Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions
Abstract
:1. Introduction
1.1. Conceptual Foundation
1.2. Factors that Influence Linkage-Making
2. Materials and Methods
2.1. Overview of Procedures for the Longitudinal Study
2.2. Criterion Sampling Strategy for In-Depth Interviews
2.3. Recruitment for In-Depth Interviews
2.4. Interview Protocol and Data Collection
2.5. Analytic Approach and Data Interpretation
3. Results
3.1. Sample Characteristics
3.2. Factors that Influence Linkage-Making
3.3. Individual Domain: Professional Knowledge Base
3.4. Relationship Domain: Interprofessional Collaboration
3.5. Community Domain: Providers’ Work-Related Changes
3.6. Policy Domain: Best Practices in a Competitive Environment
4. Discussion
4.1. Individual Domain: Professional Knowledge Base
4.2. Relationship Domain: Interprofessional Collaboration
4.3. Community Domain: Providers’ Work-Related Changes
4.4. Policy Domain: Best Practices in a Competitive Environment
4.5. Implications for Multi-Level Interventions and Future Research
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Individual Domain: Professional Knowledge Base and Life Changes | I think by doing different trainings or webinars … bringing people together to talk about challenges, then brainstorming different resources, I think is helpful. Because you tend to only see things through your agency lens and have certain referrals or who you would go to. [Participant ID: A06P06] |
I think that organizing interactive workshops where you’re sitting down with people from other agencies to try and figure out how to [link patients] is a good idea. [A01P14] | |
I’m working on my master’s. I am starting to buy into the whole thing about collaboration. There were some classes I took that it was evident collaboration was important, where instead of it being one [provider], sometimes you need an outside [provider] along with you to observe while you’re doing it and vice versa. [A03P08] | |
Relationship Domain: Interprofessional Collaboration | I said to everyone every time we have a case management meeting, “The [providers] in this room, we have a gold mine of resources. Every one of you have your own contact in every facility. Share that with your coworkers.” Because that’s the way to get in. We build—we know [providers] by name. They like that we know them by names. [A01P04] |
I know these places exist, but without personal connections to those places, it feels like a shot in the dark [A01P14] | |
You actually collaborate with your colleagues to know what agencies work, what don’t work. [A18P19] | |
That’s been helpful to develop relationships so when somebody answers the phone I know who it is. “Is that really the earliest appointment?” “Don’t you have anything on Wednesday?” I feel our clients get better treatment. [A01P09] | |
Community Domain: Providers’ Work-Related Changes | I feel like, before, I had less responsibility. I just had less responsibility, so I had more time to go more in-depth with different things. Whereas now, it’s more job responsibility and more out-of-work responsibility, has affected whether or not I’m focused on making referrals to people. [A01P14] |
I would say when certain contracts end, [providers] get laid off or dismissed, you take on extra duties. When you take on extra duties that does affect how you collaborate because you have so much more to concentrate on instead of actually doing the actual collaboration. The client can suffer. [A03P08] | |
In the last six months, one of the biggest changes is this managed care kit that’s coming out where everybody has to begin to really not only get to know the other agencies but begin collaboration for services that we don’t offer, so it’s been a lot of work. [A17P16] | |
Policy Domain: Best Practices in a Competitive Environment | I just think it’s important to get outside of your own agency and promote how you can work collaboratively. Because I think people are worried that you are going to swoop in and steal their clients. And it is a legitimate fear. [A02P14] |
It’s a very competitive world, and a lot of agencies feel that if they collaborate they will lose clients. If people would just get out of that mind frame and think that we’re all here together for one goal and we’re able to collaborate. [A12P12] | |
That’s in the back of our minds, that we would not be sending somebody out to a non-evidence-based intervention… we definitely would be thinking about that. [A01P01] | |
Yeah, that’s important to me also, because the evidence-based referral will show me that it worked. [A18P19] | |
I think it’s about setting up a spirit of collaboration and delineating who does what and how we can help each other, and less of an environment of “you’re going to steal my clients”. [A02P14] |
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Pinto, R.M.; Witte, S.S.; Filippone, P.L.; Baird, K.L.; Whitman, W.R. Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions. Int. J. Environ. Res. Public Health 2017, 14, 1355. https://doi.org/10.3390/ijerph14111355
Pinto RM, Witte SS, Filippone PL, Baird KL, Whitman WR. Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions. International Journal of Environmental Research and Public Health. 2017; 14(11):1355. https://doi.org/10.3390/ijerph14111355
Chicago/Turabian StylePinto, Rogério M., Susan S. Witte, Prema L. Filippone, Karen L. Baird, and Wendy R. Whitman. 2017. "Factors That Influence Linkages to HIV Continuum of Care Services: Implications for Multi-Level Interventions" International Journal of Environmental Research and Public Health 14, no. 11: 1355. https://doi.org/10.3390/ijerph14111355