Implementation of National HIV Screening Recommendations in the Indian Health Service

Reilley, Brigg; Leston, Jessica; Tulloch, Scott; Neel, Lisa; Galope, Megan; Taylor, Melanie

doi:10.1177/2325957415570744

Cited by 8 publications

(9 citation statements)

References 24 publications

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“…HCV testing coverage is measured as the proportion of the total health care users within the population (i.e., AI/AN residents of a defined catchment community with at least one clinical visit in the past 3 Because IHS facilities are decentralized, implementation of HCV testing for persons in the birth cohort is a local decision based on capacity and priorities. With the publication of HCV screening recommendations by CDC in August 2012, support for HCV testing was integrated into existing programs using methods and strategies that have been documented as successful in IHS facilities (e.g., EHR clinical decision support tools, local testing policies, and nursing collaborative agreements to order laboratory tests for indicated testing procedures) (7). Based on best practices identified nationally, regionally, and locally, IHS also implemented clinical trainings and obtained telehealth support.…”

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confidence: 99%

Birth Cohort Testing for Hepatitis C Virus — Indian Health Service 2012–2015

Reilley¹,

Leston²,

Hariri³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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Hepatitis C virus (HCV) infection is a substantial and largely unrecognized public health problem. An estimated 3.5 million persons in the United States are currently living with HCV infection, at least half of whom are unaware of their infection (1-3). Persons born during 1945-1965 (the "baby boomer" birth cohort) have a sixfold higher prevalence (2.6%) than adults of other ages, and represent 81% of all persons chronically infected with HCV (4). Therefore, in addition to recommending testing for all persons at risk for HCV infection, CDC and the U.S. Preventive Services Task Force (USPSTF) recommend one-time HCV testing for the birth cohort (5,6). Compared with the national average, American Indian/Alaska Native (AI/AN) persons have approximately twofold the rate of acute HCV incidence and HCV associated mortality (2). In June 2012, the Indian Health Service (IHS) implemented HCV testing in the 1945-1965 birth cohort and created a nationally standardized performance measure to monitor implementation of the recommendation. As of June 2015, the proportion of the birth cohort screened for HCV increased from a baseline of 7.9% (14,402/182,503) to 32.5% (68,514/211,014) among the AI/AN population served by IHS nationwide; provider training and the use of clinical decision tools were associated with increases in HCV testing. With this fourfold increase in testing in just 3 years, IHS needs to prepare for the challenges associated with increased identification of persons living with HCV infection.

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confidence: 99%

Birth Cohort Testing for Hepatitis C Virus — Indian Health Service 2012–2015

Reilley¹,

Leston²,

Hariri³

et al. 2016

MMWR Morb. Mortal. Wkly. Rep.

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“…11 If our results represent earlier detection of HIV infection in the IHS, this may be partially attributable to wide adoption of routine HIV screening of adults and adolescents per national recommendations. 12 Of note, AI/ANs have significantly higher death rates from HIV than non-Hispanic white people. IHS data do not implicate late diagnosis as a contributing factor and may point to a need for research assessing other possible factors that contribute to this disparity, such as access to care or adherence to treatment.…”

Section: Discussionmentioning

confidence: 99%

Assessing New Diagnoses of HIV Among American Indian/Alaska Natives Served by the Indian Health Service, 2005-2014

et al. 2018

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“…Defaults influence health care provider behaviour by reducing medical uncertainty: because all patients are tested for HIV, health care providers do not have to assess their patients' risk or decide who should be tested and who should not. Default reminders can also keep health care providers from overlooking recommended tests . HIV testing could easily be added onto orders for other laboratory tests that are often done on a default basis (such as cholesterol screening).…”

Section: Behavioural Economicsmentioning

confidence: 99%

A comprehensive theoretical framework for the implementation and evaluation of opt‐out HIV testing

Leidel

Leslie

Boldy

et al. 2016

Evaluation Clinical Practice

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Opt-out HIV testing (in which patients are offered HIV testing as a default) is a potentially powerful strategy for increasing the number of people who know their HIV status and thus limiting viral transmission. Like any change in clinical practice, implementation of opt-out HIV testing in a health service requires a change management strategy, which should have theoretical support. This paper considers the application of three theories to the implementation and evaluation of an opt-out HIV testing programme: Behavioural Economics, the Health Belief Model and Normalisation Process Theory. An awareness, understanding and integration of these theories may motivate health care providers to order HIV tests that they may not routinely order, influence their beliefs about who should be tested for HIV and inform the operational aspects of opt-out HIV testing. Ongoing process evaluation of opt-out HIV testing programmes (based on these theories) will help to achieve individual health care provider self-efficacy and group collective action, thereby improving testing rates and health outcomes.

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Implementation of National HIV Screening Recommendations in the Indian Health Service

Cited by 8 publications

References 24 publications

Birth Cohort Testing for Hepatitis C Virus — Indian Health Service 2012–2015

Birth Cohort Testing for Hepatitis C Virus — Indian Health Service 2012–2015

Assessing New Diagnoses of HIV Among American Indian/Alaska Natives Served by the Indian Health Service, 2005-2014

A comprehensive theoretical framework for the implementation and evaluation of opt‐out HIV testing

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