Identifying Implementation Strategies That Address Barriers and Facilitate Implementation of Digital Interventions in HIV Primary Care Settings: Results from the Pilot Implementation of Positive Health Check

Zulkiewicz, Brittany; Burrus, O; Harshbarger, Camilla; Ortiz, Alexa; Garner, Bryan; Lewis, Megan A.

doi:10.1007/s10461-020-02944-9

Cited by 8 publications

(9 citation statements)

References 32 publications

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“…During implementation, each clinical site received tailored support, lessons learned were shared across sites, FAQs were revised in real time, implementation technical assistance was provided as needed, PHC implementation was monitored via the clinic web application, and the Centers for Disease Control and Prevention maintained a Help Line users could call with technical questions. 50 Setting PHC implementation and data collection occurred simultaneously across 4 demographically diverse US-based HIV care clinics, 1 in the south-central region, 2 in the southeast region, and 1 in the northeast region. The clinics are described as follows:…”

Section: Implementation Strategymentioning

confidence: 99%

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Garner

Burrus

Ortiz

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Positive Health Check is an evidence-based video doctor intervention developed for improving the medication adherence, retention in care, and viral load suppression of people with HIV receiving clinical care.Setting: Four HIV primary care clinics within the United States. Methods:As part of a type 1 hybrid trial, a mixed-methods approach was used to longitudinally assess the following 3 key implementation constructs over a 23-month period: innovationvalues fit (ie, the extent to which staff perceive innovation use will foster the fulfillment of their values), organizational readiness for change (ie, the extent to which organizational members are psychologically and behaviorally prepared to implement organizational change), and implementation climate (ie, the extent to which implementation is expected, supported, and rewarded). Quantitative mixed-effects regression analyses were conducted to assess changes over time in these constructs. Qualitative analyses were integrated to help provide validation and understanding.Results: Innovation-values fit and organizational readiness for change were found to be high and relatively stable. However, significant curvilinear change over time was found for implementation climate. Based on the qualitative data, implementation climate declined toward the end of implementation because of decreased engagement from clinic champions and differences in priorities between research and clinic staff. Conclusions:The Positive Health Check intervention was found to fit within HIV primary care service settings, but there were some logistical challenges that needed to be addressed. Additionally, even within the context of an effectiveness trial, significant and nonlinear change in implementation climate should be expected over time.

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Section: Implementation Strategymentioning

confidence: 99%

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Garner

Burrus

Ortiz

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…We found both promise and room for growth here. For example, whereas some scholars used an IS framework to develop strategies [44 ▪▪ ,48 ▪▪ ], others did not [59 ▪▪ ,60–62]. Addressing a key gap, several studies [21 ▪▪ ,22 ▪▪ ,24 ▪▪ ,41 ▪▪ ,59 ▪▪ ] mapped implementation strategies to the Expert Recommendations for Implementing Change, which established conceptual clarity for 73 strategies [55].…”

Section: Opportunities For Implementation Science To Strengthen Socia...mentioning

confidence: 99%

“…For example, whereas some scholars used an IS framework to develop strategies [44 ▪▪ ,48 ▪▪ ], others did not [59 ▪▪ ,60–62]. Addressing a key gap, several studies [21 ▪▪ ,22 ▪▪ ,24 ▪▪ ,41 ▪▪ ,59 ▪▪ ] mapped implementation strategies to the Expert Recommendations for Implementing Change, which established conceptual clarity for 73 strategies [55]. SBS interventions also evaluated implementation strategies using qualitative [22 ▪▪ ,24 ▪▪ ,41 ▪▪ ,59 ▪▪ ] and quantitative methods [19 ▪▪ ,40 ▪▪ ].…”

Section: Opportunities For Implementation Science To Strengthen Socia...mentioning

confidence: 99%

Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic

Pyra

Motley

Bouris

2022

Current Opinion in HIV and AIDS

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Purpose of reviewSince the beginning of the HIV epidemic, social and behavioral scientists have developed interventions to stem the spread of the virus. The dissemination of these interventions has traditionally been a lengthy process; however, implementation science (IS) offers a route toward hastening delivery of effective interventions. A transdisciplinary approach, wherein IS informs and is informed by social and behavioral sciences (SBS) as well as community participation, offers a strategy for more efficiently moving toward health equity and ending the HIV epidemic. Recent findingsThere has been considerable growth in HIV research utilizing IS theories, methods and frameworks. Many of these studies have been multi or interdisciplinary in nature, demonstrating the ways that IS and SBS can strengthen one another. We also find areas for continued progress toward transdisciplinarity.

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“…The aim of this study was to assess the barriers and facilitators associated with the implementation of the intervention. 17 The results of this initial study would be fed into the design of a future study of the clinical effectiveness of the PHC intervention. The pilot study included 4 clinics in a variety of settings from a small rural, non-profit to a large urban specialty care practice.…”

Section: Implementation Supportmentioning

confidence: 99%

“…Encouraging the clinic staff to be adaptable when facing barriers did not have the impact the authors had expected due to the structured nature of the intervention that did not allow for much change in practice. 17 The level of engagement from other clinic staff who were not directly involved in the PHC intervention directly affected implementation. The clinics with low engagement from clinic staff found it to be a barrier to implementation and clinics with high engagement found it facilitated implementation of PHC.…”

Section: Implementation Supportmentioning

confidence: 99%

Management of HIV Care in Primary Care Settings

Clark¹,

MacDougall²

2022

cjht

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People living with HIV (PLWH) are living longer; this has resulted in the need to manage care for both HIV and non-communicable chronic diseases as these individuals age. The shift of care to primary care physicians from HIV specialists has not generally resulted in a change to patient outcomes. Primary care physicians may need more training to augment their HIV-specific knowledge and increase their comfort and confidence in providing HIV care to PLWH.

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Identifying Implementation Strategies That Address Barriers and Facilitate Implementation of Digital Interventions in HIV Primary Care Settings: Results from the Pilot Implementation of Positive Health Check

Cited by 8 publications

References 32 publications

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Moving toward equity: fostering transdisciplinary research between the social and behavioral sciences and implementation science to end the HIV epidemic

Management of HIV Care in Primary Care Settings

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