Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV/AIDS in teen club program in Malawi: health care providers perspectives.
Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV/AIDS in teen club program in Malawi: health care providers perspectives.
复制标题
马拉维青少年俱乐部方案中对感染艾滋病毒/艾滋病的青少年实施HEADSS心理社会筛查工具的障碍和促进因素：保健提供者的观点。
DOI：
10.1186/s13033-022-00520-3
复制
发表时间：
2022-01-31
影响因子：
3.6
通讯作者：
Gaynes BN
中科院分区：
文献类型：
--
作者：
Kip EC;Udedi M;Kulisewa K;Go VF;Gaynes BN
青少年艾滋病毒感染者（ALHIV）有很高的风险经历心理健康问题。抑郁症是ALHIV患者中HIV相关疾病负担的主要贡献者，与不依从抗逆转录病毒治疗（ART）密切相关，但尚未得到充分认识。2015年，贝勒医学院国际儿科艾滋病倡议（BIPAI）建议使用心理社会筛查工具家庭，教育，活动，药物，性行为，自杀/抑郁症（HEADSS）来筛查马拉维的ALHIV，他们是青少年抗逆转录病毒治疗计划的一部分，称为“青少年俱乐部”。然而，HEADSS工具的利用率很低。本研究评估的障碍和促进者实施HEADSS ALHIV参加青少年俱乐部计划在马拉维的四个选定的卫生设施。我们在2019年4月至5月期间在四个项目地点（两个地区的一家地区医院和一家卫生中心）进行了一项半结构化访谈的定性研究。根据他们的角色和经验，有目的地选择了二十个关键的线人参加这项研究。我们使用了实施研究综合框架（CFIR）的五个领域来指导访谈指南的制定，结果的分析和解释。障碍包括：对综合HEADSS方法的规划不足;担心HEADSS工具太长、耗时、缺乏适当的文化背景和工作量增加;以及参与者报告说，他们没有知识和技能使用这一工具筛查ALHIV。实施筛查的促进因素是，医疗保健提供者将筛查视为更好的系统咨询的指南，认为筛查可以建立更好的客户-提供者关系，并认为它可以融入现有的工作实践，因为它并不复杂。一个文化上适应的筛选工具，特别是一个可以使用的非临床医生，如外行卫生工作者，将提高能力，以解决ALHIV的心理健康需求，在许多初级保健和社会服务环境中，专业的心理健康工作人员的资源是有限的。这些研究结果是一个跳板，努力适应文化的HEADSS筛查工具，在马拉维参加ART计划的ALHIV患者中检测精神和危险行为。
Adolescents living with HIV (ALHIV) are at high risk of experiencing mental health problems. Depression is a major contributor to the burden of HIV-related disease amongst ALHIV and is significantly linked to non-adherence to anti-retroviral therapy (ART), yet it is under-recognized. In 2015, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) recommended that the psychosocial screening tool Home, Education, Activities, Drugs, Sexuality, Suicide/Depression (HEADSS) be used to screen ALHIV in Malawi who were part of an adolescent antiretroviral therapy program termed “Teen Club”. However, the HEADSS tool has been substantially under-utilized. This study assessed barriers and facilitators to implementing HEADSS for ALHIV attending Teen Club Program in four selected health facilities in Malawi. We conducted a qualitative study using semi-structured interviews at four program sites (one district hospital and one health center each in two districts) between April and May 2019. Twenty key informants were purposively selected to join this study based on their role and experiences. We used the five domains of the Consolidated Framework for Implementation Research (CFIR) to guide the development of the interview guides, analysis and interpretation of results. Barriers included inadequate planning for integration of the HEADSS approach; concerns that the HEADSS tool was too long, time consuming, lacked appropriate cultural context, and increased workload; and reports by participants that they did not have knowledge and skills to screen ALHIV using this tool. Facilitators to implementing the screening were that health care providers viewed screening as a guide to better systematic counselling, believed that screening could build better client provider relationship, and thought that it could fit into the existing work practice since it is not complex. A culturally adapted screening tool, especially one that can be used by non-clinicians such as lay health workers, would improve the ability to address mental health needs of ALHIV in many primary care and social service settings where resources for professional mental health staff are limited. These findings are a springboard for efforts to culturally adapt the HEADSS screening tool for detection of mental and risky behaviors among ALHIV attending ART program in Malawi.
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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
影响因子：
4.2
作者：
Kirk, Jeanette W.;Sivertsen, Ditte M.;Petersen, Helle V.
通讯作者：
Petersen, Helle V.
影响因子：
0.8
作者：
Chikaphupha, Kingsley R.;Kok, Maryse C.;Theobald, Sally
通讯作者：
Theobald, Sally
影响因子：
6
作者：
Kim MH;Mazenga AC;Yu X;Ahmed S;Paul ME;Kazembe PN;Abrams EJ
通讯作者：
Abrams EJ
影响因子：
4.4
作者：
Kim MH;Mazenga AC;Yu X;Devandra A;Nguyen C;Ahmed S;Kazembe PN;Sharp C
通讯作者：
Sharp C