Division of Infectious Diseases, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
Department of Pediatrics, Division of Adolescent Medicine, University of Alabama at Birmingham, Birmingham, USA.
BMC Health Serv Res. 2024 Jan 18;24(1):101. doi: 10.1186/s12913-023-10451-5.
Alabama is one of seven priority states for the National Ending the HIV Epidemic Initiative due to a disproportionate burden of rural infections. To reverse growing infection rates, the state must increase its focus on prevention efforts, including novel strategies. One such approach is to utilize dashboards that visualize real-time data on the pre-exposure prophylaxis (PrEP) care continuum to assist in prioritizing evidence-based preventative care for those most vulnerable for HIV infection.
We conducted a mixed methods evaluation to ascertain stakeholders' perceptions on the acceptability, feasibility, appropriateness, and usability of a PrEP care continuum dashboard, as well as gain insight on ways to improve the activities necessary to sustain it. Clinicians, administrators, and data personnel from participating sites in Alabama completed surveys (n = 9) and participated in key informant interviews (n = 10) to better understand their experiences with the prototype data dashboard and to share feedback on how it can be modified to best fit their needs.
Surveys and interviews revealed that all participants find the pilot data dashboard to be an acceptable, feasible, and appropriate intervention for clinic use. Overall, stakeholders find the pilot dashboard to be usable and helpful in administrative efforts, such as report and grant writing; however, additional refining is needed in order to reduce burden and optimize usefulness. Participants voiced concerns about their site's abilities to sustain the dashboard, including the lack of systematized PrEP protocols and limited funds and staff time dedicated to PrEP data collection, cleaning, and upload.
Study participants from clinics providing HIV prevention services, including PrEP, in Alabama voiced interest in sustaining and refining a data dashboard that tracks clients across the PrEP care continuum. Despite viewing the platform itself as an acceptable, feasible, and appropriate intervention, participants agreed that efforts need to be focused on standardizing PrEP data collection protocols in order to ensure consistent, accurate data capture and that limited funds and staff time are barriers to the sustained implementation of the dashboard in practice.
阿拉巴马州是全国终结艾滋病毒流行倡议的七个重点州之一，因为该州农村地区的感染负担不成比例。为了扭转感染率不断上升的趋势，该州必须更加注重预防工作，包括新的策略。一种方法是利用仪表板实时显示暴露前预防 (PrEP) 护理连续体的数据，以帮助为最易感染艾滋病毒的人群提供基于证据的预防护理。
我们进行了一项混合方法评估，以确定利益相关者对 PrEP 护理连续体仪表板的可接受性、可行性、适当性和可用性的看法，以及了解如何改进维持该仪表板所需的活动。来自阿拉巴马州参与地点的临床医生、管理人员和数据人员完成了调查（n=9）并参加了关键知情人访谈（n=10），以更好地了解他们使用原型数据仪表板的经验，并就如何对其进行修改以最好地满足他们的需求提供反馈。
调查和访谈显示，所有参与者都认为试点数据仪表板是一种可接受、可行且适合诊所使用的干预措施。总体而言，利益相关者认为试点仪表板在行政工作（如报告和资助申请写作）方面具有可操作性和帮助，但需要进一步改进以减轻负担并优化其有用性。参与者对其所在站点维持仪表板的能力表示担忧，包括缺乏系统的 PrEP 方案以及用于 PrEP 数据收集、清理和上传的有限资金和员工时间。
来自阿拉巴马州提供艾滋病毒预防服务（包括 PrEP）的诊所的研究参与者对维持和改进跟踪 PrEP 护理连续体的客户的数据仪表板表示了兴趣。尽管参与者认为该平台本身是一种可接受、可行且合适的干预措施，但他们一致认为需要集中精力标准化 PrEP 数据收集方案，以确保一致、准确的数据捕获，并且有限的资金和员工时间是在实践中持续实施仪表板的障碍。
