An exploratory study to examine intentions to adopt an evidence-based HIV linkage-to-care intervention among state health department AIDS directors in the United States

Wynne E Norton, Wynne E Norton

Abstract

Background: Widespread dissemination and implementation of evidence-based human immunodeficiency virus (HIV) linkage-to-care (LTC) interventions is essential for improving HIV-positive patients' health outcomes and reducing transmission to uninfected others. To date, however, little work has focused on identifying factors associated with intentions to adopt LTC interventions among policy makers, including city, state, and territory health department AIDS directors who play a critical role in deciding whether an intervention is endorsed, distributed, and/or funded throughout their region.

Methods: Between December 2010 and February 2011, we administered an online questionnaire with state, territory, and city health department AIDS directors throughout the United States to identify factors associated with intentions to adopt an LTC intervention. Guided by pertinent theoretical frameworks, including the Diffusion of Innovations and the "push-pull" capacity model, we assessed participants' attitudes towards the intervention, perceived organizational and contextual demand and support for the intervention, likelihood of adoption given endorsement from stakeholder groups (e.g., academic researchers, federal agencies, activist organizations), and likelihood of enabling future dissemination efforts by recommending the intervention to other health departments and community-based organizations.

Results: Forty-four participants (67% of the eligible sample) completed the online questionnaire. Approximately one-third (34.9%) reported that they intended to adopt the LTC intervention for use in their city, state, or territory in the future. Consistent with prior, related work, these participants were classified as LTC intervention "adopters" and were compared to "nonadopters" for data analysis. Overall, adopters reported more positive attitudes and greater perceived demand and support for the intervention than did nonadopters. Further, participants varied with their intention to adopt the LTC intervention in the future depending on endorsement from different key stakeholder groups. Most participants indicated that they would support the dissemination of the intervention by recommending it to other health departments and community-based organizations.

Conclusions: Findings from this exploratory study provide initial insight into factors associated with public health policy makers' intentions to adopt an LTC intervention. Implications for future research in this area, as well as potential policy-related strategies for enhancing the adoption of LTC interventions, are discussed.

