Experiences and resultant care gaps among women with HIV in Canada: concept mapping the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study (CHIWOS) findings

Medeiros, Priscilla; Koebel, Jill; Yu, Amy; Kazemi, Mina; Nicholson, Valerie; Frank, Peggy; Persad, Yasmeen; O'Brien, Nadia; Bertozzi, Breklyn; Smith, Stephanie; Ndung'u, Mary; Fraleigh, Annette; Gagnier, Brenda; Cardinal, Claudette; Webster, Kath; Sanchez, Margarite; Lee, Melanie; Lacombe-Duncan, A; Logie, Carmen H; Gormley, Rebecca; de Pokomandy, Alexandra; Kaida, Angela; Loutfy, Mona R

doi:10.1136/bmjopen-2023-078833

Cited by 1 publication

(1 citation statement)

References 35 publications

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“…Our approach sought to provide a comprehensive set of EBS so that decision-makers might consider a broader set of possibilities than what they would generate with limited time. This modification to group concept mapping in the brainstorming phase has been utilized previously [ 39 , 60 , 63 – 65 ]. Furthermore, elicitation through qualitative interviews that were guided by the Practice Change Model [ 48 ], allowed for in-depth understandings of adaptations made in the context of COVID-19 pandemic constraints [ 66 ], which subsequently identified adaptations to be considered during the rating and sorting activities [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Use of concept mapping to inform a participatory engagement approach for implementation of evidence-based HPV vaccination strategies in safety-net clinics

Tsui,

Shin,

Sloan

et al. 2024

Implement Sci Commun

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Background Multiple evidence-based strategies (EBS) for promoting HPV vaccination exist. However, adolescent HPV vaccination rates remain below target levels in communities at high risk for HPV-associated cancers and served by safety-net clinics. Participatory engaged approaches are needed to leverage the expertise of community and clinical partners in selecting EBS relevant to their local context. We engaged concept mapping as a method to inform the adoption and adaptation of EBS that seeks to empower implementation partners to prioritize, select, and ultimately implement context-relevant EBS for HPV vaccination. Methods Using 38 EBS statements generated from qualitative interviews and national HPV vaccine advocacy sources, we conducted a modified concept mapping activity with partners internal to safety-net clinics and external community members in two study sites of a larger implementation study (Greater Los Angeles and New Jersey), to sort EBS into clusters and rate each EBS by importance and feasibility for increasing HPV vaccination within safety-net clinics. Concept mapping findings (EBS statement ratings, ladder graphs and go-zones) were shared with leaders from a large federally qualified health center (FQHC) system (focusing on three clinic sites), to select and implement EBS over 12 months. Results Concept mapping participants (n=23) sorted and rated statements, resulting in an eight-cluster solution: 1) Community education and outreach; 2) Advocacy and policy; 3) Data access/quality improvement monitoring; 4) Provider tracking/audit and feedback; 5) Provider recommendation/communication; 6) Expanding vaccine access; 7) Reducing missed opportunities; and 8) Nurse/staff workflow and training. The FQHC partner then selected to intervene on eight of 17 EBS statements in the “go-zone” for action, with three from “reducing missed opportunities,” two from “nurse/staff workflow and training,” and one each from “provider tracking/audit and feedback,” “provider recommendation/communication,” and “expanding vaccine access,” which the research team addressed through the implementation of three multi-level intervention strategies (e.g., physician communication training, staff training and workflow assessment, audit and feedback of clinic processes). Conclusions Concept mapping provided a powerful participatory approach to identify multilevel EBS for HPV vaccination relevant to the local safety-net clinic context, particularly when several strategies exist, and prioritization is necessary. This study demonstrates how a clinic system benefited directly from the ratings and prioritization of EBS by multilevel clinic and community partners within the broader safety-net clinic context to identify and adapt prioritized solutions needed to advance HPV vaccine equity.

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