Jain Kriti M, Maulsby Cathy, Kinsky Suzanne, Khosla Nidhi, Charles Vignetta, Riordan Maura, Holtgrave David R
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Health Educ Behav. 2016 Dec;43(6):674-682. doi: 10.1177/1090198116629422. Epub 2016 May 9.
Many out-of-care people living with HIV have unmet basic needs and are served by loosely connected agencies. Prior research suggests that increasing agencies' coordination may lead to higher quality and better coordinated care. This study examines four U.S. interagency networks in AIDS United's HIV linkage and retention in care program. This study explores changes in the networks of implementing agencies.
Each network included a lead agency and collaborators. One administrator and service provider per agency completed an online survey about collaboration prior to and during Positive Charge. We measured how many organizations were connected to one another through density, or the proportion of reported connections out of all possible connections between organizations. Network centralization was measured to investigate whether this network connectivity was due to one or more highly connected organizations or not. To compare collaboration by type, density and centralization were calculated for any collaboration and specific collaboration types: technical assistance, shared resources, information exchange, and boosting access. To characterize the frequency of collaboration, we examined how often organizations interacted by "monthly or greater" versus "less than monthly."
Density increased in all networks. Density was highest for information exchange and referring clients. When results were restricted to "monthly or greater," the densities of all networks were lower.
This study suggests that a targeted linkage to care initiative may increase some collaboration types among organizations serving people living with HIV. It also provides insights to policy makers about how such networks may evolve.
许多未接受治疗的艾滋病毒感染者有未得到满足的基本需求，由联系松散的机构提供服务。先前的研究表明，加强机构间协调可能会带来更高质量、更协调的护理。本研究考察了美国艾滋病联合会的艾滋病毒关联与护理保留项目中的四个跨机构网络。本研究探讨了实施机构网络的变化情况。
每个网络包括一个牵头机构和若干合作机构。每个机构的一名管理人员和服务提供者完成了一项关于在“积极充电”之前和期间合作情况的在线调查。我们通过密度，即组织之间所有可能联系中报告的联系比例，来衡量有多少组织相互连接。测量网络集中化程度，以调查这种网络连通性是否归因于一个或多个高度连接的组织。为了按类型比较合作情况，计算了任何合作以及特定合作类型（技术援助、共享资源、信息交流和增加服务可及性）的密度和集中化程度。为了描述合作频率，我们考察了组织“每月或更频繁地”互动与“每月少于一次”互动的频率。
所有网络的密度均有所增加。信息交流和转介客户方面的密度最高。当结果仅限于“每月或更频繁地”时，所有网络的密度都较低。
本研究表明，一项有针对性的护理关联倡议可能会增加为艾滋病毒感染者提供服务的组织之间的某些合作类型。它还为政策制定者提供了有关此类网络可能如何演变的见解。
