Practice transformations to optimize the delivery of HIV primary care in community healthcare settings in the United States: A program implementation study

Steward, Wayne T.; Koester, Kimberly A.; Guzé, Mary A.; Kirby, Valerie B.; Fuller, Shannon; Moran, Lissa; Botta, Emma Wilde; Gaffney, Stuart; Heath, Corliss D.; Bromer, Steven P.; Shade, Starley B.

doi:10.1371/journal.pmed.1003079

Cited by 10 publications

(7 citation statements)

References 14 publications

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“…According to the Cochrane tool ( 19 ), in the definition branch, six studies had a low risk of bias ( 27 – 29 , 31 , 32 , 39 ), 18 studies had a moderate risk of bias ( 24 , 26 , 30 , 33 – 36 , 38 , 43 – 46 , 48 , 50 , 52 , 58 , 69 , 79 ), 38 had an important risk of bias ( 21 , 22 , 37 , 40 – 42 , 49 , 51 , 54 , 56 , 57 , 59 – 68 , 70 – 72 , 74 – 78 , 80 – 88 ), and two studies had a very important risk of bias ( 23 , 73 ). Nine studies were not assessable with the tool (protocols or qualitative/mixed methods studies) ( 13 , 25 , 47 , 53 , 89 – 93 ).…”

Section: Resultsmentioning

confidence: 99%

Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis

et al. 2022

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In 2015, we conducted a randomized controlled trial (RCT) in primary care to evaluate if posters and pamphlets dispensed in general practice waiting rooms enhanced vaccination uptake for seasonal influenza. Unexpectedly, vaccination uptake rose in both arms of the RCT whereas public health data indicated a decrease. We wondered if the design of the trial had led to a Hawthorne effect (HE). Searching the literature, we noticed that the definition of the HE was unclear if stated. Our objectives were to refine a definition of the HE for primary care, to evaluate its size, and to draw consequences for primary care research. We designed a Preferred Reporting Items for Systematic reviews and Meta-Analyses review and meta-analysis between January 2012 and March 2022. We included original reports defining the HE and reports measuring it without setting limitations. Definitions of the HE were collected and summarized. Main published outcomes were extracted and measures were analyzed to evaluate odds ratios (ORs) in primary care. The search led to 180 records, reduced on review to 74 for definition and 15 for quantification. Our definition of HE is “an aware or unconscious complex behavior change in a study environment, related to the complex interaction of four biases affecting the study subjects and investigators: selection bias, commitment and congruence bias, conformity and social desirability bias and observation and measurement bias.” Its size varies in time and depends on the education and professional position of the investigators and subjects, the study environment, and the outcome. There are overlap areas between the HE, placebo effect, and regression to the mean. In binary outcomes, the overall OR of the HE computed in primary care was 1.41 (95% CI: [1.13; 1.75]; I2 = 97%), but the significance of the HE disappears in well-designed studies. We conclude that the HE results from a complex system of interacting phenomena and appears to some degree in all experimental research, but its size can considerably be reduced by refining study designs.

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Section: Resultsmentioning

confidence: 99%

Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis

et al. 2022

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“…This program provides access to vulnerable populations for HIV care, treatment, and support services. 26 Funded by the federal government, the program supports community health clinics to cover costs for primary medical care, essential support services, and medications for low-income people with HIV. The program offers a free tool on their website (https://hab.hrsa.gov/get-care) to identify locations for treatment.…”

Section: Strategies To Optimize Hiv Before Surgerymentioning

confidence: 99%

Movement is Life—Optimizing Patient Access to Total Joint Arthroplasty: HIV and Hepatitis C Disparities

