Liberalized Policies for Distribution of Oral Contraceptives
In: Studies in family planning: a publication of the Population Council, Band 5, Heft 2, S. 62
ISSN: 1728-4465
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In: Studies in family planning: a publication of the Population Council, Band 5, Heft 2, S. 62
ISSN: 1728-4465
In: American journal of health promotion, Band 32, Heft 1, S. 48-58
ISSN: 2168-6602
Purpose: To collect information that will inform the development of an intervention to support the maintenance of HIV-related health-promoting behaviors. Design: Focused, in-depth individual and group interviews. Setting: The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) and DOHMH-funded community-based organizations that primarily serve low-income people living with HIV within the five boroughs of NYC. Participants: A total of 42 individuals who had participated in The Positive Life Workshop—an HIV self-management intervention adapted and implemented by the NYC DOHMH. Method: Purposive sampling was used to recruit study participants. Five 60- to 90-minute focus groups (n = 38) and 4 individual interviews were conducted to assess motivations for and barriers to maintaining HIV-related health-promoting behaviors and to elicit feedback on the content and format for the proposed maintenance intervention. Thematic analysis was used to summarize the data. Results: Participants reported that relationships with family, a responsibility to protect others from HIV, and faith/spirituality supported the maintenance of health-promoting behaviors. Barriers to behavior maintenance included substance use and mental health issues. Meeting in small groups was also highlighted as a motivator to sustaining health behaviors, particularly in decreasing isolation and receiving affirmation from others. Conclusion: Participants identified several factors that could be incorporated into an intervention to support HIV-related health-promoting behavior maintenance that could supplement existing HIV self-management interventions.
In: Journal of the International AIDS Society, Band 25, Heft 3
ISSN: 1758-2652
AbstractIntroductionThe PROMISE study was launched in 2018 to assess and document the implementation of changes to an existing HIV Care Coordination Programme (CCP) designed to address persistent disparities in care and treatment engagement among persons with HIV in New York City. We evaluated provider endorsement of features of the CCP to understand drivers of engagement with the programme.MethodsWe used a discrete choice experiment to measure provider endorsement of four CCP attributes, including: (1) how CCP helps with medication adherence, (2) how CCP helps with primary care appointments, (3) how CCP helps with issues other than primary care and (4) where CCP visits take place (visit location). Each attribute had three to four levels. Our primary outcomes were relative importance and part‐worth utilities, measures of preference for the levels of the four CCP program attributes, estimated using a hierarchical‐Bayesian multinomial logit model. All non‐medical providers in the core CCP positions of patient navigator, care coordinator and programme director or other administrator from each of the 25 revised CCP‐implementing agencies were eligible to participate.ResultsWe received responses from 152 providers, 68% of whom identified as women, 49% identified as Latino/a, 34% identified as Black and 60% were 30–49 years old. Visit location (28.6%, 95% confidence interval [CI] 27.0–30.3%) had the highest relative importance, followed by how staff help with ART adherence (24.3%, 95% CI 22.4–26.1%), how staff help with issues other than primary care (24.2%, 95% CI 22.7–25.7%) and how staff help with primary care appointments (22.9%, 95% CI 21.7–24.1%). Within each of the above attributes, respectively, the levels with the highest part‐worth utilities were home visits 60 minutes from the program or agency (utility 19.9, 95% CI 10.7–29.0), directly observed therapy (utility 26.1, 95% CI 19.1–33.1), help with non‐HIV specialty medical care (utility 26.5, 95% CI 21.5–31.6) and reminding clients about and accompanying them to primary care appointments (utility 20.8, 95% CI 15.6–26.0).ConclusionsOngoing CCP refinements should account for how best to support and evaluate the intensive CCP components endorsed by providers in this study.
In: Journal of the International AIDS Society, Band 26, Heft 8
ISSN: 1758-2652
AbstractIntroductionThe PROMISE study, launched in 2018, evaluates the implementation of revisions to the HIV Care Coordination Program (CCP) designed to minimize persistent disparities in HIV outcomes among high‐need persons living with HIV in New York City. We conducted a discrete choice experiment (DCE) assessing the preferences of CCP clients to inform improvements to the program's design.MethodsClients chose between two hypothetical CCP options that varied across four program attributes: help with antiretroviral therapy (ART) adherence (directly observed therapy [DOT] vs. remind via phone/text vs. adherence assessment), help with primary care appointments (remind and accompany vs. remind and transport vs. remind only), help with issues other than primary care (coverage and benefits vs. housing and food vs. mental health vs. specialty medical care) and visit location (meet at home vs. via phone/video vs. program visit 30 or 60 minutes away). The latent class analysis identified different preference patterns. A choice simulation was performed to model client preferences for hypothetical CCPs as a whole.ResultsOne hundred and eighty‐one CCP clients from six sites implementing the revised CCP completed the DCE January 2020–March 2021. Most clients had stable housing (68.5%), reported no problem substance use in the last 3 months (72.4%) and achieved viral suppression (78.5) with only 26.5% receiving DOT within a CCP. 77.3% of responses were obtained before the COVID‐19 pandemic. Preferences clustered into three groups. Visit location and ART adherence support were the most important attributes. Group 1 (40%) endorsed telehealth for visit location; telehealth for ART adherence support; and help with securing housing/food; Group 2 (37%) endorsed telehealth for visit location; telehealth for ART adherence support; and staff reminding/arranging appointment transportation; Group 3 (23%) endorsed staff meeting clients at program location and staff working with clients for medication adherence. In the choice simulation, Basic and Medium hypothetical CCPs were endorsed more than Intensive CCPs.ConclusionsThis DCE revealed a strong preference for telehealth and a relatively low preference for intensive services, such as DOT and home visits; preferences were heterogeneous. The findings support differentiated care and remote service delivery options in the NYC CCP, and can inform improvements to CCP design.
In: Journal of HIV/AIDS & social services: research, practice, and policy adopted by the National Social Work AIDS Network (NSWAN), Band 17, Heft 3, S. 195-207
ISSN: 1538-151X