Training Multidisciplinary Teams to Deliver High-Quality HIV Care to Families in Resource-Limited Settings: The MTCT-Plus Initiative Experience

Toro, Patricia Lasso; Rabkin, Miriam; Flam, Robin; El‐Sadr, Wafaa; Donahue, Marie Collins; Chadwick, Ellen G.; Abrams, Elaine J.

doi:10.1016/j.jana.2011.12.007

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Our evaluation design and analysis were not guided by an overarching framework, in part because we wanted to embrace a grounded theory methodology [ 22 ] that allows for the data to inform resulting conceptual frameworks for this program. While there is a wealth of research on team formation and cross-disciplinary communication, including the seminal model of “forming-storming-norming-performing” developed by Bruce Tuckman [ 23 , 24 ], very little focuses on teams in a global, low-resource setting [ 25 ], and existing global health educational frameworks focus on the individual experience, particularly among medical and nursing trainees [ 26 – 28 ].…”

Section: Discussionmentioning

confidence: 99%

"The era of single disease cowboys is out": evaluating the experiences of students, faculty, and collaborators in an interdisciplinary global health training program

et al. 2018

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BackgroundGlobal Health is an inherently interdisciplinary field but overseas training in global health, particularly among health science institutions, has been an ‘individual’ or ‘individual discipline’ experience. Team-based training is an approach to global health education which is increasing in popularity; research on team-training demonstrates that teams are more productive than individuals. In 2015, the Johns Hopkins Center for Global Health (CGH) developed the Global Established Multidisciplinary Sites (GEMS) program, an interdisciplinary training program which was designed to establish a new norm in global health training by bringing interdisciplinary teams of faculty and students together to identify and solve complex global health challenges. This research aims to evaluate the program’s first year and contribute to the literature on interdisciplinary team training. We conducted 22 in-depth interviews with students, faculty, and local collaborators from 3 GEMS project sites. Findings were analyzed for themes through a framework approach.ResultsThe program exposed students, faculty, and collaborators to a wide range of disciplines in global health. Students’ desire to learn how other disciplines contribute to global health solutions was an important motivator for joining GEMS; many participants including faculty and collaborators valued exposure to multiple disciplines. Mentorship and communication were a challenge across all teams in part due to members having distinct “disciplinary languages”. Balancing disciplinary representation on teams and establishing work plans were also key challenges.ConclusionsBased on the data the CGH provides four recommendations for institutions developing global health interdisciplinary teams to optimize team functioning and address challenges in mentorship, language, and roles: 1) address interdisciplinary communication early, 2) develop work plans during group formation, 3) meet as a team prior to travel, and 4) establish regular check ins. This article provides first-hand reflections on interdisciplinary team experiences in a global context and provides a pathway for the development of innovative strategies in global health training.

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Section: Discussionmentioning

confidence: 99%

"The era of single disease cowboys is out": evaluating the experiences of students, faculty, and collaborators in an interdisciplinary global health training program

et al. 2018

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“…The programme was run by Makerere University–Johns Hopkins University (MU‐JHU) Research Collaboration with technical support from Columbia University, USA (Toro et al . ). From March 2003 to October 2007, HIV‐infected women and their families were enrolled into the MTCT‐Plus programme to receive long‐term HIV/AIDS care.…”

Section: Methodsmentioning

confidence: 97%

“…At Mulago Hospital, HIV-infected women identified through the PMTCT programme or perinatal studies were referred to the MTCT-Plus programme for HIV/ AIDS care. The programme was run by Makerere University-Johns Hopkins University (MU-JHU) Research Collaboration with technical support from Columbia University, USA (Toro et al 2012). From March 2003 to October 2007, HIV-infected women and their families were enrolled into the MTCT-Plus programme to receive long-term HIV/AIDS care.…”

Section: Study Setting and Populationmentioning

confidence: 99%

Long‐term clinical and immunologic outcomes of HIV‐infected women with and without previous exposure to nevirapine

Mudiope

Kim

Wabwire

et al. 2013

Tropical Med Int Health

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Abstractobjectives To determine and compare the clinical and immunologic outcomes for HIV-infected women initiated on antiretroviral therapy (ART), with and without previous exposure to single-dose nevirapine in the MTCT-Plus programme -Kampala, Uganda, from 2003 to 2011.methods Retrospective comparison of prospectively collected programmatic data of clinical and immunologic treatment outcomes among HIV-infected Ugandan women, with and without prior exposure to sdNVP, who received NNRTI-based ART for a median follow-up of 6 years.results Of the 408 women in the programme, 289 (70.8%) were started on ART, of whom 205 (70.9%) had prior exposure to sdNVP. Clinical, immunologic and combined (clinical and or immunologic) treatment failure occurred in 29 (10.0%), 132 (45.7%) and 142 (49.1%) women, respectively. There was no significant difference in the distribution of time to immunologic failure for women by exposure to sdNVP (log-rank P = 0.98). In Cox proportional hazard modelling, exposure to sdNVP was not associated with immunologic failure [adjusted hazard ratio (HR) = 0.89, 95% confidence interval (CI): 0.61-1.30]. CD4 count >100 cells/mm 3 at initiation was associated with reduced incidence of immunologic failure in adjusted analyses (HR = 0.32, 95% CI: 0.22-0.48).conclusions HIV-infected Ugandan women initiated on an NVP-based ART regimen had similar immunologic treatment outcomes irrespective of previous NVP exposure. CD4 cell count prior to initiating HAART was a key prognostic factor for successful long-term immunologic treatment outcomes. In poor settings, regular follow-up of patients on HAART with adequate counselling to promote adherence and safe disclosure may promote low clinical failure rates.

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Nursing Allies in ANAC: One Psychologist's Perspective

Vance¹

2020

J Assoc Nurses AIDS Care

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Training Multidisciplinary Teams to Deliver High-Quality HIV Care to Families in Resource-Limited Settings: The MTCT-Plus Initiative Experience

Cited by 5 publications

References 13 publications

"The era of single disease cowboys is out": evaluating the experiences of students, faculty, and collaborators in an interdisciplinary global health training program

"The era of single disease cowboys is out": evaluating the experiences of students, faculty, and collaborators in an interdisciplinary global health training program

Long‐term clinical and immunologic outcomes of HIV‐infected women with and without previous exposure to nevirapine

Nursing Allies in ANAC: One Psychologist's Perspective

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