Hard-to-Reach Providers: Targeted HIV Education by the National AIDS Education and Training Centers

Abstract

A national system of AIDS Education and Training Centers (AETCs) has received federal funding since 1987 to provide education to health care personnel (HCP) about HIV infection. The purpose of this study is to describe how AETC program personnel define and recognize HCP who are hard to reach and educate about HIV and to clarify the issues that make providers hard to reach. Twenty-three semistructured telephone interviews were used to collect data from AETC faculty and staff. Respondents were asked to identify the types of HCP who are hard to reach and to discuss why they are hard to reach. Themes identified to establish which HCP are hard to reach include specific professional groups (especially physicians and dentists) as well as providers who treated less than 10 HIV-infected clients and some HIV-expert clinicians. Themes identified to establish why they are hard to reach include convenience, isolation, and attitudes. Analysis posits that hard-to-reach HCP fall into identifiable categories: "already know the information," "don't know they don't know the information," "don't think they need to know the information," or "don't want to know the information." Respondents also identified innovative ways to approach hard-to-reach providers.

Utilization of Health Care Services in Hard-to-Reach Marginalized HIV-Infected Individuals

“…Previous studies guided the selection of these services, venues, and populations as likely ways to find hard-to-reach HIV-infected individuals. [24][25][26][27][28][29][30] Despite the range of services, venues, and populations, all of the programs provided supportive outreach services to link HIV-infected individuals who were not in any care, not in consistent care, or were at risk of dropping out of care. For more detailed information about the specific sites see www.bu.…”

Results From 10 Years of Interprofessional Training on Motivational Interviewing

“…Participants' CE credit did not depend on their responses, and questions on the survey did not ask about sensitive topics. The instrument was completed posttraining instead of pretraining, because pilot data showed that participants initially ''didn't know what they didn't know'' (Bradley-Springer et al, 2003), for instance, believing that their current practice behavior was already patient centered and autonomy supporting. After trainees learned more about MI, pilot results showed that their scores declined significantly from pretraining to posttraining.…”

“…As MI is more broadly disseminated and HCPs have multiple opportunities to receive training, it is possible that trainees' baseline level of ability with MI will be different than it was 5 or 10 years previously or that prior experiences will make them either more or less receptive to training. Trainees might have greater expertise after repeated exposure to a concept (Cook, Friedman, Lord, & Bradley-Springer, 2009), or they might benefit less from training because they already believe that they know the content (Bradley-Springer, Vojir, & Messeri, 2003). Therefore, it was of interest to characterize changes over the course of our 10-year study period in the knowledge, attitude, and behavior of MI trainees.…”

A Training Program for Nurses and Other Health Professionals in Rural-Based Settings on Screening and Clinical Management of HIV and Other Sexually Transmitted Infections

“…The national AIDS Education and Training Centers consider hard-to-reach clinical care providers, including those in rural settings, an important training and education priority (Bradley-Springer, Vojir, & Messeri, 2003). In this report, the authors describe a rural-based training program conducted throughout Minnesota.…”