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1 – 10 of 47Ryan J. Chan, Shiran Isaacksz, Brian Low, Cecile Raymond, Lori Seeton and Christopher T. Chan
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples…
Abstract
Purpose
Health care systems aspire to adopt integration strategies shifting the focus from acute care to a broader focus on community-based health and social services. Real-world examples demonstrating effective delivery of integrated care are essential.
Design/methodology/approach
In this article, we introduce UHN Connected Care Hub, an innovative model of care comprising an interdisciplinary team designing sustainable, shareable practices across the continuum of care alongside community and health organization partnerships.
Findings
We describe UHN Connected Care Hub’s ability to identify patients from high-risk population and collaborate to delivery timely care, in detailing the real world experience of this model of care in the organization of a centralized system of micro-clinics to administer a therapeutic for pre-exposure prophylaxis against COVID-19 (Tixagevimab/cilgavimab [Evusheld]) in a population of immunocompromised patients.
Practical implications
Having a centralized system of micro-clinics for care delivery presents opportunities for increased adaptability, patient accessibility, enhanced community partnerships and integratedness. Expansion in the scope of services could also create new opportunities in preventative therapies for optimizing the cost effectiveness and quality of health care provided at the population level.
Originality/value
There is limited evidence on how to efficiently deliver integrated care, particularly to vulnerable and co-morbid patients. We discuss how dynamic organizations with proper infrastructure and a network of healthcare partnerships may allow a more fluid response to rapidly changing policies and procedures and facilitate preparedness for future health care crises or pandemics.
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Naruemon Auemaneekul, Sirirat Lertpruek, Pratana Satitvipawee and Nik AA Tuah
The purpose of this study aimed to assess factors associated with the intention to take pre-exposure prophylaxis (PrEP) among Thai young men who have sex with men (YMSM) and…
Abstract
Purpose
The purpose of this study aimed to assess factors associated with the intention to take pre-exposure prophylaxis (PrEP) among Thai young men who have sex with men (YMSM) and transgender women (TGW) in Bangkok.
Design/methodology/approach
The study surveyed 350 sexually active Thai YMSM and TGW aged between 18 and 24 years registered with a nongovernmental organization (NGO) working with the MSM community. Data were collected using snowball sampling from four venues. Participants completed a self-administered questionnaire. Logistic regression was used to evaluate factors associated with the intention to take PrEP daily.
Findings
The results showed that of all those surveyed, n = 310 (88%) participated. The median age was 21 years. In all, 18% of participants had heard about PrEP, and 36% correctly identified that PrEP is used for prevention. After receiving information, 31% intended to take daily PrEP and the Voluntary Counseling and Testing (VCT) rate was 35.5%. Factors significantly associated with intention to take daily PrEP were history of HIV testing (adjusted odds ratio (AOR), 2.3, 95% CI, 1.3–4.1), and high perceived behavioral control of PrEP adherence scores (AOR 3.0, 95% CI, 1.8–5.2).
Originality/value
This study showed that intention to take and knowledge of daily PrEP among YMSM and TGW was low. Promoting health education to YMSM and TGW about PrEP and MSM-friendly VCT services are needed to effectively implement PrEP in HIV prevention programs.
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Rapeepun Jommaroeng, Kerry Anne Richter, Aphichat Chamratrithirong and Amara Soonthorndhada
The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW).
Abstract
Purpose
The purpose of this paper is to investigate the effectiveness of the national HIV prevention outreach program for men who have sex with men (MSM) and transgender women (TGW).
Design/methodology/approach
It examined changes in condom use, lubricant use, HIV testing and counseling (HTC) uptake and sexually transmitted infection (STI) screening uptake, as well as how and why changes did or did not occur. The study applied mixed methods of both quantitative and qualitative approaches.
