HIV system navigation: An emerging model to improve HIV care access
HIV system navigation: An emerging model to improve HIV care access
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DOI：
10.1089/apc.2007.9987
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发表时间：
2007-06-01
影响因子：
4.9
通讯作者：
Cunningham, William
中科院分区：
文献类型：
--
作者：
Bradford, Judith B.;Coleman, Sharon;Cunningham, William
人们对外展干预措施的有效性知之甚少，这些干预措施旨在让未得到充分服务的艾滋病毒携带者获得稳定的初级医疗服务。这项研究提供了一个机会，使最初为癌症护理开发的患者导航模型用于评估其对感染艾滋病毒的弱势人群的有效性。卫生资源和服务管理局(HRSA)资助的外联倡议的四名受赠者制定并成功实施了类似导航的干预措施。我们检查了这些干预措施在减少艾滋病毒初级医疗保健障碍和改善健康结果方面的有效性。1993年美国医学研究所报告《获得美国卫生保健》中提出的概念框架为指导分析提供了有价值的启发，我们使用该模型为研究选择措施。在12个月的干预期内，观察到障碍的减少、介体的改善和健康结果的改善。艾滋病毒护理和提供者参与的结构性障碍与健康结果显著相关。根据研究结果，我们建议，一种被称为“艾滋病毒系统导航”的适应导航方法有望改善获得艾滋病毒护理的机会，并值得进一步发展。
Little is known about the effectiveness of outreach interventions to engage and retain underserved populations living with HIV in stable, primary medical care. This study provided an opportunity to adapt a patient navigation model first developed for cancer care to assess its effectiveness with HIV- infected disadvantaged populations. Four grantees from the Health Resources and Services Administration ( HRSA)- funded Outreach Initiative developed and successfully implemented navigation- like interventions. We examined the effectiveness of these interventions in decreasing barriers to HIV primary medical care and improving health outcomes. The conceptual framework laid out in the 1993 Institute of Medicine report Access to Health Care in America provided a valuable heuristic for guiding the analysis, and we used the model to select measures for the study. A reduction in barriers, improvement in mediators, and improved health outcomes were observed over the 12- month intervention period. Structural barriers to HIV care and provider engagement were significantly associated with health outcomes. Based on study results, we propose that an adapted navigation approach referred to as "HIV System Navigation" has promise for improving access to HIV care and warrants further development.