Nancy Puttkammer, Jane M. Simoni, Tracy Sandifer, Jean Marcxime Chéry, Witson Dervis, Jean Gabriel Balan, Jean Geto Dubé, Guirlaine Calixte, Ermane Robin, Kesner François, Cameron Casey, Ira Wilson & Jean Guy Honoré
University of Washington affiliated authors are displayed in bold.
Published: July 2020
Elizabeth H. Connors, Susan Douglas, Amanda Jensen-Doss, Sara J. Landes, Cara C. Lewis, Bryce D. McLeod, Cameo Stanick, & Aaron R. Lyon
University of Washington affiliated authors are displayed in bold.
Published: July 2020
Alexandra L. Quittner, Janice Abbott, Saida Hussain, Thida Ong, Ahmet Uluer, Sarah Hempstead, Paula Lomas, & Beth Smith
University of Washington affiliated authors are displayed in bold.
Published: July 2020
Molly Adrian, Jessica Coifman, Michael D. Pullmann, Jennifer B. Blossom, Casey Chandler, Glen Coppersmith, Paul Thompson, & Aaron R. Lyon
University of Washington affiliated authors are displayed in bold.
Published: July 2020
Technology-enabled services (TESs), which integrate human service and digital components, are popular strategies to increase the reach and impact of mental health interventions, but large-scale implementation of TESs has lagged behind their potential.
This study applied a mixed qualitative and quantitative approach to gather input from multiple key user groups (students and educators) and to understand the factors that support successful implementation (implementation determinants) and implementation outcomes of a TES for universal screening, ongoing monitoring, and support for suicide risk management in the school setting.
A total of 111 students in the 9th to 12th grade completed measures regarding implementation outcomes (acceptability, feasibility, and appropriateness) via an open-ended survey. A total of 9 school personnel (school-based mental health clinicians, nurses, and administrators) completed laboratory-based usability testing of a dashboard tracking the suicide risk of students, quantitative measures, and qualitative interviews to understand key implementation outcomes and determinants. School personnel were presented with a series of scenarios and common tasks focused on the basic features and functions of the dashboard. Directed content analysis based on the Consolidated Framework for Implementation Research was used to extract multilevel determinants (ie, the barriers or facilitators at the levels of the outer setting, inner setting, individuals, intervention, and implementation process) related to positive implementation outcomes of the TES.
Overarching themes related to implementation determinants and outcomes suggest that both student and school personnel users view TESs for suicide prevention as moderately feasible and acceptable based on the Acceptability of Intervention Measure and Feasibility of Intervention Measure and as needing improvements in usability based on the System Usability Scale. Qualitative results suggest that students and school personnel view passive data collection based on social media data as a relative advantage to the current system; however, the findings indicate that the TES and the school setting need to address issues of privacy, integration into existing workflows and communication patterns, and options for individualization for student-centered care.
Innovative suicide prevention strategies that rely on passive data collection in the school context are a promising and appealing idea. Usability testing identified key issues for revision to facilitate widespread implementation.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Adrienne E. Shapiro, Alastair van Heerden, Meighan Krows, Kombi Sausi, Nsika Sithole, Torin T. Schaafsma, Olivier Koole, Heidi van Rooyen, Connie L. Celum, & Ruanne V. Barnabas
University of Washington affiliated authors are displayed in bold.
Published: June 2020
In South Africa, HIV‐infected men are less likely than women to test and know their status (the first UNAIDS “90‐90‐90” target), and men have worse outcomes across the HIV care cascade. HIV self‐testing (HIVST) may address this testing disparity but questions remain over the most effective distribution strategy and linkage following a positive test result. We implemented a men‐focused HIVST distribution programme to evaluate components contributing to participation and retention.
We conducted an implementation study of multi‐venue HIVST kit distribution in rural and peri‐urban KwaZulu‐Natal (KZN), South Africa. We distributed HIVST kits at community points, workplaces and social venues for on site or take‐home use. Clients could choose blood‐based or oral‐fluid‐based HIVST kits and elect to watch an in‐person or video demonstration. We provided a USD2 incentive to facilitate reporting test results by phone or SMS. Persons with reactive HIVST results were provided immediate confirmatory tests (if used HIVST on site) or were referred for confirmatory testing (if took HIVST off site) and linkage to care for ART initiation. We describe the testing and linkage cascade in this sample and describe predictors of reactive HIVST results and linkage.
