Adherence support workers: a way to address human resource constraints in antiretroviral treatment programs in the public health setting in Zambia.
Adherence support workers: a way to address human resource constraints in antiretroviral treatment programs in the public health setting in Zambia.
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DOI：
10.1371/journal.pone.0002204
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发表时间：
2008-05-21
期刊：
影响因子：
3.7
通讯作者：
Mukadi YD
中科院分区：
文献类型：
--
作者：
Torpey KE;Kabaso ME;Mutale LN;Kamanga MK;Mwango AJ;Simpungwe J;Suzuki C;Mukadi YD
为了解决工作人员短缺的问题，并改善对接受抗逆转录病毒疗法的人的依从性咨询，赞比亚预防、护理和治疗伙伴关系制定了一项创新战略，培训社区志愿者，以便在卫生设施和社区一级提供依从性支持。本研究的目的是评估这些“坚持支持工作者”（ASW）在坚持咨询，治疗保留和解决卫生设施人力资源不足的有效性。这项研究在赞比亚四个省的五个选定的抗逆转录病毒治疗地点使用了定量和定性研究技术。500例ART患者进行了访谈，使用结构式问卷调查，以比较坚持咨询的质量之前和之后的ASW计划在选定的网站和ASW和HCWs之间引入ASW后。此外，还分析了3，903和4，972名分别在引入ASW前12个月和引入ASW后12个月内接受抗逆转录病毒治疗的所有新患者的电子记录，以评估失访率。在每间诊所进行了两次与助理社工及医护人员的专题小组讨论。还在抗逆转录病毒治疗诊所进行了关键的知情人访谈。工作量明显从保健工作者转移到助理工作者，而咨询质量没有任何妥协。ASWs的依从性咨询质量与HCWs引入后相当。研究结果表明，ASW的部署有助于减少依从性咨询的等待时间。新客户的失访率由15%下降至ASW部署后的0%。坚持咨询任务可以转移到像ASW的外行干部，而不影响咨询的质量。社区内的辅助工作者有必要对客户进行跟踪，以提高抗逆转录病毒疗法客户的保留率。
In order to address staff shortages and improve adherence counseling for people on antiretroviral therapy (ART), the Zambia Prevention, Care and Treatment Partnership (ZPCT) developed an innovative strategy of training community volunteers to provide adherence support at the health facility and community levels. The objective of this study was to assess the effectiveness of these ‘adherence support workers’ (ASWs) in adherence counseling, treatment retention and addressing inadequate human resources at health facilities. The study used quantitative and qualitative research techniques at five selected ART sites in four provinces in Zambia. Five hundred patients on ART were interviewed using a structured questionnaire to compare the quality of adherence counseling before and after the ASW scheme was introduced at the selected sites and between ASWs and HCWs after the introduction of ASWs. In addition, 3,903 and 4,972 electronic records of all new patients accessing antiretroviral therapy for the time period of 12 months before and 12 months after the introduction of ASWs respectively, were analyzed to assess loss to follow-up rates. Two focus group discussions with ASWs and health care workers (HCWs) were conducted in each clinic. Key informant interviews in the ART clinics were also conducted. There was a marked shift of workload from HCWs to ASWs without any compromise in the quality of counseling. Quality of adherence counseling by ASWs was comparable to HCWs after their introduction. The findings suggest that the deployment of ASWs helped reduce waiting times for adherence counseling. Loss to follow-up rates of new clients declined from 15% to 0% after the deployment of ASWs. Adherence counseling tasks can be shifted to lay cadres like ASWs without compromising the quality of counseling. Follow-up of clients by ASWs within the community is necessary to improve retention of clients on ART.
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DOI：
10.1097/00042560-200205010-00014
发表时间：
2002-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
de Olalla, PG;Knobel, H;Caylà, JA
通讯作者：
Caylà, JA
影响因子：
11.8
作者：
Ivers, LC;Kendrick, D;Doucette, K
通讯作者：
Doucette, K
影响因子：
3.8
作者：
Koenig, SP;Léandre, F;Farmer, PE
通讯作者：
Farmer, PE
影响因子：
168.9
作者：
Kober, K;Van Damme, W
通讯作者：
Van Damme, W
DOI：
10.1097/00126334-200408150-00014
发表时间：
2004-08-15
影响因子：
3.6
作者：
Oyugi, JH;Byakika-Tusiime, J;Bangsberg, DR
通讯作者：
Bangsberg, DR