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Comparative Study
. 2009 Dec;24(12):1275-80.
doi: 10.1007/s11606-009-1120-8. Epub 2009 Oct 2.

Evaluation of the sustainability of an intervention to increase HIV testing

Matthew Bidwell Goetz  1 , Tuyen Hoang, S Randal Henry, Herschel Knapp, Henry D Anaya, Allen L Gifford, Steven M Asch; QUERI-HIV/Hepatitis Program
Affiliations
Comparative Study

Evaluation of the sustainability of an intervention to increase HIV testing

Matthew Bidwell Goetz et al. J Gen Intern Med. 2009 Dec.

Abstract

Background: Sustainability-the routinization and institutionalization of processes that improve the quality of healthcare-is difficult to achieve and not often studied.

Objective: To evaluate the sustainability of increased rates of HIV testing after implementation of a multi-component intervention in two Veterans Health Administration healthcare systems.

Design: Quasi-experimental implementation study in which the effect of transferring responsibility to conduct the provider education component of the intervention from research to operational staff was assessed.

Patients: Persons receiving healthcare between 2005 and 2006 (intervention year) and 2006 and 2007 (sustainability year).

Measurements: Monthly HIV testing rate, stratified by frequency of clinic visits.

Results: The monthly adjusted testing rate increased from 2% at baseline to 6% at the end intervention year and then declined reaching 4% at the end of the sustainability year. However, the stratified, visit-specific testing rate for persons newly exposed to the intervention (i.e., having their first through third visits during the study period) increased throughout the intervention and sustainability years. Increases in the proportion of visits by patients who remained untested despite multiple, prior exposures to the intervention accounted for the aggregate attenuation of testing during the sustainability year. Overall, the percentage of patients who received an HIV test in the sustainability year was 11.6%, in the intervention year 11.1%, and in the pre-intervention year 5.0%

Conclusions: Provider education combined with informatics and organizational support had a sustainable effect on HIV testing rates. The effect was most pronounced during patients' early contacts with the healthcare system.

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Figures

Figure 1
Figure 1
Adjusted HIV testing rates among all patients with identified risk factors for HIV infection. The active intervention period started in study month one and lasted through study month 12. The sustainability period started in study month 13.
Figure 2
Figure 2
(a). Adjusted HIV testing rates among patients as stratified by outpatient study visit number. The starting period for the strata are offset at monthly intervals as very few patients had more than one visit per month. (b). Proportion of outpatient visits grouped by visit number.
Figure 3
Figure 3
The vertical bars depict the adjusted rates at which patients with HIV risk factors underwent tests or were stated to refuse testing. The lines indicate the proportion of patients who were offered HIV testing and then underwent testing.
See this image and copyright information in PMC

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References

    1. Committee on Quality of Health Care in America IoM. Crossing the Quality Chasm. A New Health System for the 21st Century. National Academy Press. Washington, DC; 2001:1–337.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '8491630', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/8491630/'}]}
    2. Goodman RM, McLeroy KR, Steckler AB, Hoyle RH. Development of level of institutionalization scales for health promotion programs. Health Educ Q. 1993;20:161–78. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/j.evalprogplan.2004.01.002', 'is_inner': False, 'url': 'https://doi.org/10.1016/j.evalprogplan.2004.01.002'}]}
    2. Johnson K, Hays C, Center H, Daley C. Building capacity and sustainable prevention innovations: a sustainability planning model. Eval Program Plann. 2004;27:135–49.
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1136/bmj.327.7428.1376', 'is_inner': False, 'url': 'https://doi.org/10.1136/bmj.327.7428.1376'}, {'type': 'PMC', 'value': 'PMC292986', 'is_inner': False, 'url': 'https://pmc.ncbi.nlm.nih.gov/articles/PMC292986/'}, {'type': 'PubMed', 'value': '14670880', 'is_inner': True, 'url': 'https://pubmed.ncbi.nlm.nih.gov/14670880/'}]}
    2. Knox KL, Litts DA, Talcott GW, Feig JC, Caine ED. Risk of suicide and related adverse outcomes after exposure to a suicide prevention programme in the US Air Force: cohort study. BMJ. 2003;327:1376. - PMC - PubMed
    1. DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in HIV-infected adults and adolescents. Available at http://aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf. Accessed September 2009.

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