Translation and sustainability of an HIV prevention intervention in Lusaka, Zambia

Vamos, Szonja; Mumbi, Miriam; Cook, Ryan; Chitalu, Ndashi; Weiss, Stephen M.

doi:10.1007/s13142-013-0237-9

Cited by 15 publications

(17 citation statements)

References 29 publications

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“…Many studies have been conducted in low-and middle-income countries, most commonly in Africa (4,15,63,143). Such studies indicate the importance of strategic partnerships (89,112) and the impact of the broader social context and of health system weaknesses (15,63) as important influences on sustainability.…”

Section: Low-and Middle-income Countriesmentioning

confidence: 99%

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

Shelton

Cooper

Stirman

2024

Annual Review of Public Health

475

569

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intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented. This review critically examines and discusses conceptual and methodological issues in studying sustainability, summarizes the multilevel factors that have been found to influence the sustainability of interventions in a range of public health and health care settings, and highlights key areas for future research. AbstractThere is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient (17,97,109). Although numerous evidence-based public health interventions and clinical preventive strategies and treatments are available, it can be challenging to implement and sustain them outside of controlled settings, particularly if they were originally tested in narrow populations or unrepresentative circumstances (49). As a rapidly growing field, implementation science has focused on understanding factors and strategies that influence the initial adoption and integration of evidence-based interventions (EBIs) in real-world settings (103). Whereas significant advancements have been made in understanding the adoption and implementation of EBIs across a range of community and health care settings, less is known about their sustainability. Recently, experts have prioritized sustainability as an understudied area (45), identifying it as "one of the most significant translational research problems of our time" (103, p. 2) and as a persistent challenge across a range of settings and service delivery sectors, and across health behaviors and outcomes.Maximizing the public health impact of EBIs will require investing in sustainability research. This research will enable us to better understand what factors and processes influence the sustainability of interventions and how to plan proactively for the continuation of EBIs. Moreover, there has been growing consideration of the policy and ethical implications of developing effective health programs without investing in sustainability (118). Researchers, health leaders, advocates, policy makers, practitioners, and funders alike have concerns about the long-term impact and value of their investment in discontinued interventions. In addition to lost investments, time, and resources, there are other reasons for which advancing our understanding of the sustainability of EBIs has value (99, 122). Maintaining effective programs and practices is critical for achieving health benefits, particularly if there is a latency period betwee...

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Section: Low-and Middle-income Countriesmentioning

confidence: 99%

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

Shelton

Cooper

Stirman

2024

Annual Review of Public Health

475

569

View full text Add to dashboard Cite

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“…Task-shifting has been used elsewhere in healthcare to address scaling problems (e.g., providing mental health services and HIV treatment in resource poor countries: Patel, Chowdhary, Rahman & Verdeli, 2011; Vamos et al, 2014), but had not been used previously with the BP or any similar program. Several studies supported task-shifting delivery of the BP (Becker et al, 2006; Becker, Bull, Schaumberg, Cauble, & Franco, 2008; Becker et al, 2010), with 8- and 14-month within-group effect sizes for ED risk factors and symptoms being similar in magnitude to those reported in the Stice et al (2006; 2008) trials using benchmarking (McFall, 1996).…”

Section: Addressing the Scalability Problem: Task-shifting To Peer-lementioning

confidence: 99%

From efficacy to effectiveness to broad implementation: Evolution of the Body Project.

