Provider Perspectives on Evidence-Based HIV Prevention Interventions: Barriers and Facilitators to Implementation

Abstract

Since the beginning of the HIV/AIDS epidemic, community-based organizations (CBOs) have been key players in combating this disease through grassroots prevention programs and close ties to at-risk populations. Increasingly, both funding agencies and public health institutions require that CBOs implement evidence-based HIV prevention interventions, most of which are researcher developed. However, after completing training for these evidence-based interventions (EBIs), agencies may either abandon plans to implement them or significantly modify the intervention. Based on 22 semistructured interviews with HIV prevention service providers, this article explores the barriers and facilitators to dissemination and implementation of EBIs included in the Centers for Disease Control and Prevention's (CDC) Diffusion of Effective Behavioral Interventions (DEBI) program. Results suggest that there is a tension between the need to implement interventions with fidelity and the lack of guidance on how to adapt the interventions for their constituencies and organizational contexts. Findings suggest the need for HIV prevention intervention development and dissemination that integrate community partners in all phases of research and dissemination.

Fiscal loss and program fidelity: impact of the economic downturn on HIV/STI prevention program fidelity

“…Prior work examining HIV program fidelity has identified a number of fidelity challenges at the program level (e.g., training, client fit, procedural fit) [13,14,17,[24][25][26][27][28][29]. However, past studies have not examined how agencies adapt to economic strains and the influence of those adaptations on program fidelity.…”

Translation of a comprehensive health behavior intervention for women living with HIV: the SMART/EST Women's Program

“…Despite the variety of challenges to implementation that have been documented at the organization, provider, and intervention levels [41][42][43][44][45], this translation was effective in achieving health behavior change at the community health center level. By providing services targeting multiple chronic health conditions in the settings where persons living with HIV receive their primary medical care, they can take full advantage of the increased longevity associated with improved medication and treatment.…”

Adaptations to an Hiv Counseling and Testing Intervention From a Counselor Perspective

“…Factors influencing how agencies and program delivery staff adapt interventions are ubiquitous. Many adaptations are made intentionally to integrate interventions into the local agency and community context (Galbraith et al., ; Kalichman et al., ; Morrison et al., ; Neumann et al., ; Owczarzak & Dickson‐Gomez, ). Conversely, there is some indication that agencies and staff members make adaptations to programs based on unanticipated factors that change the context in which a program is delivered (Chillag et al., ; Hamdallah, Vargo, & Herrera, ).…”

“…r 893 fidelity and potentially reduce the effectiveness of programs (Elliott & Mihalic, 2004;Norton et al, 2009;Owczarzak & Dickson-Gomez, 2011). Thus, core components have frequently served as criteria for measuring fidelity (Mowbray, Holter, Teague, & Bybee, 2003;Neumann et al, 2011).…”