Understanding the potential implementation determinants of Our Plan: a couples-based digital human immunodeficiency virus prevention intervention for same-gender male couples.

IF 2.2 Q2 HEALTH CARE SCIENCES & SERVICES
mHealth Pub Date : 2024-04-09 eCollection Date: 2024-01-01 DOI:10.21037/mhealth-23-57
Kristi E Gamarel, Adrian Rodriguez-Bañuelos, Ini-Abasi Ubong, Janae N Best, Laura Jadwin-Cakmak, Jason W Mitchell
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引用次数: 0

Abstract

Background: There has been a proliferation of digital health interventions (DHIs) focused on addressing human immunodeficiency virus (HIV) prevention and treatment outcomes, including couples-based interventions with same-gender male couples. However, the barriers and facilitators of implementing couples-based HIV and sexually transmitted infection (STI) prevention interventions using digital platforms in community-based organizations remains largely unknown. The goal of this study was to explore the implementation determinants of Our Plan, a couples-based DHI designed for new relationships of same-gender male couples and dyadic, sexual partnerships.

Methods: Qualitative interviews were conducted with 40 organization leaders, healthcare providers, and staff at acquired immunodeficiency syndrome (AIDS)-service and community-based organizations in 13 states serving populations in Ending the HIV Epidemic jurisdictions. Interview items and follow-up questions were guided by the Consolidated Framework for Implementation Research (CFIR) to inquire about implementation determinants of Our Plan.

Results: Most participants highlighted several relative advantages of Our Plan: increasing capacity to support couples, potential synergy with existing programs, and opportunities to increase patient engagement. Participants also discussed relative disadvantages: misalignment with organizational values in the provision of patient-centered models of care and low interest from some priority populations. Participants emphasized the need for adaptability of Our Plan to fit within their local contexts, which encompassed support for both implementers and end-users, cultural tailoring, and privacy and security features. The desired evidence needed to implement Our Plan focused on data on impact, acceptability, and usability and functionality from communities most heavily impacted by the HIV epidemic. The majority of participants described how Our Plan could be integrated within service delivery and aligned with their organization's aspirational values; however, some noted that their organizational culture valued in-person interactions, particularly among patients experiencing structural vulnerabilities. Finally, participants discussed how the implementation of Our Plan would require additional training and funding for staff to support end-users and a relationship with the developers so that they could demonstrate their investment in the communities that their organizations served.

Conclusions: Our Plan was deemed a promising tool among potential implementers. To ensure optimal implementation and organizational fit, Our Plan refinement and evaluation must include implementers and end-users most impacted by the HIV epidemic throughout the entire process.

了解 "我们的计划 "的潜在实施决定因素:针对同性男性伴侣的基于夫妻的数字化人体免疫缺陷病毒预防干预措施。
背景:数字健康干预措施(DHIs)已经大量涌现,其重点是解决人类免疫缺陷病毒(HIV)的预防和治疗效果问题,包括对同性男性夫妇采取基于夫妇的干预措施。然而,在社区组织中使用数字平台实施以夫妇为基础的 HIV 和性传播感染(STI)预防干预措施的障碍和促进因素在很大程度上仍不为人所知。本研究的目的是探索 "我们的计划 "的实施决定因素。"我们的计划 "是一项以夫妻为基础的 DHI,专为新的同性男性夫妻关系和双性性伴侣关系而设计:我们对 13 个州的 40 名组织领导者、医疗保健提供者以及获得性免疫缺陷综合症(AIDS)服务机构和社区机构的工作人员进行了定性访谈,这些机构为 "终结 HIV 流行 "辖区内的人群提供服务。访谈项目和后续问题以实施研究综合框架(CFIR)为指导,旨在了解 "我们的计划 "的实施决定因素:大多数参与者强调了 "我们的计划 "的几个相对优势:提高支持夫妇的能力、与现有计划的潜在协同作用以及提高患者参与度的机会。与会者还讨论了相对劣势:在提供以患者为中心的护理模式方面与组织的价值观不一致,以及一些重点人群的兴趣不高。与会者强调,"我们的计划 "需要适应当地环境,这包括对实施者和最终用户的支持、文化定制以及隐私和安全功能。实施 "我们的计划 "所需的理想证据侧重于受艾滋病疫情影响最严重的社区提供的有关影响、可接受性、可用性和功能性的数据。大多数与会者介绍了如何将 "我们的计划 "整合到服务交付中,并与其组织的理想价值观保持一致;但是,一些与会者指出,他们的组织文化重视面对面的互动,尤其是在经历结构性脆弱性的患者中。最后,与会者讨论了实施 "我们的计划 "如何需要为员工提供额外的培训和资金,以支持最终用户,以及如何与开发者建立关系,从而证明他们对其组织所服务社区的投资:结论:"我们的计划 "在潜在实施者中被认为是一个很有前途的工具。为确保最佳的实施效果和组织适应性,"我们的计划 "的完善和评估必须将实施者和受艾滋病毒流行影响最大的最终用户纳入整个过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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