Implementation fidelity to HIV assisted partner services (aPS) during scale-up in western Kenya: a convergent mixed methods study.
Implementation fidelity to HIV assisted partner services (aPS) during scale-up in western Kenya: a convergent mixed methods study.
复制标题
DOI：
10.1186/s12913-023-09541-1
复制
发表时间：
2023-05-19
影响因子：
2.8
通讯作者：
Weiner, Bryan
中科院分区：
文献类型：
--
作者：
Wamuti, Beatrice;Owuor, Mercy;Liu, Wenjia;Katz, David;Lagat, Harison;Otieno, George;Kariithi, Edward;Macharia, Paul;Masyuko, Sarah;Mugambi, Mary;Farquhar, Carey;Weiner, Bryan
关键词：
艾滋病毒辅助性伴侣服务是一种干预措施，旨在提高新诊断为艾滋病毒感染者（索引客户）的性伴侣和注射毒品伴侣对艾滋病毒状况的认识。实施灵活性-干预措施按预期进行的程度-对有效性至关重要，但有关艾滋病毒检测服务（HTS）提供者提供的aPS保真度的数据有限。我们探讨了影响在肯尼亚西部两个艾滋病毒高流行县实施保真度的因素。我们使用收敛的混合方法适应的概念框架内的aPS规模扩大项目的实施保真度。这是一项实施研究，检查了在基苏穆和荷马湾县招募女性索引客户的男性性伴侣（MSP）的HTS方案内扩大APS的规模。我们将实现保真度定义为HTS提供商在六次预期跟踪尝试中遵循电话和亲自参与者跟踪协议的程度。从2018年11月至2020年12月期间31个设施的追踪报告中收集了定量数据，并与HTS提供商进行了深入访谈。描述性统计用于描述追踪尝试。使用主题内容分析法对IDIs进行了分析。总的来说，提到了3017名MSP，其中98%（2969/3017）被追踪，大多数追踪尝试成功（2831/2969，95%）。14名HTS提供者参加了IDIs，其中大多数为女性（10/14，71%），中位年龄为35岁（范围25-52），均接受过中学后教育（14/14，100%）。通过电话进行追踪的比例从47%到66%不等，第一次尝试的比例最高，第六次尝试的比例最低。背景因素增强或阻碍了对aPS的实施保真度。积极的供应商态度，对APS和有利的工作环境因素促进实施保真度，而消极的MSP响应和具有挑战性的跟踪条件阻碍了它。在个人（供应商），人际（客户端提供者），和卫生系统（设施）层面的互动影响实施保真度的APS。随着政策制定者优先考虑减少新的艾滋病毒感染的战略，我们的研究结果强调了进行保真度评估的重要性，以更好地预测和减轻干预措施扩大期间背景因素的影响。在线版本包含补充材料，可通过10.1186/s12913-023-09541-1获得。
HIV assisted partner services (aPS) is an intervention to improve HIV status awareness among sex and drug-injecting partners of people newly diagnosed with HIV (index clients). Implementation fidelity—the degree to which an intervention is conducted as intended – is critical to effectiveness, but there are limited data about aPS fidelity when delivered by HIV testing service (HTS) providers. We explored factors affecting implementation fidelity to aPS in two high-HIV prevalence counties in western Kenya. We used convergent mixed methods adapting the conceptual framework for implementation fidelity within the aPS scale-up project. This was an implementation study examining scale-up of APS within HTS programs in Kisumu and Homa Bay counties that recruited male sex partners (MSPs) of female index clients. We defined implementation fidelity as the extent to which HTS providers followed the protocol for phone and in-person participant tracing at six expected tracing attempts. Quantitative data were collected from tracing reports in 31 facilities between November 2018 and December 2020, and in-depth interviews (IDIs) were conducted with HTS providers. Descriptive statistics were used to describe tracing attempts. IDIs were analyzed using thematic content analysis. Overall, 3017 MSPs were mentioned of whom 98% (2969/3017) were traced, with most tracing attempts being successful (2831/2969, 95%). Fourteen HTS providers participated in the IDIs—mostly females (10/14, 71%) with a median age of 35 years (range 25–52), who all had post-secondary education (14/14, 100%). The proportion of tracing attempts occurring by phone ranged from 47 to 66%, with the highest proportion occurring on the first attempt and lowest on the sixth attempt. Contextual factors either enhanced or impeded implementation fidelity to aPS. Positive provider attitudes towards aPS and conducive work environment factors promoted implementation fidelity, while negative MSP responses and challenging tracing conditions impeded it. Interactions at the individual (provider), interpersonal (client—provider), and health systems (facility) levels affected implementation fidelity to aPS. As policymakers prioritize strategies to reduce new HIV infections, our findings highlight the importance of conducting fidelity assessments to better anticipate and mitigate the impact of contextual factors during the scale-up of interventions. The online version contains supplementary material available at 10.1186/s12913-023-09541-1.
登录
查看更多内容
DOI：
10.1097/qad.0000000000001555
发表时间：
2017-08-24
期刊：
AIDS (London, England)
影响因子：
--
作者：
Dalal S;Johnson C;Fonner V;Kennedy CE;Siegfried N;Figueroa C;Baggaley R
通讯作者：
Baggaley R
DOI：
10.1016/s2352-3018(16)30214-4
发表时间：
2017-02
期刊：
The lancet. HIV
影响因子：
--
作者：
Cherutich P;Golden MR;Wamuti B;Richardson BA;Ásbjörnsdóttir KH;Otieno FA;Ng'ang'a A;Mutiti PM;Macharia P;Sambai B;Dunbar M;Bukusi D;Farquhar C;aPS Study Group
通讯作者：
aPS Study Group
影响因子：
3.7
作者：
Narh-Bana SA;Kawonga M;Chirwa ED;Ibisomi L;Bonsu F;Chirwa TF
通讯作者：
Chirwa TF
影响因子：
9.2
作者：
Grosfeld-Nir, Abraham;Ronen, Boaz;Kozlovsky, Nir
通讯作者：
Kozlovsky, Nir
影响因子：
6
作者：
Monroe-Wise, Aliza;Mutiti, Peter Maingi;Farquhar, Carey
通讯作者：
Farquhar, Carey