Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
Implement Sci. 2012 Apr 2;7:27. doi: 10.1186/1748-5908-7-27.
Widespread dissemination and implementation of evidence-based human immunodeficiency virus (HIV) linkage-to-care (LTC) interventions is essential for improving HIV-positive patients' health outcomes and reducing transmission to uninfected others. To date, however, little work has focused on identifying factors associated with intentions to adopt LTC interventions among policy makers, including city, state, and territory health department AIDS directors who play a critical role in deciding whether an intervention is endorsed, distributed, and/or funded throughout their region.
Between December 2010 and February 2011, we administered an online questionnaire with state, territory, and city health department AIDS directors throughout the United States to identify factors associated with intentions to adopt an LTC intervention. Guided by pertinent theoretical frameworks, including the Diffusion of Innovations and the "push-pull" capacity model, we assessed participants' attitudes towards the intervention, perceived organizational and contextual demand and support for the intervention, likelihood of adoption given endorsement from stakeholder groups (e.g., academic researchers, federal agencies, activist organizations), and likelihood of enabling future dissemination efforts by recommending the intervention to other health departments and community-based organizations.
Forty-four participants (67% of the eligible sample) completed the online questionnaire. Approximately one-third (34.9%) reported that they intended to adopt the LTC intervention for use in their city, state, or territory in the future. Consistent with prior, related work, these participants were classified as LTC intervention "adopters" and were compared to "nonadopters" for data analysis. Overall, adopters reported more positive attitudes and greater perceived demand and support for the intervention than did nonadopters. Further, participants varied with their intention to adopt the LTC intervention in the future depending on endorsement from different key stakeholder groups. Most participants indicated that they would support the dissemination of the intervention by recommending it to other health departments and community-based organizations.
Findings from this exploratory study provide initial insight into factors associated with public health policy makers' intentions to adopt an LTC intervention. Implications for future research in this area, as well as potential policy-related strategies for enhancing the adoption of LTC interventions, are discussed.
广泛传播和实施基于证据的人类免疫缺陷病毒（HIV）衔接治疗（LTC）干预措施对于改善 HIV 阳性患者的健康结果和减少对未感染者的传播至关重要。然而，迄今为止，很少有工作专注于确定与政策制定者（包括城市、州和地区卫生部门艾滋病主任）采用 LTC 干预措施的意图相关的因素，这些主任在决定是否在其地区认可、分发和/或资助一项干预措施方面发挥着关键作用。
在 2010 年 12 月至 2011 年 2 月期间，我们向美国各地的州、地区和城市卫生部门艾滋病主任发放了一份在线问卷，以确定与采用 LTC 干预措施的意图相关的因素。根据相关理论框架，包括创新传播和“推-拉”能力模型，我们评估了参与者对干预措施的态度、对干预措施的组织和环境需求和支持的看法、在得到利益相关者群体（如学术研究人员、联邦机构、激进组织）认可的情况下采用干预措施的可能性，以及通过向其他卫生部门和社区组织推荐干预措施来为未来的传播工作提供支持的可能性。
44 名参与者（合格样本的 67%）完成了在线问卷。大约三分之一（34.9%）的参与者表示，他们打算在未来将 LTC 干预措施用于其所在的城市、州或地区。与之前的相关工作一致，这些参与者被归类为 LTC 干预措施的“采用者”，并与“非采用者”进行数据分析比较。总体而言，采用者对干预措施的态度更为积极，对干预措施的需求和支持也更大。此外，参与者对未来采用 LTC 干预措施的意图取决于不同关键利益相关者群体的认可。大多数参与者表示，他们将通过向其他卫生部门和社区组织推荐该干预措施来支持其传播。
这项探索性研究的结果提供了与公共卫生政策制定者采用 LTC 干预措施意图相关因素的初步见解。讨论了这一领域未来研究的意义，以及增强 LTC 干预措施采用的潜在政策相关策略。
