Patient and provider perceptions of a peer-delivered intervention ('Khanya') to improve anti-retroviral adherence and substance use in South Africa: a mixed methods analysis.
Patient and provider perceptions of a peer-delivered intervention ('Khanya') to improve anti-retroviral adherence and substance use in South Africa: a mixed methods analysis.
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DOI：
10.1017/gmh.2022.47
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Magidson, Jessica F.
中科院分区：
文献类型：
--
作者：
Rose, Alexandra L.;Belus, Jennifer M.;Hines, Abigail C.;Barrie, Issmatu;Regenauer, Kristen S.;Andersen, Lena S.;Joska, John A.;Ciya, Nonceba;Ndamase, Sibabalwe;Myers, Bronwyn;Safren, Steven A.;Magidson, Jessica F.
尽管南非艾滋病毒感染者中问题药物使用的流行率很高，但在艾滋病毒护理系统内获得药物使用服务的机会仍然有限。为了解决这一差距，我们的团队以前开发和调整了六个会议，同行交付的问题解决和行为激活为基础的干预（Khanya），以提高艾滋病毒药物治疗的依从性，减少物质使用在开普敦。本研究评估了患者和提供者对干预措施的看法，以指导实施和未来的适应。干预完成后，我们进行了半结构化的个人访谈，患者（n = 23）和供应商（n = 9），以了解的可行性，可接受性和适当性的Khanya和它的实施同行的观点。患者还在治疗后和6个月随访时对个体干预成分（解决药物依从性问题的“生命步骤”，行为激活，正念训练和复发预防）的有用性进行了定量排名，我们将其与定性反馈进行三角测量，以检查方法之间的收敛性和发散性。患者和提供者报告Khanya的整体可接受性、可行性和适当性较高，尽管存在一些可行性挑战。正念和生活步骤被确定为特别可接受的，可行的，和适当的组成部分，患者的方法，而复发预防策略不太突出。不同方法的行为激活结果不太一致。研究结果强调了检查患者对干预方案中特定干预成分的看法的重要性。虽然消费者对正念训练和同伴交付模式有积极的看法，但它们很少用于低收入和中等收入国家的任务共享行为干预。
Despite a high prevalence of problematic substance use among people living with HIV in South Africa, there remains limited access to substance use services within the HIV care system. To address this gap, our team previously developed and adapted a six-session, peer-delivered problem-solving and behavioral activation-based intervention (Khanya) to improve HIV medication adherence and reduce substance use in Cape Town. This study evaluated patient and provider perspectives on the intervention to inform implementation and future adaptation. Following intervention completion, we conducted semi-structured individual interviews with patients (n = 23) and providers (n = 9) to understand perspectives on the feasibility, acceptability, and appropriateness of Khanya and its implementation by a peer. Patients also quantitatively ranked the usefulness of individual intervention components (problem solving for medication adherence ‘Life-Steps’, behavioral activation, mindfulness training, and relapse prevention) at post-treatment and six months follow-up, which we triangulated with qualitative feedback to examine convergence and divergence across methods. Patients and providers reported high overall acceptability, feasibility, and appropriateness of Khanya, although there were several feasibility challenges. Mindfulness and Life-Steps were identified as particularly acceptable, feasible, and appropriate components by patients across methods, whereas relapse prevention strategies were less salient. Behavioral activation results were less consistent across methods. Findings underscore the importance of examining patients’ perspectives on specific intervention components within intervention packages. While mindfulness training and peer delivery models were positively perceived by consumers, they are rarely used within task-shared behavioral interventions in low- and middle-income countries.
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影响因子：
2.2
作者：
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通讯作者：
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DOI：
10.1111/add.14049
发表时间：
2018-03
期刊：
Addiction (Abingdon, England)
影响因子：
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作者：
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影响因子：
11.3
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DOI：
10.1016/j.socscimed.2020.113424
发表时间：
2020-12
期刊：
Social science & medicine (1982)
影响因子：
--
作者：
Magidson JF;Satinsky EN;Luberto CM;Myers B;Funes CJ;Vanderkruik R;Andersen LS
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