References

    1. Mayer KH. Introduction: Linkage, engagement, and retention in HIV care: essential for optimal individual- and community-level outcomes in the era of highly active antiretroviral therapy. Clin Infect Dis. 2011;52(Suppl 2):S205–207.
    1. Samet JH, Freedberg KA, Stein MD, Lewis R, Savetsky J, Sullivan L, Levenson SM, Hingson R. Trillion virion delay: time from testing positive for HIV to presentation for primary care. Arch Intern Med. 1998;158:734–740. doi: 10.1001/archinte.158.7.734.
    1. Ulett KB, Willig JH, Lin HY, Routman JS, Abroms S, Allison J, Chatham A, Raper JL, Saag MS, Mugavero MJ. The therapeutic implications of timely linkage and early retention in HIV care. AIDS Patient Care STDS. 2009;23:41–49. doi: 10.1089/apc.2008.0132.
    1. Marks G, Gardner LI, Craw J, Crepaz N. Entry and retention in medical care among HIV-diagnosed persons: a meta-analysis. AIDS. 2010;24:2665–2678. doi: 10.1097/QAD.0b013e32833f4b1b.
    1. Horberg MA, Aberg JA, Cheever LW, Renner P. O'Brien Kaleba E, Asch SM: Development of national and multiagency HIV care quality measures. Clin Infect Dis. 2010;51:732–738. doi: 10.1086/655893.
    1. Cunningham WE, Markson LE, Andersen RM, Crystal SH, Fleishman JA, Golin C, Gifford A, Liu HH, Nakazono TT, Morton S. et al.Prevalence and predictors of highly active antiretroviral therapy use in patients with HIV infection in the united states. HCSUS Consortium. HIV Cost and Services Utilization. J Acquir Immune Defic Syndr. 2000;25:115–123. doi: 10.1097/00126334-200010010-00005.
    1. Keller S, Jones J, Erbelding E. Choice of Rapid HIV Testing and Entrance Into Care in Baltimore City Sexually Transmitted Infections Clinics. AIDS Patient Care STDS. 2011;25:237–243. doi: 10.1089/apc.2010.0298.
    1. Bamford LP, Ehrenkranz PD, Eberhart MG, Shpaner M, Brady KA. Factors associated with delayed entry into primary HIV medical care after HIV diagnosis. AIDS. 2010;24:928–930. doi: 10.1097/QAD.0b013e328337b116.
    1. Aziz M, Smith KY. Challenges and successes in linking HIV-infected women to care in the United States. Clin Infect Dis. 2011;52(Suppl 2):S231–237.
    1. Christopoulos KA, Das M, Colfax GN. Linkage and retention in HIV care among men who have sex with men in the United States. Clin Infect Dis. 2011;52(Suppl 2):S214–222.
    1. Krawczyk CS, Funkhouser E, Kilby JM, Kaslow RA, Bey AK, Vermund SH. Factors associated with delayed initiation of HIV medical care among infected persons attending a southern HIV/AIDS clinic. South Med J. 2006;99:472–481. doi: 10.1097/01.smj.0000215639.59563.83.
    1. Krawczyk CS, Funkhouser E, Kilby JM, Vermund SH. Delayed access to HIV diagnosis and care: Special concerns for the Southern United States. AIDS Care. 2006;18(Suppl 1):S35–44.
    1. McCoy SI, Miller WC, MacDonald PD, Hurt CB, Leone PA, Eron JJ, Strauss RP. Barriers and facilitators to HIV testing and linkage to primary care: narratives of people with advanced HIV in the Southeast. AIDS Care. 2009;21:1313–1320. doi: 10.1080/09540120902803174.
    1. Reed JB, Hanson D, McNaghten AD, Bertolli J, Teshale E, Gardner L, Sullivan P. HIV testing factors associated with delayed entry into HIV medical care among HIV-infected persons from eighteen states, United States, 2000-2004. AIDS Patient Care STDS. 2009;23:765–773. doi: 10.1089/apc.2008.0213.
    1. Zaller ND, Fu JJ, Nunn A, Beckwith CG. Linkage to care for HIV-infected heterosexual men in the United States. Clin Infect Dis. 2011;52(Suppl 2):S223–230.
    1. Zaller ND, Holmes L, Dyl AC, Mitty JA, Beckwith CG, Flanigan TP, Rich JD. Linkage to treatment and supportive services among HIV-positive ex-offenders in Project Bridge. J Health Care Poor Underserved. 2008;19:522–531. doi: 10.1353/hpu.0.0030.
    1. Bhatia R, Hartman C, Kallen MA, Graham J, Giordano TP. Persons newly diagnosed with HIV infection are at high risk for depression and poor linkage to care: Results from the steps study. AIDS Behav. 2010.
    1. Fuqua V, Chen YH, Packer T, Dowling T, Ick TO, Nguyen B, Colfax GN, Raymond HF. Using Social Networks to Reach Black MSM for HIV Testing and Linkage to Care. AIDS Behav. 2011.
    1. Gardner LI, Marks G, Craw J, Metsch L, Strathdee S, Anderson-Mahoney P, del Rio C. Demographic, psychological, and behavioral modifiers of the Antiretroviral Treatment Access Study (ARTAS) intervention. AIDS Patient Care STDS. 2009;23:735–742. doi: 10.1089/apc.2008.0262.
    1. Torian LV, Wiewel EW, Liu KL, Sackoff JE, Frieden TR. Risk factors for delayed initiation of medical care after diagnosis of human immunodeficiency virus. Arch Intern Med. 2008;168:1181–1187. doi: 10.1001/archinte.168.11.1181.
