Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study.
Adapting a tobacco cessation treatment intervention and implementation strategies to enhance implementation effectiveness and clinical outcomes in the context of HIV care in Vietnam: a case study.
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DOI：
10.1186/s43058-022-00361-8
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发表时间：
2022-10-17
影响因子：
--
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中科院分区：
文献类型：
--
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越南的吸烟率仍然很高，特别是在艾滋病毒/艾滋病（PLWH）感染者中，但门诊艾滋病毒诊所（OPCs）不提供戒烟服务。该研究小组正在进行一项II型混合随机对照试验（RCT），比较在越南艾滋病毒诊所接受治疗的艾滋病毒感染者中三种戒烟干预措施的成本效益。该研究同时评估了旨在加强在艾滋病毒护理背景下实施烟草依赖治疗的战略的实施过程和结果。本文描述了在启动试验之前，在高收入国家（最近在越南）调整干预成分和实施策略并证明其有效性的系统的、理论驱动的过程，以适应新的人群（即PLWH）和新的临床环境。数据收集和分析以两个实施科学框架和社会生态模型为指导。对三个门诊中心的13名保健提供者和24名患者进行了定性访谈。在每个OPC中进行工作流程分析。采用快速定性分析程序对定性数据进行分析。根据研究结果，对干预的组成部分和实施策略进行了调整，随后在一个OPC进行了为期3个月的试点研究，其中16名患者被随机分配到两个干预组之一。主要调整包括修改TDT干预咨询内容，以解决PLWH戒烟障碍和越南支持戒烟的社会文化规范。实施策略（即培训和系统变更）进行了调整，以应对提供者和诊所层面的实施有效性决定因素（例如，知识差距、OPC资源限制、人员配置结构、兼容性）。通过一种混合方法促进适应，利益攸关方（患者和保健提供者、地区保健负责人）参与评估具体情况对干预措施和执行效果的影响。这种数据驱动的改进和调整组成部分的方法旨在优化艾滋病毒护理背景下的干预效果和实施。通过使用快速分析程序和多种方法来平衡实用主义与严谨性，增加了适应过程的可行性。ClinicalTrials.gov NCT05162911。于2021年12月16日注册。在线版本包含补充材料，可在10.1186/s43058-022-00361-8获得。
Smoking rates remain high in Vietnam, particularly among people living with HIV/AIDS (PLWH), but tobacco cessation services are not available in outpatient HIV clinics (OPCs). The research team is conducting a type II hybrid randomized controlled trial (RCT) comparing the cost-effectiveness of three tobacco cessation interventions among PLWH receiving care in HIV clinics in Vietnam. The study is simultaneously evaluating the implementation processes and outcomes of strategies aimed at increasing the implementation of tobacco dependence treatment (TDT) in the context of HIV care. This paper describes the systematic, theory-driven process of adapting intervention components and implementation strategies with demonstrated effectiveness in high-income countries, and more recently in Vietnam, to a new population (i.e., PLWH) and new clinical setting, prior to launching the trial. Data collection and analyses were guided by two implementation science frameworks and the socio-ecological model. Qualitative interviews were conducted with 13 health care providers and 24 patients in three OPCs. Workflow analyses were conducted in each OPC. Qualitative data were analyzed using rapid qualitative analysis procedures. Based on findings, components of the intervention and implementation strategies were adapted, followed by a 3-month pilot study in one OPC with 16 patients randomized to one of two intervention arms. The primary adaptations included modifying the TDT intervention counseling content to address barriers to quitting among PLWH and Vietnamese sociocultural norms that support smoking cessation. Implementation strategies (i.e., training and system changes) were adapted to respond to provider- and clinic-level determinants of implementation effectiveness (e.g., knowledge gaps, OPC resource constraints, staffing structure, compatibility). Adaptations were facilitated through a mixed method, stakeholder (patient and health care provider, district health leader)-engaged evaluation of context-specific influences on intervention and implementation effectiveness. This data-driven approach to refining and adapting components aimed to optimize intervention effectiveness and implementation in the context of HIV care. Balancing pragmatism with rigor through the use of rapid analysis procedures and multiple methods increased the feasibility of the adaptation process. ClinicalTrials.gov NCT05162911. Registered on December 16, 2021. The online version contains supplementary material available at 10.1186/s43058-022-00361-8.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
越南短信戒烟干预措施的适应和评估：试点随机对照试验。
影响因子：
5
作者：
Jiang N;Nguyen N;Siman N;Cleland CM;Nguyen T;Doan HT;Abroms LC;Shelley DR
通讯作者：
Shelley DR
DOI：
10.1186/s13012-017-0605-9
发表时间：
2017-06-21
期刊：
Implementation science : IS
影响因子：
--
作者：
Atkins L;Francis J;Islam R;O'Connor D;Patey A;Ivers N;Foy R;Duncan EM;Colquhoun H;Grimshaw JM;Lawton R;Michie S
通讯作者：
Michie S
影响因子：
4.6
作者：
Hoang Van Minh;Kim Bao Giang;Nguyen Thi Xuyen
通讯作者：
Nguyen Thi Xuyen