Implementing a brief evidence-based HIV intervention: a mixed methods examination of compliance fidelity

Dolcini, M. Margaret; Catania, Joseph A.; Gandelman, Alice; Ozer, Elizabeth M.

doi:10.1007/s13142-014-0268-x

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…After weighting participants, many main effects of Condition on sexual behaviors disappeared as expected, and there were many significant effects of risk behavior declining over time, especially for participants who had been recently sexually active at baseline. The results of this study further support research that indicates that brief interventions such CTR can be an effective [21,23] and cost-effective [24] HIV prevention intervention with broad reach, including for the most vulnerable populations [25].…”

Section: Discussionsupporting

confidence: 79%

Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers

Owczarzak

Broaddus

Tarima

2018

Translational Behavioral Medicine

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Carefully conducted randomized trials have established that sexual behavior change interventions can significantly reduce intervention participants' risk of acquiring HIV. Establishing the effectiveness of these evidence-based interventions when implemented by frontline HIV prevention service providers is increasingly important in order to achieve maximum public health impact. This study sought to assess the effectiveness of an evidence-based intervention when implemented by frontline HIV prevention service providers. We evaluated Sisters Informing Sisters on Topics about AIDS (SISTA), an HIV prevention intervention for heterosexual African American women, as implemented by four AIDS service organizations. Women enrolled in HIV counseling, testing, and referral (CTR) at each agency served as contemporaneous controls. Measures included self-reported number of occasions of unprotected vaginal intercourse and number of vaginal sex partners in the previous 90 days. 1,262 participants completed baseline and follow-up assessments across both conditions (SISTA = 537 [57%]; CTR = 725 [62%]). In the full sample of HIV-negative women, CTR participants' odds of having had unprotected sex decreased over time by 38% while SISTA participants' odds of having had unprotected sex did not change. Similar results were found among only those participants who had sex at baseline. Hypothesized interaction effects indicating positive changes in sexual risks over time for SISTA participants were not observed.

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Section: Discussionsupporting

confidence: 79%

Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers

Owczarzak

Broaddus

Tarima

2018

Translational Behavioral Medicine

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“… a Project RESPECT = data from translation of project RESPECT (see references [ 28 – 30 ]). RCT = data from the original RESPET randomized controlled trial (see references [ 24 , 25 ]).…”

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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“…To resolve this issue, staff opted to de-couple RESPECT from testing, offer the intervention to HIV-positive individuals, and leverage relationships with other staff to increase referral of HIV-positive individuals who would potentially benefit from intervention. Although it is likely that many agencies implementing RESPECT did not adapt the program in this way, a national-level study shows that other agencies delivered RESPECT to HIV-positive clients [20], and RESPECT was approved to be delivered without testing [19]. After RE-SPECT was de-adopted, however, staff from other programs at the agency continued to refer clients to RESPECT, leading to frequent negative interactions with misinformed clients and confused staff.…”

Section: Discussionmentioning

confidence: 99%

The dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention

McKay

Dolcini

Hoffer

2017

Behav. Med. Pract. Policy Res.

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Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de-adoption. The current mixed-method study examines EBI de-adoption and the subsequent impact on a community-based organization (CBO) dedicated to HIV prevention. We conducted a case study with a CBO implementing RESPECT, an HIV prevention EBI, over 5 years (2010-2014), but then de-adopted the intervention. We collected archival data documenting RESPECT implementation and conducted two semi-structured interviews with RESPECT staff (N = 5). Using Fixsen and colleagues' implementation framework, we developed a narrative of RESPECT implementation, delivery, and de-adoption and a thematic analysis to understand additional consequences of RESPECT de-adoption. Discontinuation of RESPECT activities unfolded in a process over time, requiring effort by RESPECT staff. RESPECT de-adoption had wide-reaching influences on individual staff, interactions between the staff and the community, the agency overall, and for implementation of future EBIs. We propose a revision of the implementation framework, incorporating EBI de-adoption as a phase of the implementation cycle. Furthermore, EBI de-adoption may have important, unintended consequences and can inform future HIV prevention strategies and guide research focusing on EBI de-adoption.

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Implementing a brief evidence-based HIV intervention: a mixed methods examination of compliance fidelity

Cited by 9 publications

References 29 publications

Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers

Effectiveness of an evidence-based HIV prevention intervention when implemented by frontline providers

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

The dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention

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