Evidence map›Paper›PMID 39804947›Full record

ArticlePLOS global public health2025

Sustainability of an evidence-based intervention supporting transition to independent care for youth living with HIV in Kenya.

Alina Metje, Sarah Shaw, Cyrus Mugo, Mercy Awuor, Annabell Dollah, Hellen Moraa, Christine Kundu, Dalton Wamalwa, Grace John-Stewart, Kristin Beima-Sofie and 1 more

Abstract read
In one paragraph

Article in PLOS global public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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. Review
  2. 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

11 authors.

Alina MetjeDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0009-0008-0910-6713
Sarah ShawDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.ORCID https://orcid.org/0000-0002-3517-0881
Cyrus MugoKenyatta National Hospital, Nairobi, Kenya.ORCID https://orcid.org/0000-0001-7516-2168
Mercy AwuorKenyatta National Hospital, Nairobi, Kenya.
Annabell DollahKenyatta National Hospital, Nairobi, Kenya.
Hellen MoraaKenyatta National Hospital, Nairobi, Kenya.ORCID https://orcid.org/0000-0001-8862-3058
Christine KunduKenyatta National Hospital, Nairobi, Kenya.ORCID https://orcid.org/0009-0005-3446-0915
Dalton WamalwaDepartment of Pediatrics and Child Health, University of Nairobi, Nairobi, Kenya.
Grace John-StewartDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Kristin Beima-SofieDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.
Irene NjugunaDepartment of Global Health, University of Washington, Seattle, Washington, United States of America.

Funding

University of Washington/Fred Hutch Center for AIDS ResearchP30AI027757 · NIAID · UNIVERSITY OF WASHINGTON · PI CONNIE L CELUM · 1988 to 2026
$104.9M
VENEREAL DISEASET32AI007140 · NIAID · UNIVERSITY OF WASHINGTON · PI Julia Cook Dombrowski · 1985 to 2026
$19.4M
Understanding the role of schools in supporting HIV treatment outcomes among HIV infected adolescentsK43TW011422 · FIC · KENYATTA NATIONAL HOSPITAL · PI NJUGUNA, IRENE NYAMBURA · 2020 to 2024
$603k
FIC NIH HHS K43 TW011422NIAID NIH HHS P30 AI027757NIAID NIH HHS T32 AI007140
6 · The paper itself

Abstract

Integrating and sustaining evidence-based interventions (EBIs) in routine care is crucial to improving HIV treatment outcomes among youth living with HIV (YLH). However, EBIs are often not sustained post clinical trial. An Adolescent Transition Package (ATP) delivered by health care workers (HCWs) and tested in Kenya in 2021 significantly improved YLH readiness to transition to independent care. Post-trial, participating clinics could continue using the ATP. We conducted 30 in-depth interviews with health care workers to evaluate determinants of continued ATP implementation one-year post-trial. Interviews used semi-structured guides, informed by the Consolidated Framework for Implementation Research version 2.0 (CFIR v2.0). Transcripts were analyzed thematically to identify key influences of ATP sustainment and fidelity post-trial. Effective training during and after the trial, and continued internal and external support for implementation, were crucial for sustained acceptability and feasibility. In contrast, staff shortages and high turnover, lack of integration into the existing electronic medical system, and maintaining staff motivation were barriers to ATP sustainment. Implementation fidelity was limited by workforce constraints and HCW beliefs about the importance of individualizing content and delivery to be responsive to individual client needs. ATP adaptability afforded optimization of delivery to overcome workforce constraints and meet client needs, increasing HCW perceptions of feasibility and motivating continued use. Alignment between observed impact and care provision goals further motivated ongoing ATP utilization. Strategies to ensure continued training and integration of tools into existing systems have the potential to further enhance ATP sustainability.

Identifiers

PMID39804947
PMCPMC11981535

What OpenQuestion holds

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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.