Becker¹,

Stice

2017

Journal of Consulting and Clinical Psychology

130

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Objective At the turn of the millennium, eating disorders (ED) prevention was largely non-existent. No program had reduced future onset of EDs in even a single trial and most had not reduced ED symptoms. Sixteen years later, the ED prevention field has translated basic risk factor research into interventions with demonstrated efficacy and effectiveness in reducing ED risk factors and symptoms, as well as future ED onset in some trials. This paper reviews the aforementioned progress focusing on a model intervention (i.e., the Body Project (BP)). Method The paper is a qualitative review of the existing BP literature. Results Although clinical psychology has struggled with bridging the research practice gap and translating efficacy and effectiveness research into clinical implementation, researchers, clinicians, and community stakeholders working with the BP have made significant progress in addressing barriers to scalability, large-scale implementation, and sustainability, reaching 3.5 million girls and young women in 125 countries. Conclusion The successful evolution of the BP from basic research to traversing the efficacy-to-effectiveness-to-dissemination/implementation continuum has yielded significant public health impact and is thus a fitting case for this special issue commemorating the 125th anniversary of the American Psychological Association. The BP example may help others broadly implement efficacious interventions for other mental health problems. Public Health Impact The Body Project (BP) has reduced eating disorder (ED) risk factors, symptoms, and future ED onset, though the latter effects were only observed in some trials; research also indicates that the BP can be broadly implemented using scalable strategies. To date, the BP has impacted the lives of over 3.5 million girls and young women in 125 countries thanks to strategic partnerships between researchers, clinicians, and community stakeholders.

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“…Recordings were reviewed and rated using a checklist to evaluate the provision of key intervention elements in each of the sessions. Ratings indicated that in cohort 2, the first CHC led cohort, providers delivered 90% of intervention elements, and in cohorts 3 and 4, the CHC led and co-led cohort, providers delivered 75% of intervention elements [27]. Periodic visits and regular conference calls were held with all sites to guide strategies to enhance sustainability, and a refresher workshop was held yearly to enhance fidelity of intervention delivery.…”

Section: Resultsmentioning

confidence: 99%

“…Meetings were held at each clinic with CHC Clinic Officers, Sisters in Charge and staff members to review Partner Project strategies and goals. Based on criteria outlined by the Partner Project regarding the duties associated with conducting the intervention [27], senior CHC staff selected those staff most appropriate for training as group leaders. Ongoing monthly meetings were conducted with Community Advisory Boards (CABs) at each clinic to facilitate community acceptance and uptake of the intervention across the duration of the study.…”

Section: Methodsmentioning

confidence: 99%

Implementation of HIV Prevention Interventions in Resource Limited Settings: The Partner Project

et al. 2013

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Introduction Evidence-based HIV prevention interventions have been translated to a variety of contexts across sub-Saharan Africa. Non-specialized community health center (CHC) staff members have been successfully engaged to deliver the interventions, which can be integrated into pre-existing HIV service programs in community-based health care delivery sites. This manuscript describes the process of implementing the Partner Project, a couples HIV risk reduction intervention, and examines the ability of CHC staff to achieve risk reduction outcomes comparable to those of the highly-trained research staff. Methods The Partner Project was implemented within the HIV Counseling and Testing program in 6 urban community health clinics in Lusaka, Zambia. One hundred ninety seven HIV-seroconcordant and –discordant couples were sequentially enrolled to the control group or to receive the intervention from Partner research or CHC staff members. Couple members completed assessments on condom use, alcohol use, and intimate partner violence (IPV) at baseline, 6, and 12 months follow-up. Results Sexual barrier use outcomes achieved by the CHC staff were comparable to or better than those achieved by the Partner Project research staff, and both were superior to the control group. A reduction in IPV was observed for the entire sample, although no change in alcohol use was observed. Conclusions Implementation of HIV prevention interventions at the community level should take advantage of existing resources available within the CHC staff. This is especially relevant in resource limited settings as consideration of the financial and clinical requirements of intervention programs is essential to the achievement of successful program implementation.

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Translation and sustainability of an HIV prevention intervention in Lusaka, Zambia

Cited by 15 publications

References 29 publications

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

The Sustainability of Evidence-Based Interventions and Practices in Public Health and Health Care

From efficacy to effectiveness to broad implementation: Evolution of the Body Project.

Implementation of HIV Prevention Interventions in Resource Limited Settings: The Partner Project

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