莫桑比克医疗服务提供者的重复技术援助支持访问与积极健康、尊严和预防（PHDP）信息传递之间的关系：一项纵向多层次分析
The Relationship of Repeated Technical Assistance Support Visits to the Delivery of Positive Health, Dignity, and Prevention (PHDP) Messages by Healthcare Providers in Mozambique: A Longitudinal Multilevel Analysis.
作者信息
Gutin Sarah A, Amico K Rivet, Hunguana Elsa, Munguambe António Orlando, Rose Carol Dawson
机构信息
1 Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
2 Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA, USA.
出版信息
J Int Assoc Provid AIDS Care. 2017 Sep/Oct;16(5):487-493. doi: 10.1177/2325957417724206. Epub 2017 Aug 10.
BACKGROUND
Positive health, dignity, and prevention (PHDP) is Mozambique's strategy to engage clinicians in the delivery of prevention messages to their HIV-positive clients. This national implementation strategy uses provider trainings on offering key messages and focuses on intervening on 9 evidence-based risk reduction areas. We investigated the impact of longitudinal technical assistance (TA) as an addition to this basic training.
METHODS
We followed 153 healthcare providers in 5 Mozambican provinces over 6 months to evaluate the impact of on-site, observation-based TA on PHDP implementation. Longitudinal multilevel models were estimated to model change in PHDP message delivery over time among individual providers.
RESULTS
With each additional TA visit, providers delivered about 1 additional PHDP message ( P < .001); clinicians and nonclinicians started at about the same baseline level, but clinicians improved more quickly ( P = .004). Message delivery varied by practice sector; maternal and child health sectors outperformed other sectors.
CONCLUSION
Longitudinal TA helped reach the programmatic goals of the PHDP program in Mozambique.
背景
积极健康、尊严与预防（PHDP）是莫桑比克的一项战略，旨在促使临床医生向其艾滋病毒呈阳性的患者传达预防信息。这项国家实施战略通过对提供者进行关键信息提供方面的培训，并侧重于在9个基于证据的风险降低领域进行干预。我们调查了纵向技术援助（TA）作为这种基础培训补充的影响。
方法
我们在6个月内跟踪了莫桑比克5个省份的153名医疗保健提供者，以评估基于现场观察的TA对PHDP实施的影响。估计纵向多层次模型以模拟个体提供者随时间推移在PHDP信息传递方面的变化。
结果
每次额外的TA访问，提供者大约多传达1条PHDP信息（P <.001）；临床医生和非临床医生的基线水平大致相同，但临床医生改善得更快（P =.004）。信息传递因执业部门而异；母婴健康部门表现优于其他部门。
结论
纵向TA有助于实现莫桑比克PHDP项目的规划目标。
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