Findings
There were 16,539 MSM, and TGW reached at least three times in the program during October 2011‒September 2012. The program was found to affect changes in condom use with steady partners (p<0.000), condom use with casual partners (p<0.000), water-based lubricant use (p<0.000), HTC uptake (p<0.000) and STIs screening uptake (p<0.000). Age and province of outreach are associated with HTC uptake and STI screening (p<0.000), slightly as well as gender identity (p<0.1). Gender identity and province of outreach are associated with condom use with steady partners (p<0.000). Gender identity (p<0.000) and sex work (p<0.05) are associated with the use of lubricant. The qualitative results showed that the program had an immediate effect on HTC and STIs screening due to successful bond between the outreach workers and their clients, leading to trust and influencing behavior change.
Originality/value
HIV prevention by peer educators continues to be proved the most effective method, assuming its program consistency. TGW are more vulnerable to MSM to protect themselves, and they have steady partners. Future program for MSM can be replicated and scaled up, but more empowerment component and self-esteem building should be integrated to target TGW.
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Emily Dauria, Christopher Rodriguez, Sarah Bauerle Bass, Marina Tolou-Shams and Katerina Christopoulos
Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of…
Abstract
Purpose
Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services.
Design/methodology/approach
This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator.
Findings
Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. “peers”) and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma.
Originality/value
Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.
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Sarah Bauerle Bass, Patrick J.A. Kelly, Jesse Brajuha, Luis Gutierrez-Mock, Paul D'Avanzo, Samantha Herrera and Jae Sevelius
The purpose of this study was to develop pre-exposure prophylaxis (PrEP) education materials that directly address the needs of trans women. PrEP medication is an effective HIV…
Abstract
Purpose
The purpose of this study was to develop pre-exposure prophylaxis (PrEP) education materials that directly address the needs of trans women. PrEP medication is an effective HIV prevention strategy, but some groups at high risk of HIV, such as transgender (trans) women, have suboptimal uptake and adherence. Most PrEP marketing has been aimed fat men who have sex with men (MSM) and include trans women as part of that audience, but this strategy ignores important differences in perceptions of and barriers to PrEP.
Design/methodology/approach
This study used a social marketing approach grounded in exchange theory to systematically develop and pretest PrEP messaging and communication materials for trans women through qualitative (focus groups: n = 5, 34 participants) and quantitative (surveys: n = 128) methods in Philadelphia and the San Francisco Bay area. Segmentation analysis, perceptual mapping and vector message modeling techniques were used to create three-dimensional visualizations of PrEP perceptions to identify highly targeted messaging. Working with trans artists, the authors developed prototype materials using the targeted messaging and pretested these (n = 11) in both locations for feedback on content, look and insight on appropriate intervention strategies.
Findings
Using segmentation and perceptual mapping, this study identified key PrEP messaging across different subgroups, including by demographic and psychographic variables. Differences by group were determined to not be significant and overall messages that would resonate with all groups were built into the materials. Pretesting sessions indicated high acceptability of the messaging and trans women-centered approach to increase PrEP uptake.
Originality/value
To the best of the authors’ knowledge, this is the first study to use a social marketing framework to create targeted PrEP communication materials for trans women in partnership with trans women.
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Jordan Parsons and Chelsea Cox
The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in…
Abstract
Purpose
The purpose of this paper is to discuss the possibility of using pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention in prisons. PrEP is primarily discussed in relation to men who have sex with men (MSM), meaning other high-risk populations, such as prisoners, are often side-lined. The authors wanted to consider how it could prove beneficial beyond the MSM community.
Design/methodology/approach
First, the authors discuss whether the common objections to existing HIV harm reduction interventions in prisons, such as needle exchanges, are applicable to PrEP. The authors then apply common objections to the provision of PrEP in the general population to the provision of PrEP in a prison context in order to assess their strength. Finally, the authors discuss what the authors anticipate to be a key objection to PrEP in prisons: post-incarceration access.
Findings
The authors argue that both sets of common objections considered are easily refuted in the case of PrEP in prisons. The unique setting and nature of the intervention are such that it is without immediately apparent flaws. In addressing post-incarceration access, the authors suggest that a longitudinal consideration of a prisoner’s HIV risk undermines the objection.