Between July and November 2018, we distributed 4496 HIVST kits in two regions of KZN (96% to men, median age 28 (IQR 23 to 35). Most participants (58%) chose blood‐based HIVST and 42% chose oral‐swab kits. 11% of men were testing for the first time. A total of 3902 (83%) of testers reported their test result to the study team, with 314 (8%) screening positive for HIV. Among 274 men with reactive HIVST results, 68% linked to ART; no significant predictors of linkage were identified. 10% of kit users reported they would prefer a different type (oral vs. blood) of kit for repeat testing than the type they used.
HIVST is acceptable to men and rapid distribution with optional testing support is feasible in rural and peri‐urban settings. HIVST kits successfully reached younger men and identified undetected infections. Both oral and blood‐based HIVST were selected. Scaling up HIVST distribution and guidance may increase the number of first‐time testers among men and help achieve the first UNAIDS “90” for men in South Africa.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Judy Leong, Sou Hyun Jang, Sonia K. Bishop, Emily V. R. Brown, Eun Jeong Lee, Linda K. Ko
University of Washington affiliated authors are displayed in bold.
Published: June 2020
Wan-Ju Wu, Aparna Tiwari, Nandini Choudhury, Indira Basnett, Rita Bhatt, David Citrin, Scott Halliday, Lal Kunwar, Duncan Maru, Isha Nirola, Sachit Pandey, Hari Jung Rayamazi, Sabitri Sapkota, Sita Saud, Aradhana Thapa, Alisa Goldberg, & Sheela Maru
University of Washington affiliated authors are displayed in bold.
Published: June 2020
Unmet need for postpartum contraception in rural Nepal remains high and expanding access to sexual and reproductive healthcare is essential to achieving universal healthcare. We evaluated the impact of an integrated intervention that employed community health workers aided by mobile technology to deliver patient-centred, home-based antenatal and postnatal counseling on postpartum modern contraceptive use. This was a pre–post-intervention study in seven village wards in a single municipality in rural Nepal.
The primary outcome was modern contraceptive use among recently postpartum women. We performed a multivariable logistic regression to examine contraceptive use among postpartum women pre- and one-year post-intervention. We conducted qualitative interviews to explore the implementation process. There were 445 postpartum women in the pre-intervention group and 508 in the post-intervention group.
Modern contraceptive use increased from 29% pre-intervention to 46% post-intervention (p < 0.0001). Adjusting for age, caste, and household expenditure, time since delivery and sex of child in the index pregnancy, postpartum women one-year post-intervention had twice the odds (OR 2.3; CI 1.7, 3.1; p < 0.0001) of using a modern contraceptive method as compared to pre-intervention. Factors at the individual, family, and systems level influenced women’s contraceptive decisions. The intervention contributed to increasing contraceptive use through knowledge transfer, demand generation, referrals to healthcare facilities, and follow-up.
A community-based, patient-centered contraceptive counseling intervention supported by mobile technology and integrated into longitudinal care delivered by community health workers appears to be an effective strategy for improving uptake of modern contraception among postpartum women in rural Nepal.
**This abstract is posted with permission under the Creative Commons Attribution 4.0 International License**
Harison Lagat, Monisha Sharma, Edward Kariithi, George Otieno, David Katz, Sarah Masyuko, Mary Mugambi, Beatrice Wamuti, Bryan Weiner & Carey Farquhar
University of Washington affiliated authors are displayed in bold.
Published: June 2020]
Melanie C. Goebel, Barbara W. Trautner, Yiqun Wang, John N. Van, Laura M. Dillon, Payal K. Patel, Dimitri M. Drekonja, Christopher J. Graber, Bhavarth S. Shukla, Paola Lichtenberger, Christian D. Helfrich, Anne Sales, & Larissa Grigoryan
University of Washington affiliated authors are displayed in bold.
Published: May 2020
Dana Atkins, Anjuli D. Wagner, Junyi Zhang, Irene N. Njuguna, Jillian Neary, Vincent O. Omondi, Verlinda A. Otieno, Kenneth Ondeng'e, Dalton C. Wamalwa, Grace John-Stewart, Jennifer A. Slyker, and Kristin Beima-Sofie
University of Washington affiliated authors are displayed in bold.
Published: May 2020