Evidence map›Paper›PMID 37074998›Full record

ArticlePLOS global public health2023

Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial.

Pamela K Kohler, Cyrus Mugo, Kate S Wilson, Hellen Moraa, Alvin Onyango, Kenneth Tapia, Kenneth Pike, Caren Mburu, Margaret Nduati, Brandon Guthrie and 6 more

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02928900 (Simulated Patient Encounters to Promote Early Detection and Engagement in HIV Care for Adolescents), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 27% of its field
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.

NCT02928900 nacompletednot on this map

Simulated Patient Encounters to Promote Early Detection and Engagement in HIV Care for Adolescents

TypeinterventionalSponsorUniversity of WashingtonRan2016 to 2021Enrolled24ConditionsHIV/AIDSArmsClinician training intervention
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
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

16 authors at 4 institutions in 2 countries.

Pamela K KohlerDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0001-6176-6374
Cyrus MugoDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.ORCID https://orcid.org/0000-0001-7516-2168
Kate S WilsonDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Hellen MoraaDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Alvin OnyangoDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Kenneth TapiaDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-9393-0770
Kenneth PikeDepartment of Child, Family, and Population Health Nursing, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-7730-6476
Caren MburuDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Margaret NduatiDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Brandon GuthrieDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Barbra A RichardsonDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Tamara OwensHoward University, Washington, DC, United States of America.
David BukusiDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Irene InwaniKenyatta National Hospital, Nairobi, Kenya.
Grace John-StewartDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Dalton WamalwaDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
University of Washington · USUniversity of Nairobi · KEHoward University · USKenyatta National Hospital · KE

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
Simulated Patient Encounters to Promote Early Detection and Engagement in HIV Care for AdolescentsR01HD085807 · NICHD · UNIVERSITY OF WASHINGTON · PI KOHLER, PAMELA · 2015 to 2019
$2.1M
NIAID NIH HHS P30 AI027757NICHD NIH HHS R01 HD085807
6 · The paper itself

Abstract

Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after >3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19-23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88-1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05-1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19-0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900.

Identifiers

PMID37074998
PMCPMC10115282
OpenAlexW4366350998

What OpenQuestion holds

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Registered trials

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.