Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave., 33136 Miami, FL USA.
University of Zambia Teaching Hospital Nationalist Road, P/Bag RW 1X, Ridgeway 15102 Lusaka, Zambia.
Transl Behav Med. 2014 Jun;4(2):141-8. doi: 10.1007/s13142-013-0237-9.
The scale-up of HIV treatment programs in sub-Saharan Africa necessitates creative solutions that do not further burden the health system to meet global initiatives in prevention and care. This study assessed the work environment and impact of providing a behavioral risk reduction intervention in six community health centers (CHCs) in Lusaka, Zambia; opportunities and challenges to long-term program sustainability were identified. CHC staff participants (n = 82) were assessed on perceived clinic burden, job satisfaction, and burnout before and after implementation of the intervention. High levels of clinic burden were identified; however, no increase in perceived clinic burden or staff burnout was associated with providing the intervention. The intervention was sustained at the majority of CHCs and also adopted at additional clinics. Behavioral interventions can be successfully implemented and maintained in resource-poor settings. Creative strategies to overcome structural and economic challenges should be applied to enhance translation research.
在撒哈拉以南非洲扩大艾滋病毒治疗方案需要创造性的解决方案,这些方案不应进一步加重卫生系统的负担,以实现预防和护理方面的全球倡议。本研究评估了在赞比亚卢萨卡的六个社区卫生中心(CHC)提供行为风险降低干预措施的工作环境和影响;确定了长期方案可持续性的机会和挑战。在实施干预措施之前和之后,对 CHC 工作人员(n=82)进行了感知诊所负担、工作满意度和倦怠情况的评估。确定了高诊所负担水平;但是,提供干预措施与感知诊所负担或员工倦怠的增加无关。该干预措施在大多数 CHC 得以维持,并在其他诊所采用。行为干预措施可以在资源匮乏的环境中成功实施和维持。应该应用创造性的策略来克服结构和经济挑战,以加强转化研究。