Identifying factors associated with successful implementation and uptake of an evidence-based voluntary medical male circumcision program in Zambia: the Spear and Shield 2 Program
Autor: | Aileen de la Rosa, Violeta J. Rodriguez, Nicholas V. Cristofari, Deborah L. Jones, Tae Kyoung Lee, Stephen M. Weiss, Ndashi Chitalu, Robert Zulu, Antonio Chahine |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Male
Evidence-based practice Health Personnel Sexual Behavior Psychological intervention Zambia Human sexuality Qualitative property HIV Infections Burnout 03 medical and health sciences Behavioral Neuroscience 0302 clinical medicine Interim Health care Humans 030212 general & internal medicine Applied Psychology Original Research Medical education 030505 public health business.industry Circumcision Male Implementation research 0305 other medical science Psychology business |
Zdroj: | Transl Behav Med |
Popis: | Voluntary medical male circumcision has been shown to provide a 50%–70% reduction in the risk of HIV infection without contributing to behavioral disinhibition of safer sexual practices. This study examined the interim implementation and dissemination data of Spear and Shield 2, an HIV risk-reduction program in Zambia. The purpose of this interim review was to identify contextual challenges to implementation and implement midcourse corrections associated with sustainability of program delivery. Using a mixed-methods design, quantitative evaluations of organizational functioning, barriers to implementation, burnout, and organizational readiness, as well as qualitative data utilizing the Consolidated Framework for Implementation Research (CFIR), were examined to evaluate program implementation. Participants were 184 health care providers from 46 clinics in Zambia. Successful implementation was associated with better community and leader support, and employee readiness and motivation. Quantitative assessments were not related to implementation and provided a limited picture of implementation outcomes. Results suggest that the qualitative data underlying the CFIR constructs provided a nuanced, contextual assessment of implementation, and dissemination outcomes. The CFIR may be valuable in informing the implementation of evidence-based interventions in other parts of Zambia. |
Databáze: | OpenAIRE |
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