Controlled Pilot Study of a Culturally-Tailored Counseling Intervention to Increase Uptake of HIV Pre-exposure Prophylaxis Among Young Black Men Who Have Sex with Men in Washington, DC. AIDS Behav (2018).

The C4™ model is a self-determination theory-based intervention approach. It is supported by a vast evidence-base on the efficacy and effectiveness of interventions that are grounded in self-determination theory.

For more comprehensive look at self-determination theory research go to the official website, selfdeterminationtheory.org.

C4™ leads to higher attainment of health behavior goals and maintenance of health behaviors for longer periods.

The most important impediments to individuals achieving their health goal are factors related to the healthcare environment and other social and structural barriers. The demands and complexities of health and social service work can also affect motivation of agency staff.

C4™ moves beyond focus on the client as the sole target for health behavior change, towards engaging staff in re-creating their environments into ones that facilitate healthy behavior change and positive psychological well-being for their clients. It is an evidence-based approach (CRCS,  HPTN 073) supported through rigorous research on the effect of autonomy support on health behavior outcomes. It is culturally responsive, theoretically grounded and designed to support clients across the HIV continuum—from prevention through treatment.

our team

LaRon Nelson

PhD, RN, FNP, FNAP, FAAN

Dr. Nelson is the Independence Foundation Associate Professor at Yale School of Nursing. He is also a Full Scientist in the MAP Centre for Urban Health Solutions at the Li Ka Shing Knowledge Institute of Unity Health Toronto St. Michael’s Hospital. He is the inaugural holder of the OHTN HIV Research Chair in Implementation Science with African, Caribbean and Black Communities. Dr. Nelson’s domestic and international research investigates strategies to reduce race and sexuality-based disparities in HIV outcomes. He is s public health nurse and family nurse practitioner who is recognized as the world’s leading authority on the application of self-determination theory for HIV prevention and care. He is an expert in developing program models to reduce the negative impacts of stigma on health of individuals and communities.

Kristaps Dzonsons

Kristaps has extensive experience in building robust, secure systems — particularly web applications. He has a background in computational mathematics, building large high-performance systems, and is a prolific open source contributor.

Faith Lambert

Faith is a second-year MSN and PhD student at the University of Rochester school of Nursing. She's on the Family Nurse Practitioner track in the masters program, and her PhD focus is in HIV research. Faith is from Brooklyn, New York.

Martez Smith

Martez is a PhD student at the University of Rochester, School of Nursing. Currently, Martez is researching the impact of social support on HIV care continuum outcomes among Black men who have sex with men belonging to the house ball community.