Impact of Human Resources on Implementing an Evidence-Based HIV Prevention Intervention

McKay, Virginia; Dolcini, M. Margaret; Catania, Joseph A.

doi:10.1007/s10461-016-1425-7

Cited by 8 publications

(14 citation statements)

References 34 publications

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“…RCT = data from the original RESPET randomized controlled trial (see references [ 24 , 25 ]). RESPECT case = data from the RESPECT de-adoption study (see reference [ 31 ])…”

Section: Methodsmentioning

confidence: 99%

The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach

et al. 2018

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BackgroundSustaining evidence-based interventions (EBIs) is an ongoing challenge for dissemination and implementation science in public health and social services. Characterizing the relationship among human resource capacity within an agency and subsequent population outcomes is an important step to improving our understanding of how EBIs are sustained. Although human resource capacity and population outcomes are theoretically related, examining them over time within real-world experiments is difficult. Simulation approaches, especially agent-based models, offer advantages that complement existing methods.MethodsWe used an agent-based model to examine the relationships among human resources, EBI delivery, and population outcomes by simulating provision of an EBI through a hypothetical agency and its staff. We used data from existing studies examining a widely implemented HIV prevention intervention to inform simulation design, calibration, and validity. Once we developed a baseline model, we used the model as a simulated laboratory by systematically varying three human resource variables: the number of staff positions, the staff turnover rate, and timing in training. We tracked the subsequent influence on EBI delivery and the level of population risk over time to describe the overall and dynamic relationships among these variables.ResultsHigher overall levels of human resource capacity at an agency (more positions) led to more extensive EBI delivery over time and lowered population risk earlier in time. In simulations representing the typical human resource investments, substantial influences on population risk were visible after approximately 2 years and peaked around 4 years.ConclusionsHuman resources, especially staff positions, have an important impact on EBI sustainability and ultimately population health. A minimum level of human resources based on the context (e.g., size of the initial population and characteristics of the EBI) is likely needed for an EBI to have a meaningful impact on population outcomes. Furthermore, this model demonstrates how ABMs may be leveraged to inform research design and assess the impact of EBI sustainability in practice.Electronic supplementary materialThe online version of this article (10.1186/s13012-018-0767-0) contains supplementary material, which is available to authorized users.

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“…RCT = data from the original RESPET randomized controlled trial (see references [ 24 , 25 ]). RESPECT case = data from the RESPECT de-adoption study (see reference [ 31 ])…”

Section: Methodsmentioning

confidence: 99%

The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach

et al. 2018

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“…Leadership support is crucial to develop capacities, especially those needed for the specific implementation of this project. The innovation-specific capacities should be expanded at the individual level (motivation and skills) and at the organizational level (human, technical, physical, and financial resources) [32,33]. Building specific capacities will allow the project to continue without further dependence on external support.…”

Section: Structural-level Barriersmentioning

confidence: 99%

Implementing a Canadian shared-care ADHD program in Beijing: Barriers and facilitators to consider prior to start-up

et al. 2022

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Background The shared care pathway for ADHD is a program developed in Canada with two main strategies: (a) implement a shared care pathway between general practitioners (GPs) and specialists, and (b) step up or down care so that the patient is treated at the most appropriate level of care, depending on the complexity or outcome of their illness. The current study aims to identify the challenges and facilitators of implementing this program in a Chinese mental health service setting. Methods Two focus groups were conducted using semi-structured interviews with a total of 7 health care providers in Beijing. An adapted grounded theory methodology using open-ended, axial and selective coding was used for data analysis. Results We identified three main levels related to barriers and facilitators: (1) a sociocultural level of patients' and health care providers' perspectives; (2) a structural level related to internal and external organizational environments; (3) and the level of the intervention itself with its characteristics. The project is generally aligned with the mandates and goals of the health system, but two of the main obstacles are the varying qualifications of physicians in hospitals of different levels, implying different needs and flexible and adapted training programs, and the lack of appropriate patient referral systems between the different hospital levels. Conclusion Our study highlights the importance of consultation to obtain a "lay of the land" for deciding on the implementation steps of an a priori well accepted model of care.

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“…High staff turnover led to poor recruitment and attendance. Prior research in non-dental contexts has found high turnover to have broad effects on program implementation, including implementation fidelity, reach, and sustainability [26][27][28]. Although high staff turnover directly influences the number of staff available for screening clients, we found that even with low turnover, agencies with insufficient staff size (e.g., DCOs) reported problems with increasing client recruitment efforts (e.g., attending parent/teacher conferences and registration nights), particularly when schools scheduled overlapping events.…”

Section: Workforce Capacitymentioning

confidence: 99%

Implementation problems and adaptations among organizations delivering school‐based dental sealant programs

AlEissa

Catania

2022

J Public Health Dent

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Objectives: Although research supports the effectiveness of school-based dental sealant programs (SBDSPs) in increasing access to dental care and reducing dental caries, there is limited information on the implementation processes that impact success at the population level. This study assessed SBDSP program implementation in terms of problems (and adaptations) encountered during school and client (students) recruitment, client attendance, and workforce capacity. These four factors are necessary for reaching eligible youth. Methods: We interviewed program personnel (n = 18) at five organizations delivering SBDSPs in Oregon in 2018. Qualitative analysis employed a directed content approach. Results: Specific implementation problems included the following: school recruitment: workforce limitations, school refusals, community objections; client recruitment: ineffective recruitment materials, poor parent/guardian engagement, consent form shortcomings, poor consent forms dissemination and return, low school cooperation; client attendance: poor school cooperation, physical barriers, scheduling conflicts; workforce capacity: insufficient size, high turnover. Participants reported that their respective organizations successfully adapted to resolve these implementation problems with some exceptions (e.g., insufficiencies in workforce capacity). Conclusion: Implementation problems related to school and client recruitment, client attendance, and workforce capacity may impact SBDSP reach. Adaptations to address these problems provide a basis for specific program recommendations. Larger systemic and translational problems were also observed, and recommendations were made regarding organizational communication and the need for additional pre-implementation planning and pilot testing.

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Impact of Human Resources on Implementing an Evidence-Based HIV Prevention Intervention

Cited by 8 publications

References 34 publications

The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach

The dynamic influence of human resources on evidence-based intervention sustainability and population outcomes: an agent-based modeling approach

Implementing a Canadian shared-care ADHD program in Beijing: Barriers and facilitators to consider prior to start-up

Implementation problems and adaptations among organizations delivering school‐based dental sealant programs

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