The promise of outreach for engaging and retaining out-of-care persons in HIV medical care
The promise of outreach for engaging and retaining out-of-care persons in HIV medical care
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DOI：
10.1089/apc.2007.9983
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发表时间：
2007-06-01
影响因子：
4.9
通讯作者：
Bradford, Judith B.
中科院分区：
文献类型：
--
作者：
Bradford, Judith B.
自艾滋病毒/艾滋病流行以来，外展工作人员一直站在艾滋病毒预防的第一线，在社区场所工作，以增加知识并促进减少艾滋病毒传播的行为。随着艾滋病毒感染者的人口统计数据发生变化，寻找脱离护理人员并了解如何吸引和留住他们接受艾滋病毒护理的需求也越来越大。通过卫生资源和服务管理局 (HRSA) 国家意义特别项目 (SPNS) 外展计划，美国各地的 10 个地点实施并评估了强化的外展模式，旨在提高服务不足、弱势艾滋病毒感染者对艾滋病毒护理的参与度和保留率。尽管这些模型根据当地需求和组织特征而有所不同，但都使用了共同的概念框架，并且都使用了相同的数据收集和报告协议。研究小组招募了明显缺席研究和实践的艾滋病毒感染者并为其提供行为干预。他们的干预措施包括辅导、技能建设和教育，并成功减少或消除了妨碍公平获得艾滋病毒护理的结构性、财务和个人/文化障碍。实现了提高艾滋病毒卫生保健参与度和保留率的预期结果。结果表明，可以通过外展模型制定干预措施，促进弱势群体公平获得艾滋病毒护理。对多地点数据的定性和定量分析表明，进一步开发和评估基于外展的干预措施将产生有效的工具来帮助艾滋病毒感染者，否则他们将得不到所需的护理。
From the beginning of the HIV/AIDS epidemic, outreach workers have been on the frontlines of HIV prevention, working in community venues to increase knowledge and promote behaviors to reduce HIV transmission. As demographics of the HIV- infected population have changed, the need has grown to locate out- of- care individuals and learn how to engage and retain them in HIV care. Through the Health Resources and Services Administration ( HRSA) Special Projects of National Significance ( SPNS) Outreach Initiative, 10 sites across the United States implemented and evaluated enhanced outreach models designed to increase engagement and retention in HIV care for underserved, disadvantaged HIV- infected individuals. Although the models differed in response to local needs and organizational characteristics, all made use of a common conceptual framework, and all used the same data collection and reporting protocols. Study teams enrolled and provided behavioral interventions to HIV- infected individuals who have been noticeably absent from research and from practice. Their interventions incorporated coaching, skills- building, and education, and were successful in reducing or removing structural, financial, and personal/ cultural barriers that interfered with equitable access to HIV care. Desired outcomes of increased engagement and retention in HIV health care were achieved. Results demonstrate that interventions to promote equitable access to HIV care for disadvantaged population groups can be built from outreach models. Qualitative and quantitative analysis of the multisite data indicates that further development and evaluation of outreach- based interventions will result in effective tools for reaching HIV-infected individuals who would otherwise remain without needed care.