Implementing enhanced patient care to promote patient engagement in HIV care in a rural setting in Kenya
| Autor: | Becky L. Genberg, Ann Mwangi, Omar Galárraga, Ira B. Wilson, Siika Abraham, Juddy Wachira, Diana Chemutai |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Rural Population
Patient engagement Qualitative property Context (language use) HIV Infections Health informatics Health administration 03 medical and health sciences 0302 clinical medicine Health facility Nursing Intervention (counseling) Health care Medicine Humans 030212 general & internal medicine Adaptation Qualitative Research business.industry 030503 health policy & services Health Policy Nursing research Kenya Implementation Patient Care Public aspects of medicine RA1-1270 HIV care Patient Participation 0305 other medical science business Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, Vol 21, Iss 1, Pp 1-9 (2021) |
| ISSN: | 1472-6963 |
| Popis: | Background Patient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of system-level barriers including provider training, continuity of clinician-patient relationship, enhanced treatment dialogue and better clinic scheduling. We describe the initial implementation of the EPC intervention in a rural HIV clinic in Kenya, and the factors that facilitated its implementation. Methods The intervention occurred in one of the rural Academic Model Providing Healthcare (AMPATHplus) health facilities in Busia County in the western region of Kenya. Both qualitative and quantitative data were collected through training and meeting proceedings/minutes, a patient tracking tool, treatment dialogue and a peer confirmation tool. Qualitative data were coded and emerging themes on the implementation and adaptation of the intervention were developed. Descriptive analysis including percentages and means were performed on the quantitative data. Results Our analysis identified four key factors that facilitated the implementation of this intervention. (1) The smooth integration of the intervention as part of care that was facilitated by provider training, biweekly meetings between the research and clinical team and having an intervention that promotes the health facility agenda. (2) Commitment of stakeholders including providers and patients to the intervention. (3) The adaptability of the intervention to the existing context while still maintaining fidelity to the intervention. (4) Embedding the intervention in a facility with adequate infrastructure to support its implementation. Conclusions This analysis demonstrates the value of using mixed methods approaches to study the implementation of an intervention. Our findings emphasize how critical local support, local infrastructure, and effective communication are to adapting a new intervention in a clinical care program. |
| Databáze: | OpenAIRE |
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