Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Lewis, Megan A.; Harshbarger, Camilla; Bann, Carla; Marconi, Vincent C.; Somboonwit, Charurut; DallaPiazza, Michelle; Swaminathan, Shobha; Burrus, O; Galindo, Carla A; Borkowf, Craig B.; Marks, Gary; Karns, Shawn; Zulkiewicz, Brittany; Ortiz, Alexa; Abdallah, Iddrisu; Garner, Bryan; Courtenay‐Quirk, Cari

doi:10.1097/qai.0000000000003045

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…Males were more likely to achieve viral suppression, and the youngest and oldest participants were more likely to be retained in care. 42…”

Section: Introductionmentioning

confidence: 99%

“…Males were more likely to achieve viral suppression, and the youngest and oldest participants were more likely to be retained in care. 42 The design of the PHC effectiveness-implementation hybrid trial has been previously described. 43 As prompted by Kemp and Velloza, one aim of the PHC pragmatic trial was to explore beyond feasibility and acceptability to what extent other important implementation constructs could be identified as predictors of implementation effectiveness.…”

Section: Introductionmentioning

confidence: 99%

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A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Garner

Burrus

Ortiz

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Positive Health Check is an evidence-based video doctor intervention developed for improving the medication adherence, retention in care, and viral load suppression of people with HIV receiving clinical care.Setting: Four HIV primary care clinics within the United States. Methods:As part of a type 1 hybrid trial, a mixed-methods approach was used to longitudinally assess the following 3 key implementation constructs over a 23-month period: innovationvalues fit (ie, the extent to which staff perceive innovation use will foster the fulfillment of their values), organizational readiness for change (ie, the extent to which organizational members are psychologically and behaviorally prepared to implement organizational change), and implementation climate (ie, the extent to which implementation is expected, supported, and rewarded). Quantitative mixed-effects regression analyses were conducted to assess changes over time in these constructs. Qualitative analyses were integrated to help provide validation and understanding.Results: Innovation-values fit and organizational readiness for change were found to be high and relatively stable. However, significant curvilinear change over time was found for implementation climate. Based on the qualitative data, implementation climate declined toward the end of implementation because of decreased engagement from clinic champions and differences in priorities between research and clinic staff. Conclusions:The Positive Health Check intervention was found to fit within HIV primary care service settings, but there were some logistical challenges that needed to be addressed. Additionally, even within the context of an effectiveness trial, significant and nonlinear change in implementation climate should be expected over time.

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“…Males were more likely to achieve viral suppression, and the youngest and oldest participants were more likely to be retained in care. 42…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Garner

Burrus

Ortiz

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

Self Cite

View full text Add to dashboard Cite

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“…Our calculation of the average cost per virally suppressed patient included all participants receiving PHC and SOC services (PHC + SOC). We did not assess cost per additional patient virally suppressed (ie, incremental cost) relative to SOC alone because the trial results showed no statistically significant differences between PHC + SOC and SOC on overall outcomes 16. We conducted sensitivity analysis excluding recruitment and outreach costs to generate average PHC intervention costs per patients receiving the intervention, retained in care, and remained virally suppressed.…”

Section: Methodsmentioning

confidence: 99%

“…15 The trial outcome analyses showed no statistically significant differences between PHC + SOC (standard of care) and SOC when analyzing all participants for either the primary or secondary endpoints. 16 However, males in the PHC intervention arm improved on viral suppression more so than males assigned to the control arm. Furthermore, retention in care improved more among the youngest and oldest age groups of participants enrolled in the PHC intervention arm than those in the control arm.…”

mentioning

confidence: 98%

“…To assess the effectiveness of the PHC intervention, we conducted a type 1 hybrid effectiveness-implementation randomized trial among patients who were receiving care in HIV primary care clinics in the United States 15. The trial outcome analyses showed no statistically significant differences between PHC + SOC (standard of care) and SOC when analyzing all participants for either the primary or secondary endpoints 16. However, males in the PHC intervention arm improved on viral suppression more so than males assigned to the control arm.…”

mentioning

confidence: 99%

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Cost Analysis of the Positive Health Check Intervention to Suppress HIV Viral Load and Retain Patients in HIV Clinical Care

Shrestha

Galindo

Courtenay‐Quirk

et al. 2023

Journal of Public Health Management and Practice

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Context: Digital video-based behavioral interventions are effective tools for improving HIV care and treatment outcomes.Objective: To assess the costs of the Positive Health Check (PHC) intervention delivered in HIV primary care settings. Design, Setting, and Intervention: The PHC study was a randomized trial evaluating the effectiveness of a highly tailored, interactive video-counseling intervention delivered in 4 HIV care clinics in the United States in improving viral suppression and retention in care. Eligible patients were randomized to either the PHC intervention or the control arm. Control arm participants received standard of care (SOC), and intervention arm participants received SOC plus PHC. The intervention was delivered on computer tablets in the clinic waiting rooms. The PHC intervention improved viral suppression among male participants. A microcosting approach was used to assess the program costs, including labor hours, materials and supplies, equipment, and office overhead. Participants: Persons with HIV infection, receiving care in participating clinics. Main Outcome Measures: The primary outcome was the number of patients virally suppressed, defined as having fewer than 200 copies/mL by the end of their 12-month follow-up. Results: A total of 397 (range across sites [range], 95-102) participants were enrolled in the PHC intervention arm, of whom 368 participants (range, 82-98) had viral load data at baseline and were included in the viral load analyses. Of those, 210 (range, 41-63) patients were virally suppressed at the end of their 12-month follow-up visit. The overall annual program cost

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Implementation of Low-Barrier Human Immunodeficiency Virus Care: Lessons Learned From the Max Clinic in Seattle

Dombrowski

Ramchandani

Golden

2023

Clinical Infectious Diseases

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Low-barrier care (LBC) for people with HIV is a differentiated service delivery strategy to engage people in HIV treatment who are not well-engaged in conventionally organized HIV medical care. The LBC approach is flexible, but experience suggests that the intervention has distinct core components. This review summarizes our experience implementing one model of LBC, the Max Clinic in Seattle; describes the core components of the intervention; and presents a framework for implementing low-barrier HIV care with the goal of providing a practical guide for clinical and public health leaders seeking to implement a new LBC program. A systematic approach to addressing key factors during LBC implementation can support practitioners to design an LBC approach that fits the local context while maintaining essential elements of the intervention.

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Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 5 publications

References 34 publications

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1 Effectiveness-Implementation Hybrid Trial

Cost Analysis of the Positive Health Check Intervention to Suppress HIV Viral Load and Retain Patients in HIV Clinical Care

Implementation of Low-Barrier Human Immunodeficiency Virus Care: Lessons Learned From the Max Clinic in Seattle

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