    1. Leider J, Fettig J, Calderon Y. Engaging HIV-positive individuals in specialized care from an urban emergency department. AIDS Patient Care STDS. 2011;25:89–93. doi: 10.1089/apc.2010.0205.
    1. Gardner LI, Metsch LR, Anderson-Mahoney P, Loughlin AM, del Rio C, Strathdee S, Sansom SL, Siegal HA, Greenberg AE, Holmberg SD. Efficacy of a brief case management intervention to link recently diagnosed HIV-infected persons to care. AIDS. 2005;19:423–431. doi: 10.1097/01.aids.0000161772.51900.eb.
    1. Craw JA, Gardner LI, Marks G, Rapp RC, Bosshart J, Duffus WA, Rossman A, Coughlin SL, Gruber D, Safford LA. et al.Brief strengths-based case management promotes entry into HIV medical care: results of the antiretroviral treatment access study-II. J Acquir Immune Defic Syndr. 2008;47:597–606. doi: 10.1097/QAI.0b013e3181684c51.
    1. Mugavero MJ. Improving engagement in HIV care: what can we do? Top HIV Med. 2008;16:156–161.
    1. Wanyenze RK, Hahn JA, Liechty CA, Ragland K, Ronald A, Mayanja-Kizza H, Coates T, Kamya MR, Bangsberg DR. Linkage to HIV Care and Survival Following Inpatient HIV Counseling and Testing. AIDS Behav. 2010.
    1. Molitor F, Kuenneth C, Waltermeyer J, Mendoza M, Aguirre A, Brockmann K, Crump C. Linking HIV-infected persons of color and injection drug users to HIV medical and other services: the California Bridge Project. AIDS Patient Care STDS. 2005;19:406–412. doi: 10.1089/apc.2005.19.406.
    1. Molitor F, Waltermeyer J, Mendoza M, Kuenneth C, Aguirre A, Brockmann K, Crump C. Locating and linking to medical care HIV-positive persons without a history of care: findings from the California Bridge Project. AIDS Care. 2006;18:456–459. doi: 10.1080/09540120500217397.
    1. Moore RD. Epidemiology of HIV infection in the united states: implications for linkage to care. Clin Infect Dis. 2011;52(Suppl 2):S208–213.
    1. Tripathi A, Youmans E, Gibson JJ, Duffus WA. The impact of retention in early HIV Medical Care on viro-immunological parameters and survival: A statewide study. AIDS Res Hum Retroviruses. 2011.
    1. Craw J, Gardner L, Rossman A, Gruber D, Noreen O, Jordan D, Rapp R, Simpson C, Phillips K. Structural factors and best practices in implementing a linkage to HIV care program using the ARTAS model. BMC Health Serv Res. 2010;10:246. doi: 10.1186/1472-6963-10-246.
    1. DiFranceisco W, Kelly JA, Otto-Salaj L, McAuliffe TL, Somlai AM, Hackl K, Heckman TG, Holtgrave DR, Rompa DJ. Factors influencing attitudes within AIDS service organizations toward the use of research-based HIV prevention interventions. AIDS Educ Prev. 1999;11:72–86.
    1. Dworkin SL, Pinto RM, Hunter J, Rapkin B, Remien RH. Keeping the spirit of community partnerships alive in the scale up of HIV/AIDS prevention: critical reflections on the roll out of DEBI (Diffusion of Effective Behavioral Interventions) Am J Community Psychol. 2008;42:51–59. doi: 10.1007/s10464-008-9183-y.
    1. Collins C, Harshbarger C, Sawyer R, Hamdallah M. The diffusion of effective behavioral interventions project: development, implementation, and lessons learned. AIDS Educ Prev. 2006;18:5–20. doi: 10.1521/aeap.2006.18.supp.5.
    1. Harshbarger C, Simmons G, Coelho H, Sloop K, Collins C. An empirical assessment of implementation, adaptation, and tailoring: the evaluation of CDC's National Diffusion of VOICES/VOCES. AIDS Educ Prev. 2006;18:184–197. doi: 10.1521/aeap.2006.18.supp.184.
    1. McKleroy VS, Galbraith JS, Cummings B, Jones P, Harshbarger C, Collins C, Gelaude D, Carey JW. Adapting evidence-based behavioral interventions for new settings and target populations. AIDS Educ Prev. 2006;18:59–73. doi: 10.1521/aeap.2006.18.supp.59.
    1. King W, Nu'Man J, Fuller TR, Brown M, Smith S, Howell AV, Little S, Patrick P, Glover L. The diffusion of a community-level HIV intervention for women: lessons learned and best practices. J Womens Health (Larchmt) 2008;17:1055–1066. doi: 10.1089/jwh.2008.1035.
    1. O'Donnell L, Scattergood P, Adler M, Doval AS, Barker M, Kelly JA, Kegeles SM, Rebchook GM, Adams J, Terry MA, Neumann MS. The role of technical assistance in the replication of effective HIV interventions. AIDS Educ Prev. 2000;12:99–111.
    1. Wingood GM, DiClemente RJ. The ADAPT-ITT model: a novel method of adapting evidence-based HIV Interventions. J Acquir Immune Defic Syndr. 2008;47(Suppl 1):S40–46.
    1. Stallworth JM, Andia JF, Burgess R, Alvarez ME, Collins C. Diffusion of Effective Behavioral Interventions and Hispanic/Latino populations. AIDS Educ Prev. 2009;21:152–163. doi: 10.1521/aeap.2009.21.5_supp.152.
    1. Collins CB, Hearn KD, Whittier DN, Freeman A, Stallworth JD, Phields M. Implementing Packaged HIV-Prevention Interventions for HIV-Positive Individuals: Considerations for Clinic-Based and Community-Based Interventions. Public Health Reports. 2010;125:55–63.
