Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Level 5, Falmouth Building, Anzio Road, Cape Town, South Africa.
ICAP at Columbia University, Mailman School of Public Health, New York, USA.
BMC Health Serv Res. 2023 Jun 6;23(1):582. doi: 10.1186/s12913-023-09630-1.
Service providers' attitudes toward interventions are essential for adopting and implementing novel interventions into healthcare settings, but evidence of evaluations in the HIV context is still limited. This study is part of the CombinADO cluster randomized trial (ClinicalTrials.gov NCT04930367), which is investigating the effectiveness of a multi-component intervention package (CombinADO strategy) aimed at improving HIV outcomes among adolescents and young adults living with HIV (AYAHIV) in Mozambique. In this paper we present findings on key stakeholder attitudes toward adopting study interventions into local health services.
Between September and December 2021, we conducted a cross-sectional survey with a purposive sample of 59 key stakeholders providing and overseeing HIV care among AYAHIV in 12 health facilities participating in the CombinADO trial, who completed a 9-item scale on attitudes towards adopting the trial intervention packages in health facilities. Data were collected in the pre-implementation phase of the study and included individual stakeholder and facility-level characteristics. We used generalized linear regression to examine the associations of stakeholder attitude scores with stakeholder and facility-level characteristics.
Overall, service-providing stakeholders within this setting reported positive attitudes regarding adopting intervention packages across study clinic sites; the overall mean total attitude score was 35.0 ([SD] = 2.59, Range = [30-41]). The study package assessed (control or intervention condition) and the number of healthcare workers delivering ART care in participating clinics were the only significant explanatory variables to predict higher attitude scores among stakeholders (β = 1.57, 95% CI = 0.34-2.80, p = 0.01 and β = 1.57, 95% CI = 0.06-3.08, p = 0.04 respectively).
This study found positive attitudes toward adopting the multi-component CombinADO study interventions among HIV care providers for AYAHIV in Nampula, Mozambique. Our findings suggest that adequate training and human resource availability may be important in promoting the adoption of novel multi-component interventions in healthcare services by influencing healthcare provider attitudes.
服务提供者对干预措施的态度对于将新的干预措施引入医疗保健环境至关重要，但在 HIV 背景下的评估证据仍然有限。本研究是 CombinADO 集群随机试验（ClinicalTrials.gov NCT04930367）的一部分，该试验正在调查一种多组分干预包（CombinADO 策略）的有效性，该策略旨在改善莫桑比克感染艾滋病毒的青少年和年轻成年人（AYAHIV）的 HIV 结局。在本文中，我们介绍了关键利益相关者对将研究干预措施引入当地卫生服务的态度的研究结果。
2021 年 9 月至 12 月，我们对参与 CombinADO 试验的 12 个卫生设施中提供和监督 AYAHIV 艾滋病毒护理的 59 名关键利益相关者进行了一项具有针对性的横断面调查，他们完成了一项关于在卫生设施中采用试验干预措施的 9 项态度量表。数据是在研究的实施前阶段收集的，包括个人利益相关者和设施层面的特征。我们使用广义线性回归来检验利益相关者态度得分与利益相关者和设施层面特征的关联。
总体而言，在这种情况下，提供服务的利益相关者报告说，在整个研究诊所中采用干预措施的态度积极；总体平均总态度得分为 35.0（[SD] = 2.59，范围为 [30-41]）。研究包评估（对照或干预条件）和参与诊所提供 ART 护理的卫生工作者人数是唯一能够预测利益相关者更高态度得分的显著解释变量（β=1.57，95%CI=0.34-2.80，p=0.01 和β=1.57，95%CI=0.06-3.08，p=0.04）。
本研究发现，莫桑比克楠普拉的 AYAHIV 艾滋病毒护理提供者对采用多组分 CombinADO 研究干预措施持积极态度。我们的研究结果表明，充足的培训和人力资源可用性可能通过影响医疗保健提供者的态度，在促进新的多组分干预措施在医疗保健服务中的采用方面发挥重要作用。
