Safi Amelia Greiner, Perin Jamie, Mantsios Andrea, Schumacher Christina, Chaulk C Patrick, Jennings Jacky M
1 Department of Pediatrics, Center for Child and Community Health Research, Johns Hopkins School of Medicine, Baltimore, MD, USA.
2 Department of Communication, Cornell University, Ithaca, NY, USA.
Public Health Rep. 2017 Nov/Dec;132(6):609-616. doi: 10.1177/0033354917732333. Epub 2017 Oct 18.
The objective of this study was to evaluate the satisfaction with, and the feasibility and effectiveness of, a public health detailing project focused on increasing routine human immunodeficiency virus (HIV) screening of people aged 13-64 by primary care providers working in areas of Baltimore City, Maryland, with high rates of HIV transmission (defined as a mean geometric viral load of ≥1500 copies/mL per census tract). In public health detailing, trained public health professionals (ie, detailers) visit medical practice sites to meet with providers and site staff members, with the intention of influencing changes in clinical practice policy and/or behavior. During 2014, detailers made personal visits and gave HIV Testing Action Kits containing maps, educational and guideline documents, and resource lists to 166 providers and office managers at 85 primary care sites. At follow-up, 88 of 91 (96.7%) providers and 37 of 38 (97.4%) clinic managers were very satisfied or satisfied with the project. Of the 79 sites eligible at follow-up (ie, those that had not closed or merged with another practice), 76 (96.2%) had accepted at least 1 HIV Testing Action Kit, and 67 of 90 (74.4%) providers had increased their HIV screening. Public health detailing projects can be used to educate and support providers, establish relationships between providers and local health departments, and disseminate public health messages.
本研究的目的是评估一项公共卫生详细指导项目的满意度、可行性和有效性，该项目旨在提高马里兰州巴尔的摩市艾滋病毒传播率高（定义为每人口普查区平均几何病毒载量≥1500拷贝/毫升）地区的初级保健提供者对13至64岁人群进行常规人类免疫缺陷病毒（HIV）筛查的比例。在公共卫生详细指导中，经过培训的公共卫生专业人员（即指导人员）访问医疗实践场所，与提供者和场所工作人员会面，目的是影响临床实践政策和/或行为的改变。2014年期间，指导人员进行了个人访问，并向85个初级保健场所的166名提供者和办公室经理提供了包含地图、教育和指导文件以及资源清单的HIV检测行动包。随访时，91名提供者中的88名（96.7%）和38名诊所经理中的37名（97.4%）对该项目非常满意或满意。在随访时有资格参与的79个场所（即那些未关闭或与其他医疗机构合并的场所）中，76个（96.2%）接受了至少一套HIV检测行动包，90名提供者中的67名（74.4%）增加了他们的HIV筛查。公共卫生详细指导项目可用于教育和支持提供者，建立提供者与当地卫生部门之间的关系，并传播公共卫生信息。