Wiznia

Morgan

Gibson

2021

J Am Acad Orthop Surg

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This article is one of a series focusing on how the preoperative optimization process, if designed for underserved communities, can improve access to care and reduce disparities. In this article, we specifically focus on methods to improve optimization for patients with HIV and hepatitis C to facilitate their access to total joint arthroplasty. 1.2 million Americans are currently living with HIV (people living with HIV). African Americans and Hispanics account for the largest proportion of new HIV diagnoses and make up the highest proportion of people living with HIV. HIV-positive patients, many of them with complex comorbidities, are at a high risk for postoperative complications. Optimization of this vulnerable cohort involves a multidisciplinary strategy focusing on optimizing treatment modalities to reduce viral loads, leading to lower complication rates and a safer environment for the surgical team. The rates of hepatitis C have been increasing in the United States, and more than half of individuals living with hepatitis C are unaware that they are infected. Hepatitis C infections are highest in African Americans, and the rates of chronic hepatitis C are highest in those born outside the United States. Patients with hepatitis C have an increased risk for surgical complications after total joint arthroplasty, and studies have demonstrated that these risks normalize when patients are preoperatively screened and treated. Optimization in these vulnerable groups includes working closely with psychosocial resources, the primary care team, and infectious disease specialists to ensure treatment access and compliance. Providing patients support to optimize their HIV and hepatitis C comorbidities is an important step in safe and successful arthroplasty surgery. In this article, we review the healthcare disparities associated with HIV and hepatitis C, discuss the clinical implications of HIV and hepatitis C on total joint arthroplasty of the hip and knee (TJA) outcomes, and provide strategies to optimize the clinical condition to reduce disparities. Patients with

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“…Mail-in tests and telePrEP not only improve access to services or reduce providers' becoming 'burned out' but also can reduce stigma for receiving PrEP services [18,19]. Workforce shortage is also a problem among providers of HIV services; the HIV service workforce is shrinking even though the number of people with HIV in the United States has been increasing and aging [20][21][22]. To address this problem, the National HIV/AIDS Strategy for the United States 2022-2025 (NHAS) Implementation Plan now includes a proposal for the US Department of Justice to work with Boards of Pharmacy to expand pharmacy clinical consultants' roles [23].…”

Section: Introductionmentioning

confidence: 99%

Systematic review of alternative HIV pre-exposure prophylaxis (PrEP) care delivery models to improve PrEP services

Kamitani

Mizuno

DeLuca

et al. 2023

Aids

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Objectives: To identify types, evidence, and study gaps of alternative HIV preexposure prophylaxis (PrEP) care delivery models in the published literature. Design: Systematic review and narrative synthesis. Methods: We searched in the US Centers for Disease Control and Prevention (CDC) Prevention Research Synthesis (PRS) database through December 2022 (PROSPERO CRD42022311747). We included studies published in English that reported implementation of alternative PrEP care delivery models. Two reviewers independently reviewed the full text and extracted data by using standard forms. Risk of bias was assessed using the adapted Newcastle-Ottawa Quality Assessment Scale. Those that met our study criteria were evaluated for efficacy against CDC Evidence-Based Intervention (EBI) or Evidence-Informed Intervention (EI) criteria or Health Resources and Services Administration Emergency Strategy (ES) criteria, or for applicability by using an assessment based on the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. Results: This review identified 16 studies published between 2018 and 2022 that implemented alternative prescriber (n = 8), alternative setting for care (n = 4), alternative setting for laboratory screening (n = 1), or a combination of the above (n = 3) . The majority of studies were US-based (n = 12) with low risk of bias (n = 11). None of the identified studies met EBI, EI, or ES criteria. Promising applicability was found for pharmacists prescribers, telePrEP, and mail-in testing. Conclusions: Delivery of PrEP services outside of the traditional care system by expanding providers of PrEP care (e.g. pharmacist prescribers), as well as the settings of PrEP care (i.e. telePrEP) and laboratory screening (i.e. mail-in testing) may increase PrEP access and care delivery.

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Practice transformations to optimize the delivery of HIV primary care in community healthcare settings in the United States: A program implementation study

Cited by 10 publications

References 14 publications

Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis

Defining and evaluating the Hawthorne effect in primary care, a systematic review and meta-analysis

Movement is Life—Optimizing Patient Access to Total Joint Arthroplasty: HIV and Hepatitis C Disparities

Systematic review of alternative HIV pre-exposure prophylaxis (PrEP) care delivery models to improve PrEP services

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