Originality/value
This discussion is of importance due to the significantly heightened risk of HIV infection prisoners are subject to. Not only do effective HIV prevention interventions in prisons contribute to fair access to health for incarcerated individuals, but also to the wider fight against HIV. The authors demonstrate that PrEP has potential as a new approach and call for further research in this area.
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Gregg A. Stevens, Martin Morris, Tony Nguyen and Emily Vardell
Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health…
Abstract
Health science librarians occupy a unique place in librarianship, guiding healthcare professionals and the public to quality sources of medical research and consumer health information in order to improve patient outcomes and quality of life. A broader impact of health sciences librarianship is its advocacy for improvements in public health. In recent years, health science librarians have been actively involved in advocating for adequate, responsive, and culturally competent health care for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals. Health sciences librarians have advocated for LGBTQ+ individuals through a variety of specialized outreach projects to address health disparities found in the LGBTQ+ community such as HIV/AIDS, women’s health, or substance abuse, have collaborated with public health agencies and community-based organizations to identify health disparities and needs, and have implemented outreach to address these needs.
This chapter maps the landscape of health sciences librarian outreach to LGBTQ+ people. The authors develop this theme through case studies of health science librarians providing health information to the LGBTQ+ community and healthcare professionals. Following an overview of advocacy for LGBTQ+ health by the US National Network of Libraries of Medicine and professional information organizations, they conclude the chapter by discussing the “pioneering” nature of these projects and the common threads uniting them, and by identifying the next steps for continued successful outreach through the development of an evidence base and tailoring of outreach and resources to address other demographic aspects of the members of the LGBTQ+ community.
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Alexandria Macmadu, Lauren Brinkley-Rubinstein, Ian Gonsher, Jennifer G. Clarke and Bradley W. Brockmann
The purpose of this paper is to describe the course, “Designing Education for Better Prisoner and Community Health,” which provided students with the knowledge, skills and…
Abstract
Purpose
The purpose of this paper is to describe the course, “Designing Education for Better Prisoner and Community Health,” which provided students with the knowledge, skills and resources needed to build real-world health education materials for persons who are criminal justice involved.
Design/methodology/approach
A multiphase engaged scholarship course was designed and implemented through the Brown University School of Public Health in Rhode Island, USA.
Findings
Students collaborated closely with instructors, subject matter experts and affected community members to develop highly tailored health education projects across six topic areas. The structure and outcomes of the paper are described with the hope that other instructors and institutions might replicate components of the model.
Originality/value
Engaged scholarship in public health can provide students with rich, collaborative learning experiences, and when executed effectively, these endeavors can provide underserved communities with robust and informed health education interventions and programs.
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Sofie Stulens, Kim De Boeck and Nico Vandaele
Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and…
Abstract
Purpose
Despite HIV being reported as one of the major global health issues, availability and accessibility of HIV services and supplies remain limited, especially in low- and middle-income countries. The effective and efficient operation of HIV supply chains is critical to tackle this problem. The purpose of this paper is to give an introduction to HIV supply chains in low- and middle-income countries and identify research opportunities for the operations research/operations management (OR/OM) community.
Design/methodology/approach
First, the authors review a combination of the scientific and grey literature, including both qualitative and quantitative papers, to give an overview of HIV supply chain operations in low- and middle-income countries and the challenges that are faced by organizing such supply chains. The authors then classify and discuss the relevant OR/OM literature based on seven classification criteria: decision level, methodology, type of HIV service modeled, challenges, performance measures, real-life applicability and countries covered. Because research on HIV supply chains in low- and middle-income countries is limited in the OR/OM field, this part also includes papers focusing on HIV supply chain modeling in high-income countries.
Findings
The authors conclude this study by identifying several tendencies and gaps and by proposing future research directions for OR/OM research.
Originality/value
To the best of the authors’ knowledge, this paper is the first literature review addressing this specific topic from an OR/OM perspective.
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