Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti

Ramaiya, Megan; Haight, Elizabeth; Simoni, Jane M.; Chéry, Jean Marcxime; Dervis, Witson; Genna, Wilner; Dubé, Jean Geto; Calixte, Guirlène; Balan, Jean Gabriel; Honoré, Jean Guy; Puttkammer, Nancy

doi:10.1177/2325958220952631

Cited by 8 publications

(6 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The intervention effect in the ART-initiated participants may be attributed to the established stable relationships between patients on ART and their service providers through regular check-ins and medication refills. 45 These patients are more likely to be acceptive of CHW-initiated outreach, counseling, and referral efforts. The study finding suggested that ART can serve as a gateway to overall healthcare services, and the health promotion campaigns should fully utilize the ART “treatment for all” policy 46 to engage patients in primary healthcare, especially the community care system.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam

Li¹,

Lin²,

Liang³

et al. 2021

Int J STD AIDS

View full text Add to dashboard Cite

Background People living with HIV who use drugs (PLHWUD) face enormous challenges to access antiretroviral therapy (ART), addiction treatment, and other healthcare services. This study evaluated the effect of a community capacity-building approach on PLHWUD’s access to healthcare services. Methods A cluster randomized controlled trial was conducted in four provinces of Vietnam. Trained commune health workers in the intervention condition were encouraged to provide services to PLHWUD in the community and engage them in HIV/addiction treatment and care using learned knowledge and skills. A total of 241 PLHWUD participated in surveys at the baseline and every three months for one year. The primary outcome was PLHWUD’s reported barriers to seeking healthcare. A linear mixed-effects regression model with a difference in difference approach was used to estimate the intervention effect on the primary outcome. Results Adjusted analyses indicated that significant intervention effects were observed at the Sixth and ninth month follow-ups for those on ART at the baseline and increased motivation to engage in treatment at the 3-month follow-up (60.2% vs 34.4% for the intervention and control groups, respectively). Conclusions The community capacity-building intervention had shown promising yet limited outcomes among a subset of PLHWUD in the community, that is, PLHWUD who had already initiated ART.

show abstract

Section: Discussionmentioning

confidence: 99%

“…providers through regular check-ins and medication refills. 45 These patients are more likely to be acceptive of CHW-initiated outreach, counseling, and referral efforts.…”

Section: Discussionmentioning

confidence: 99%

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam

Li¹,

Lin²,

Liang³

et al. 2021

Int J STD AIDS

View full text Add to dashboard Cite

show abstract

“…The present study was part of the formative phase of a research project to develop and test the InfoPlus Adherence intervention. This intervention worked at the level of the healthcare organization, combining two components: 1) an electronic medical record (EMR)–based alert to signal patients at high, medium or low risk of future ART treatment failure (based on a prediction model using existing socio-demographic, clinical, laboratory and ART adherence data); and 2) brief person-centered ART adherence counseling from the multidisciplinary healthcare team, informed by the EMR-based alert [ 36 , 37 ].…”

Section: Methodsmentioning

confidence: 99%

Patient and health worker perspectives on quality of HIV care and treatment services in Haiti

Puttkammer

Demes

Dervis³

et al. 2023

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background Poor quality of care is a barrier to engagement in HIV care and treatment in low- and middle-income country settings. This study involved focus group discussions (FGD) with patients and health workers in two large urban hospitals to describe quality of patient education and psychosocial support services within Haiti’s national HIV antiretroviral therapy (ART) program. The purpose of this qualitative study was to illuminate key gaps and salient “ingredients” for improving quality of care. Methods The study included 8 FGDs with a total of 26 male patients and 32 female patients and 15 smaller FGDs with 57 health workers. The analysis used a directed content analysis method, with the goal of extending existing conceptual frameworks on quality of care through rich description. Results Dimension of safety, patient-centeredness, accessibility, and equity were most salient. Patients noted risks to privacy with both clinic and community-based services as well as concerns with ART side effects, while health workers described risks to their own safety in providing community-based services. While patients cited examples of positive interactions with health workers that centered their needs and perspectives, they also noted concerns that inhibited trust and satisfaction with services. Health workers described difficult working conditions that challenged their ability to provide patient-centered services. Patients sought favored relationships with health workers to help them navigate the health care system, but this undermined the sense of fairness. Both patients and health workers described frustration with lack of resources to assist patients in dire poverty, and health workers described great pressure to help patients from their “own pockets.” Conclusions These concerns reflected the embeddedness of patient – provider interactions within a health system marked by scarcity, power dynamics between patients and health workers, and social stigma related to HIV. Reinforcing a respectful and welcoming atmosphere, timely service, privacy protection, and building patient perception of fairness in access to support could help to build patient satisfaction and care engagement in Haiti. Improving working conditions for health workers is also critical to achieving quality.

show abstract

“…The present study was part of the formative phase of a research project to develop and test the InfoPlus Adherence intervention. This intervention worked at the level of the healthcare organization, combining two components: 1) an electronic medical record (EMR)-based alert to signal patients at high, medium or low risk of future ART treatment failure (based on a prediction model using existing socio-demographic, clinical, laboratory and ART adherence data); and 2) brief person-centered ART adherence counseling from the multidisciplinary healthcare team, informed by the EMR-based alert Ramaiya et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

Patient and Health Worker Perspectives on Quality of HIV Care and Treatment Services in Haiti

Puttkammer

Demes

Dervis³

et al. 2022

Preprint

Self Cite

View full text Add to dashboard Cite

Background: Poor quality of care is a barrier to engagement in HIV care and treatment in low- and middle-income country settings. This study involved focus group discussions (FGD) with patients and health workers in two large urban hospitals to describe quality of patient education and psychosocial support services within Haiti’s national HIV antiretroviral therapy (ART) program. The purpose of this qualitative study was to illuminate key gaps and salient “ingredients” for improving quality of care. Methods: The study included 8 FGDs with a total of 26 male patients and 32 female patients and 15 smaller FGDs with 57 health workers. The analysis used a directed content analysis method, with the goal of extending existing conceptual frameworks on quality of care through rich description.Results: Dimension of safety, patient-centeredness, accessibility, and equity were most salient. Patients noted risks to privacy with both clinic and community-based services as well as concerns with ART side effects, while health workers described risks to their own safety in providing community-based services. While patients cited examples of positive interactions with health workers that centered their needs and perspectives, they also noted concerns that inhibited trust and satisfaction with services. Health workers described difficult working conditions that challenged their ability to provide patient-centered services. Patients sought favored relationships with health workers to help them navigate the health care system, but this undermined the sense of fairness. Both patients and health workers described frustration with lack of resources to assist patients in dire poverty, and health workers described great pressure to help patients from their “own pockets.”Conclusions: These concerns reflected the embeddedness of patient – provider interactions within a health system marked by scarcity, power dynamics between patients and HWs, and social stigma related to HIV. Reinforcing respectful and welcoming atmosphere, timely service, privacy protection, and building patient perception of fairness in access to support could help to build patient satisfaction and care engagement in Haiti. Improving working conditions for health workers is also critical to achieving quality.

show abstract

Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti

Cited by 8 publications

References 32 publications

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam

A community approach to promote healthcare services for people living with HIV who use drugs in Vietnam

Patient and health worker perspectives on quality of HIV care and treatment services in Haiti

Patient and Health Worker Perspectives on Quality of HIV Care and Treatment Services in Haiti

Contact Info

Product

Resources

About