Client preferences for HIV Care Coordination Program features in New York City: latent class analysis of a discrete choice experiment.
Client preferences for HIV Care Coordination Program features in New York City: latent class analysis of a discrete choice experiment.
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DOI：
10.1002/jia2.26162
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发表时间：
2023-08
影响因子：
6
通讯作者：
中科院分区：
文献类型：
--
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这项于2018年启动的Promise研究评估了艾滋病毒护理协调计划(CCP)修订的实施情况，该修订旨在最大限度地减少纽约市高需求艾滋病毒携带者之间艾滋病毒结果的持续差异。我们进行了一项离散选择实验(DCE)，评估CCP客户的偏好，以便为项目设计的改进提供信息。客户在两个假想的CCP选项之间进行选择，这两个选项在四个计划属性中有所不同：帮助抗逆转录病毒药物治疗(ART)坚持(直接观察治疗[DOT]与通过电话/短信提醒与依从性评估)，帮助初级保健预约(提醒和陪伴与提醒和交通与仅提醒)，帮助解决初级保健以外的问题(覆盖范围和福利与住房和食品与心理健康与专科医疗)和就诊地点(在家中会面与通过电话/视频与计划访问30或60分钟路程)。潜在类别分析确定了不同的偏好模式。进行了选择模拟，以模拟客户对假设CCP的整体偏好。来自实施修订后的CCP的六个站点的181个CCP客户完成了DCE，时间为2020年1月至2021月。大多数患者有稳定的住房(68.5%)，最近3个月报告没有问题的药物使用(72.4%)，实现了病毒抑制(78.5)，只有26.5%的患者在CCP内接受了DOT。77.3%的回复是在新冠肺炎大流行之前获得的。他们的喜好分为三组。访问地点和艺术依从性支持是最重要的属性。第一组(40%)支持就诊地点的远程保健；远程保健支持ART坚持支持；以及帮助获得住房/食物；第二组(37%)支持探视地点的远程保健；远程保健支持ART坚持支持；以及工作人员提醒/安排预约交通；第三组(23%)支持在计划地点会见客户的工作人员和与客户合作的工作人员坚持服药。这一DCE显示出对远程医疗的强烈偏好和对密集服务的相对较低的偏好，例如DOT和家访；偏好是不同的。这些发现支持纽约市CCP中的差异化护理和远程服务交付选项，并可以为CCP设计的改进提供参考。
The PROMISE study, launched in 2018, evaluates the implementation of revisions to the HIV Care Coordination Program (CCP) designed to minimize persistent disparities in HIV outcomes among high‐need persons living with HIV in New York City. We conducted a discrete choice experiment (DCE) assessing the preferences of CCP clients to inform improvements to the program's design. Clients chose between two hypothetical CCP options that varied across four program attributes: help with antiretroviral therapy (ART) adherence (directly observed therapy [DOT] vs. remind via phone/text vs. adherence assessment), help with primary care appointments (remind and accompany vs. remind and transport vs. remind only), help with issues other than primary care (coverage and benefits vs. housing and food vs. mental health vs. specialty medical care) and visit location (meet at home vs. via phone/video vs. program visit 30 or 60 minutes away). The latent class analysis identified different preference patterns. A choice simulation was performed to model client preferences for hypothetical CCPs as a whole. One hundred and eighty‐one CCP clients from six sites implementing the revised CCP completed the DCE January 2020–March 2021. Most clients had stable housing (68.5%), reported no problem substance use in the last 3 months (72.4%) and achieved viral suppression (78.5) with only 26.5% receiving DOT within a CCP. 77.3% of responses were obtained before the COVID‐19 pandemic. Preferences clustered into three groups. Visit location and ART adherence support were the most important attributes. Group 1 (40%) endorsed telehealth for visit location; telehealth for ART adherence support; and help with securing housing/food; Group 2 (37%) endorsed telehealth for visit location; telehealth for ART adherence support; and staff reminding/arranging appointment transportation; Group 3 (23%) endorsed staff meeting clients at program location and staff working with clients for medication adherence. In the choice simulation, Basic and Medium hypothetical CCPs were endorsed more than Intensive CCPs. This DCE revealed a strong preference for telehealth and a relatively low preference for intensive services, such as DOT and home visits; preferences were heterogeneous. The findings support differentiated care and remote service delivery options in the NYC CCP, and can inform improvements to CCP design.
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影响因子：
4.5
作者：
Johnson, F. Reed;Lancsar, Emily;Bridges, John F. P.
通讯作者：
Bridges, John F. P.
影响因子：
4.5
作者：
Bridges, John F. P.;Hauber, A. Brett;Mauskopf, Josephine
通讯作者：
Mauskopf, Josephine
影响因子：
2.9
作者：
Irvine, Mary K.;Levin, Bruce;Nash, Denis
通讯作者：
Nash, Denis
在近期诊断出艾滋病病毒或有艾滋病病毒感染不良史的人群中，艾滋病护理协调的短期效果。
影响因子：
3.7
作者：
Nash D;Robertson MM;Penrose K;Chamberlin S;Robbins RS;Braunstein SL;Myers JE;Abraham B;Kulkarni S;Waldron L;Levin B;Irvine MK
通讯作者：
Irvine MK
影响因子：
4.7
作者：
Hickey MD;Sergi F;Zhang K;Spinelli MA;Black D;Sola C;Blaz V;Nguyen JQ;Oskarsson J;Gandhi M;Havlir DV
通讯作者：
Havlir DV