Using participatory system dynamics learning to support Ryan White Planning Council priority setting and resource allocations.
Using participatory system dynamics learning to support Ryan White Planning Council priority setting and resource allocations.
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DOI：
10.1016/j.evalprogplan.2022.102104
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发表时间：
2022-08
影响因子：
1.6
通讯作者：
Warren-Dias, Danielle
中科院分区：
文献类型：
--
作者：
Weeks, Margaret R.;Montaque, Helena D. Green;Lounsbury, David W.;Li, Jianghong;Ferguson, Alice;Warren-Dias, Danielle
关键词：
瑞安白色关怀法案提供联邦美元支持低收入的艾滋病毒/艾滋病感染者（PLWH）。地区瑞安白色规划委员会（RWPC）负责确定优先事项，并决定CARE法案的资金分配，利用当地数据来确定最大的需求。然而，农村妇女保护中心在解释复杂的流行病学、服务利用和社区需求数据以告知优先事项的确定和资源分配方面面临挑战。我们试点系统动力学（SD）学习，使用经过验证的艾滋病护理连续SD模拟模型校准到美国东北部的一个瑞安白色资助区。该试点项目运用系统思维来理解复杂的艾滋病毒护理连续体，并模拟和比较各种资源分配决定的结果。三个脚本研讨会提供了学习SD建模过程和模拟工具的机会，模拟各种资源分配，并比较人口健康结果。混合方法评估记录了SD建模过程，成员对建模会议的反应，以及对RWPC决策的SD建模的好处和局限性的态度。尽管成员流动率高，SD模型的复杂性，成员可以理解模拟模型，并提出策略，以寻求最大的改善艾滋病毒护理保留，病毒抑制，减少感染。研究结果表明SD建模的价值，以协助RWPC的决策。
The Ryan White CARE Act provides federal dollars supporting low income people living with HIV/AIDS (PLWH). Regional Ryan White Planning Councils (RWPC) are responsible for setting priorities and deciding CARE Act fund allocations, using local data to identify greatest need. However, RWPC are challenged with interpreting complex epidemiological, service utilization, and community needs data to inform priority setting and resource allocations. We piloted system dynamics (SD) learning, using a validated HIV care continuum SD simulation model calibrated to one northeastern U.S. Ryan White funding area. The pilot applied systems thinking to understand the complex HIV care continuum and to simulate and compare outcomes of various resource allocation decisions. Three scripted workshops provided opportunities to learn the SD modeling process and simulation tool, simulate various resource allocations, and compare population health outcomes. Mixed methods evaluation documented the SD modeling process, member responses to the modeling sessions, and attitudes regarding benefits and limitations of SD modeling for RWPC decision-making. Despite high member turnover and complexity of the SD model, members could understand the simulation model and propose strategies to seek greatest improvements in HIV care retention, viral suppression, and reduced infections. Findings suggests the value of SD modeling to assist RWPC decisions.
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