Evidence map›Paper›PMID 34044818›Full record

ArticleBMC health services research2021

Implementing enhanced patient care to promote patient engagement in HIV care in a rural setting in Kenya.

Juddy Wachira, Becky Genberg, Diana Chemutai, Ann Mwangi, Omar Galarraga, Siika Abraham, Ira Wilson

Abstract read
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Higher Clinician-Patient Communication Is Associated With Greater Satisfaction With HIV Care.Journal of the International Association of Providers of AIDS Care
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Juddy WachiraDepartment of Behavioral Sciences, School of Medicine, College of Health Sciences, Social Behavioral Team, AMPATH, Moi University, P.O Box 4604-30100, Eldoret, Kenya. wachirajuddy@gmail.com.
Becky GenbergDepartment of Epidemiology, Bloomberg School of Public Health, John Hopkins University, Baltimore, MD, USA.
Diana ChemutaiAcademic Model Providing Access to Healthcare, Eldoret, Kenya.
Ann MwangiInstitute of Biomedical Informatics, College of Health Sciences, Moi University, Eldoret, Kenya.
Omar GalarragaDepartment of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.
Siika AbrahamDepartment of Medicine, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya.
Ira WilsonDepartment of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, RI, USA.

Funding

Translational ScienceP30AI042853 · NIAID · MIRIAM HOSPITAL · PI CURT G BECKWITH · 1998 to 2026
$51.7M
Tracking and Evaluation CoreU54GM115677 · NIGMS · BROWN UNIVERSITY · PI ROUNDS, SHARON IRENE SMITH · 2016 to 2025
$45.0M
Feasibility and acceptability of Enhanced Patient Care (EPC) for adult HIV patients with unsuppressed viral loads in western KenyaK43TW010684 · FIC · MOI UNIVERSITY COLLEGE OF HEALTH SCIENCES · PI WACHIRA, JUDDY · 2018 to 2022
$553k
FIC NIH HHS K43 TW010684FIC NIH HHS K43TW010684NCATS NIH HHS U54GM115677NIAID NIH HHS P30 AI042853NIGMS NIH HHS U54 GM115677
6 · The paper itself

Abstract

backgroundPatient engagement is effective in promoting adherence to HIV care. In an effort to promote patient-centered care, we implemented an enhanced patient care (EPC) intervention that addresses a combination of system-level barriers including provider training, continuity of clinician-patient relationship, enhanced treatment dialogue and better clinic scheduling. We describe the initial implementation of the EPC intervention in a rural HIV clinic in Kenya, and the factors that facilitated its implementation.

methodsThe intervention occurred in one of the rural Academic Model Providing Healthcare (AMPATHplus) health facilities in Busia County in the western region of Kenya. Both qualitative and quantitative data were collected through training and meeting proceedings/minutes, a patient tracking tool, treatment dialogue and a peer confirmation tool. Qualitative data were coded and emerging themes on the implementation and adaptation of the intervention were developed. Descriptive analysis including percentages and means were performed on the quantitative data.

resultsOur analysis identified four key factors that facilitated the implementation of this intervention. (1) The smooth integration of the intervention as part of care that was facilitated by provider training, biweekly meetings between the research and clinical team and having an intervention that promotes the health facility agenda. (2) Commitment of stakeholders including providers and patients to the intervention. (3) The adaptability of the intervention to the existing context while still maintaining fidelity to the intervention. (4) Embedding the intervention in a facility with adequate infrastructure to support its implementation.

conclusionsThis analysis demonstrates the value of using mixed methods approaches to study the implementation of an intervention. Our findings emphasize how critical local support, local infrastructure, and effective communication are to adapting a new intervention in a clinical care program.

Indexed as

HIV InfectionsPatient ParticipationHumansKenyaPatient CareQualitative ResearchRural PopulationAdaptationHIV careImplementationPatient engagement

Identifiers

PMID34044818
PMCPMC8161597

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.