Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 30, 2023
Date Accepted: Jun 10, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Evaluating the preliminary effectiveness of the person-centered care assessment tool (PCC-AT) in Zambian health facilities: A protocol for an exploratory study
ABSTRACT
Introduction. Person-centered care (PCC) within HIV treatment services has demonstrated potential to overcome inequities in HIV service access while improving treatment outcomes. Despite PCC being widely considered a best practice, no consensus exists on its assessment and measurement. This study in Zambia, builds upon previous research which informed development of a framework for PCC and a PCC assessment tool (PCC-AT). Objectives. This study examines the preliminary effectiveness of the PCC-AT through assessing the association between client HIV service delivery indicators and facility PCC-AT scores. The study team hypothesizes that facilities with higher PCC-AT scores will demonstrate more favorable HIV treatment continuity, viral load (VL) coverage, and viral suppression in comparison to facilities with lower PCC-AT scores. Methods. The study team will implement the PCC-AT at 30 randomly selected health facilities in Copperbelt and Central provinces. For each study facility, data will be gathered from three sources: (1) PCC-AT scores, (2) PCC-AT action plans, (3) facility characteristics and (4) service delivery data. Quantitative analysis, using STATA, will include descriptive statistics on the PCC-AT results while stratifying by facility characteristics. Crosstabulations and/or regression analysis will determine if there are any associations between scores and treatment continuity, VL coverage, and/or viral suppression. Qualitative data will be collected via action planning with detailed notes collected and recorded into an action plan template. Descriptive coding and emerging themes will be analyzed with NVivo software. Discussion. Assessment and measurement of PCC within HIV treatment settings is a novel approach that offers HIV treatment practitioners the opportunity to examine their services and identify actions to improve PCC performance. Study results and the PCC-AT will be broadly disseminated for use among all project sites in Zambia as well as other HIV treatment programs, in addition to making the PCC-AT publicly available to global HIV practitioners.
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