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首页> 外文期刊>AIDS care. >A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting.
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A process evaluation of the implementation of a computer-based, health provider-delivered HIV-prevention intervention for HIV-positive men who have sex with men in the primary care setting.

机译：对在基层医疗机构中与男性发生过性关系的艾滋病毒呈阳性的男性实施以计算机为基础的，由医疗人员提供的艾滋病毒预防干预措施的过程评估。

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There is increasing interest in using healthcare providers to deliver HIV-prevention services to their patients. Unfortunately, lack of counselling skills and time constraints within busy clinics serve as barriers to such efforts. The Providers Advocating for Sexual Health Initiative (PASHIN) study used state-of-the-art computer technology to assess each participant's risk behaviours and to determine the patient's readiness for changing each behaviour. The computer synthesized the participant-entered data, determined the targeted risk behaviour and printed a behavioural theory-based provider advice sheet and a 3-point patient prescription for the targeted risk behaviour. Since the intervention does not require providers to spend time performing a detailed sexual-risk assessment and it does not require providers to have received extensive counselling training, it has the potential to minimize some of the barriers associated with provider-delivered interventions. Thus, the purpose of this process evaluation was to assess how the PASHIN intervention was implemented in the field, including issues such as the fidelity of implementation and health providers' views on and experience with implementing the intervention. Overall, the results demonstrated that the computer-based, provider-delivered intervention was successfully delivered by providers within the context of regularly scheduled treatment sessions with HIV-positive men who have sex with men (MSM) patients. The majority of providers (79.4%) and patients (83.5%) reported that the quality of HIV-prevention services delivered during these sessions was 'good'. The majority of the providers also reported that they had received adequate training, felt more confident in communicating HIV-prevention issues with their patients and provided more HIV-prevention counselling to their patients, due to the project. However, the experience of delivering HIV-prevention counselling during an 18-month period did not appear to change providers' attitudes toward a provider-delivered HIV-prevention intervention nor their belief in the effectiveness of HIV prevention in general. Future studies should focus on how to enhance providers' acceptance and commitment to delivering HIV-prevention counselling to their patients during the clinic visit.
机译：使用医疗保健提供者为其患者提供艾滋病毒预防服务的兴趣日益浓厚。不幸的是，繁忙的诊所缺乏咨询技巧和时间限制成为这种努力的障碍。倡导性健康倡议的提供者（PASHIN）研究使用了最新的计算机技术来评估每个参与者的风险行为，并确定患者是否愿意改变每种行为。计算机将参与者输入的数据进行合成，确定目标风险行为，并打印出基于行为理论的提供者建议单和针对目标风险行为的3分患者处方。由于干预措施不需要提供者花时间进行详细的性风险评估，也不需要提供者接受广泛的咨询培训，因此有可能将与提供者提供的干预措施相关的一些障碍降到最低。因此，该过程评估的目的是评估在现场如何实施PASHIN干预措施，包括诸如执行的忠实度以及卫生服务提供者对实施干预措施的看法和经验等问题。总体而言，结果表明，由提供者提供的基于计算机的干预措施已成功地由提供者在与男男性接触者（MSM）患者进行HIV阳性的男性定期安排的治疗会议中进行。大多数提供者（79.4％）和患者（83.5％）报告说，在这些会议期间提供的艾滋病毒预防服务的质量“良好”。大多数提供者还报告说，由于该项目，他们已经接受了充分的培训，对与患者交流预防艾滋病的问题感到更有信心，并为患者提供了更多的预防艾滋病咨询。但是，在18个月的时间里提供艾滋病预防咨询的经验似乎并没有改变提供者对提供者提供的艾滋病预防干预的态度，也没有改变他们对总体上预防HIV有效性的信念。未来的研究应侧重于如何提高提供者的接受度和承诺，以便在诊所就诊期间向其患者提供艾滋病毒预防咨询。

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