Crisis prevention and response in Ryan white-funded HIV clinics.

IF 1.2 4区 医学 Q4 HEALTH POLICY & SERVICES
Jakarra Jenkins, Olivia C Manders, Caroline W Kokubun, Kate Anderson, Jessica M Sales, Ameeta S Kalokhe
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Abstract

ABSTRACTThe high prevalence of trauma among people with HIV (PWH) and its negative impact on HIV outcomes underscore the need for Ryan White-funded HIV clinics (RWCs) to implement trauma-informed care (TIC) inclusive of crisis prevention and response. As part of a mixed-methods study of TIC practices employed by RWCs, we conducted qualitative interviews with 36 administrators, providers, and staff from Southeastern RWCs exploring crisis prevention and response strategies. Interviews were guided by the Substance Abuse and Mental Health Services Administration TIC framework and analyzed using a framework-driven, qualitative thematic approach. Crisis prevention strategies included: using electronic medical records to identify patients at risk for experiencing crisis, peer navigators to help patients bypass clinic public spaces, protocols to ensure perpetrator-victim pairs were not concurrently scheduled, and social workers to help patients identify crisis triggers and develop safety plans, plus dedicating safe spaces for patients with extensive trauma histories. Crisis response included patient referral to onsite and community crisis intake, trauma support, and mental health services and having onsite security personnel and alarm systems. Several participants requested additional training in response protocols. Study findings highlight the need for RW network-wide TIC training and sharing of best practices in crisis prevention and response.

瑞安-怀特资助的艾滋病诊所的危机预防和应对措施。
摘要艾滋病病毒感染者(PWH)中创伤的高发率及其对艾滋病结果的负面影响突出表明,瑞安-怀特资助的艾滋病诊所(RWCs)需要实施包括危机预防和应对在内的创伤知情护理(TIC)。作为对 RWCs 采用的 TIC 实践进行混合方法研究的一部分,我们对来自东南部 RWCs 的 36 名管理者、提供者和员工进行了定性访谈,探讨危机预防和应对策略。访谈以药物滥用和心理健康服务管理局的 TIC 框架为指导,并采用框架驱动的定性主题方法进行分析。危机预防策略包括:使用电子病历识别有危机风险的患者;同伴导航员帮助患者绕过诊所的公共场所;制定协议确保施暴者与受害者的配对不会同时安排;社工帮助患者识别危机触发因素并制定安全计划;以及为有大量创伤史的患者提供专门的安全空间。危机应对措施包括将患者转介到现场和社区危机接收、创伤支持和心理健康服务机构,以及配备现场安保人员和警报系统。一些参与者要求在应对协议方面接受更多培训。研究结果突出表明,有必要在 RW 网络范围内开展 TIC 培训,并分享危机预防和应对方面的最佳实践。
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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来源期刊
CiteScore
3.50
自引率
0.00%
发文量
172
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