    1. Kelly JA, Sogolow ED, Neumann MS. Future directions and emerging issues in technology transfer between HIV prevention researchers and community-based service providers. AIDS Educ Prev. 2000;12:126–141.
    1. Kelly JA, Spielberg F, McAuliffe TL. Defining, designing, implementing, and evaluating phase 4 HIV prevention effectiveness trials for vulnerable populations. J Acquir Immune Defic Syndr. 2008;47(Suppl 1):S28–33.
    1. Kelly JA, Somlai AM, Benotsch EG, McAuliffe TL, Amirkhanian YA, Brown KD, Stevenson LY, Fernandez MI, Sitzler C, Gore-Felton C. et al.Distance communication transfer of HIV prevention interventions to service providers. Science. 2004;305:1953–1955. doi: 10.1126/science.1100733.
    1. Kelly JA, Heckman TG, Stevenson LY, Williams PN, Ertl T, Hays RB, Leonard NR, O'Donnell L, Terry MA, Sogolow ED, Neumann MS. Transfer of research-based HIV prevention interventions to community service providers: fidelity and adaptation. AIDS Educ Prev. 2000;12:87–98.
    1. Miller RL. Adapting an evidence-based intervention: tales of the Hustler Project. AIDS Educ Prev. 2003;15:127–138. doi: 10.1521/aeap.15.1.5.127.23612.
    1. Miller RL, Bedney BJ, Guenther-Grey C. Assessing organizational capacity to deliver HIV prevention services collaboratively: tales from the field. Health Educ Behav. 2003;30:582–600. doi: 10.1177/1090198103255327.
    1. Brownson RC, Chriqui JF, Stamatakis KA. Understanding evidence-based public health policy. Am J Public Health. 2009;99:1576–1583. doi: 10.2105/AJPH.2008.156224.
    1. Brownson RC, Seiler R, Eyler AA. Measuring the impact of public health policy. Prev Chronic Dis. 2010;7:A77.
    1. Saleebey D. The strengths perspective in social work practice. 2. New York: Longman Publishers; 1997.
    1. Rapp C, Wintersteen R. The strengths model of case management: results from twelve demonstrations. Psychosoc Rehabil J. 1989;13:23–32.
    1. Orleans CT. Increasing the demand for and use of effective smoking-cessation treatments - Reaping the full health benefits of tobacco-control science and policy gains - In our lifetime. Am J Prev Med. 2007;33:S340–S348. doi: 10.1016/j.amepre.2007.09.003.
    1. Rogers EM. Diffusion of Innovations. 5. New York: Free Press; 2003.
    1. Dearing JW. Applying Diffusion of Innovation Theory to Intervention Development. Res Soc Work Pract. 2009;19:503–518. doi: 10.1177/1049731509335569.
    1. Green LW, Orleans CT, Ottoson JM, Cameron R, Pierce JP, Bettinghaus EP. Inferring strategies for disseminating physical activity policies, programs, and practices from the successes of tobacco control. Am J Prev Med. 2006;31:S66–81. doi: 10.1016/j.amepre.2006.06.023.
    1. Brownson RC, Ballew P, Dieffenderfer B, Haire-Joshu D, Heath GW, Kreuter MW, Myers BA. Evidence-based interventions to promote physical activity: what contributes to dissemination by state health departments. Am J Prev Med. 2007;33:S66–73. doi: 10.1016/j.amepre.2007.03.011. quiz S74-68.
    1. Dearing JW, Kreuter MW. Designing for diffusion: how can we increase uptake of cancer communication innovations? Patient Educ Couns. 2010;81(Suppl):S100–110.
    1. Jacobs JA, Dodson EA, Baker EA, Deshpande AD, Brownson RC. Barriers to evidence-based decision making in public health: a national survey of chronic disease practitioners. Public Health Rep. 2010;125:736–742.
    1. Moore GC, Benbasat I. Development of an instrument to measure the perceptions of adopting an information technology innovation. Inf Syst Res. 1991;2:192–222. doi: 10.1287/isre.2.3.192.
    1. Dearing JA. Measurement of innovation attributes.
    1. Brownson RC, Dodson EA, Stamatakis KA, Casey CM, Elliott MB, Luke DA, Wintrode CG, Kreuter MW. Communicating evidence-based information on cancer prevention to state-level policy makers. J Natl Cancer Inst. 2011;103:306–316. doi: 10.1093/jnci/djq529.
    1. Brownson RC, Jones E. Bridging the gap: translating research into policy and practice. Prev Med. 2009;49:313–315. doi: 10.1016/j.ypmed.2009.06.008.
    1. Brownson RC, Royer C, Ewing R, McBride TD. Researchers and policymakers: travelers in parallel universes. Am J Prev Med. 2006;30:164–172. doi: 10.1016/j.amepre.2005.10.004.
    1. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, Griffey R, Hensley M. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38:65–76. doi: 10.1007/s10488-010-0319-7.
    1. Stamatakis KA, McBride TD, Brownson RC. Communicating prevention messages to policy makers: the role of stories in promoting physical activity. J Phys Act Health. 2010;7(Suppl 1):S99–107.

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