University of Kansas Medical Center, Department of Family Medicine, Kansas City, KS, USA.
Global Health Innovations, Nairobi, Kenya.
Healthc (Amst). 2015 Dec;3(4):190-5. doi: 10.1016/j.hjdsi.2015.07.004. Epub 2015 Aug 14.
Guided by the RE-AIM model, we describe preliminary data and lessons learned from multiple serial implementations of an eHealth intervention to improve early infant diagnosis (EID) of HIV in Kenya.
We describe the reach, effectiveness, adoption, implementation and maintenance of the HITSystem, an eHealth intervention that links key stakeholders to improve retention and outcomes in EID. Our target community includes mother-infant pairs utilizing EID services and government health care providers and lab personnel. We also explore our own role as program and research personnel supporting the dissemination and scale up of the HITSystem in Kenya.
Key findings illustrate the importance of continual adaptation of the HITSystem interface to accommodate varied stakeholders' workflows in different settings. Surprisingly, technology capacity and internet connectivity posed minimal short-term challenges. Early and sustained ownership of the HITSystem among stakeholders proved critical to reach, effectiveness and successful adoption, implementation and maintenance.
Preliminary data support the ability of the HITSystem to improve EID outcomes in Kenya. Strong and sustained collaborations with stakeholders improve the quality and reach of eHealth public health interventions.
以 RE-AIM 模型为指导,我们描述了一项电子健康干预措施多次连续实施的初步数据和经验教训,以改善肯尼亚的早期婴儿艾滋病毒诊断(EID)。
我们描述了 HITSystem 的可及性、效果、采用、实施和维持情况,HITSystem 是一种电子健康干预措施,它将关键利益攸关方联系起来,以改善 EID 中的保留率和结果。我们的目标社区包括利用 EID 服务的母婴对以及政府保健提供者和实验室人员。我们还探讨了我们作为方案和研究人员在支持 HITSystem 在肯尼亚的传播和扩大规模方面的作用。
主要发现说明了不断调整 HITSystem 界面以适应不同环境中不同利益攸关方工作流程的重要性。令人惊讶的是,技术能力和互联网连接在短期内构成的挑战很小。利益攸关方对 HITSystem 的早期和持续拥有对于达到、效果和成功采用、实施和维持至关重要。
初步数据支持 HITSystem 有能力改善肯尼亚的 EID 结果。与利益攸关方建立强有力和持续的合作关系可以提高电子卫生公共卫生干预措施的质量和覆盖面。