The Public Health Agency of Sweden, Stockholm, Sweden.
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Health Promot Int. 2020 Oct 1;35(5):935-946. doi: 10.1093/heapro/daz081.
The context-sensitive nature of the European HIV epidemic (e.g. differences in key populations, prevention settings, resource commitments) makes it challenging to monitor and evaluate HIV prevention and sexual health promotion programs. Systematic quality improvement (QI) tools and quality indicators adapted to HIV prevention are not widely known or implemented. The European 'Quality Action' introduced five such tools in 26 countries involving 45 nongovernmental and governmental organizations during 2014-2016. Approximately, half of the organizations used the tool 'Succeed'. This study aims to describe challenges and supportive factors in its use, and answers the research question if Succeed can be applied as a general QI tool despite the high contextuality of the European HIV prevention field. Mixed method research was conducted: data from quantitative pre- and post-training and implementation surveys were triangulated with qualitative data from multiple data sources analysed inductively. In a second analytical step, Chaudoir's evidence-based framework on implementation of innovations (2013) guided the data analysis on five levels: policy, organization, functionality of the tool, results and perceived innovations. Succeed contributed to goal and result orientation, facilitated stakeholders' participation and contributed to organizational development. Succeed was used in similar ways and with similar results across different policy contexts, types of organizations, target groups and interventions. Contributing factors for sustainable implementation were supporting environments, sufficient resources and a strategy for training tool users. Findings strongly support the use of Succeed as a general QI tool to monitor, document, adapt and improve HIV prevention and sexual health promotion work across Europe.
欧洲艾滋病毒疫情具有语境敏感性（例如，重点人群、预防环境、资源承诺方面的差异），这使得监测和评估艾滋病毒预防和性健康促进方案具有挑战性。系统质量改进（QI）工具和适用于艾滋病毒预防的质量指标并不广为人知或实施。欧洲“质量行动”（European 'Quality Action'）在 2014 年至 2016 年期间在 26 个国家引入了五个此类工具，涉及 45 个非政府组织和政府组织。大约有一半的组织使用了“成功”（Succeed）工具。本研究旨在描述其使用过程中的挑战和支持因素，并回答以下研究问题：尽管欧洲艾滋病毒预防领域的语境高度复杂，Succeed 能否作为一种通用的 QI 工具应用。本研究采用混合方法研究：定量培训前和培训后以及实施调查的数据与来自多个数据源的定性数据进行三角分析，这些定性数据采用归纳法进行分析。在第二个分析步骤中，Chaudoir（2013 年）关于创新实施的循证框架指导了对五个层面的数据进行分析：政策、组织、工具功能、结果和感知创新。Succeed 有助于目标和结果导向，促进利益相关者参与，并有助于组织发展。Succeed 在不同的政策背景、组织类型、目标群体和干预措施中以相似的方式使用，并产生相似的结果。可持续实施的促成因素包括支持性环境、充足的资源以及培训工具使用者的策略。研究结果强烈支持将 Succeed 用作监测、记录、调整和改进整个欧洲艾滋病毒预防和性健康促进工作的通用 QI 工具。
