Telehealth-Enabled Rapid Antiretroviral Restart for People With HIV Out of Care (ACCELERATE): A Mixed-Methods Study of Staff Perspectives.

Abstract

IntroductionACCELERATE is a multisite Type II hybrid effectiveness-implementation mixed-methods study evaluating a rapid antiretroviral therapy (ART) restart model for people with HIV (PWH) out of care (OOC). We assessed staff and provider perspectives on implementation.MethodsHealthcare providers and staff at three Missouri sites completed surveys at baseline and Week 48 (W48) assessing implementation outcomes, job satisfaction, burnout, and telehealth perceptions. Semi-structured interviews were analyzed using a convergent mixed-methods design.ResultsThirty-one participants completed baseline surveys and 15 completed W48 surveys. Acceptability, feasibility, and appropriateness remained high (baseline/W48: AIM 4.63/4.47, FIM 4.43/4.50, IAM 4.60/4.42). Job satisfaction remained high, though burnout-related items increased modestly. Providers reported increased agreement that telehealth benefits outweighed negatives (p<0.05). Fourteen interviews identified barriers including staffing, care coordination, and communication, while facilitators included telehealth visits, mailed medications, streamlined workflows, and multidisciplinary support.ConclusionsStaff perceived the ACCELERATE model favorably; additional staffing and infrastructure may improve sustainability.