Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 4, 2018
Open Peer Review Period: Apr 5, 2018 - May 31, 2018
Date Accepted: Jan 26, 2019
(closed for review but you can still tweet)
Implementing a Web-Based Intervention in HIV Primary Care Clinics: A Pilot Study on the Feasibility of Positive Health Check
ABSTRACT
Background:
Web-based interventions can help people living with human immunodeficiency virus (HIV) achieve better clinical outcomes and behaviors, but integrating them into clinical practice remains challenging. Several studies report on the appropriate content for web-based interventions and their outcomes, but there is a gap in understanding the feasibility of implementing these interventions in HIV clinic settings from the clinicians’ perspective.
Objective:
We examined whether Positive Health Check (PHC)—a web-based, tailored video counseling tool—was acceptable, appropriate, and feasible for HIV primary care clinics to implement.
Methods:
Four primary care clinics implemented PHC during a 1-month pilot. Nine key clinic staff across clinics who implemented the intervention participated in 54 interviews. We used framework analysis to code the data and identify themes related to implementation outcomes; acceptability, appropriateness, and feasibility. We also analyzed patients’ (n=104) intervention usage metrics to quantify patients’ intervention completion rates (n=68).
Results:
At the start of implementation, and with increasing frequency as enrollment was opened to more diverse patient groups, clinic staff reported that PHC was an acceptable and appropriate intervention. Stakeholders successfully dedicated space for patients to use the tool, delivered patients’ handouts, and adjusted workflow to facilitate implementation. Clinic staff reported that PHC is feasible to implement in clinic settings, but challenges remained for workflow integration and the best time to administer PHC.
Conclusions:
To increase implementation effectiveness, we examined implementation outcomes related to the integration of PHC into clinic workflows. Findings from this pilot implementation suggest that PHC can be integrated into clinic workflow systems, but clinicians and researchers need to better understand the role of implementation outcomes to leverage the benefits of tailored web-based interventions for people living with HIV.
Citation
Per the author's request the PDF is not available.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.