"We're Going to Be Here": Providers' Perspectives on Implementing a Revised HIV Care Coordination Program.
As HIV outcomes continue to improve, disparities in viral suppression and care engagement persist, exacerbated by socioeconomic inequities, mental health stressors, systemic racism, HIV-related stigma, and other forms of discrimination. HIV care coordination programs address structural and psychosoc...
| Publicado en: | AIDS Patient Care & STDs Vol. 39; no. 9; pp. 363 - 371 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Sep2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187550484&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187550484 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10872914 33C jtl: AIDS Patient Care & STDs issn: 10872914 maglogo: N pubinfo: dt: Sep2025 vid: 39 iid: 9 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 187550484 187550484 187550484 10.1089/apc.2025.0047 187550484 ppf: 363 ppct: 8 formats: tig: atl: "We're Going to Be Here": Providers' Perspectives on Implementing a Revised HIV Care Coordination Program. aug: au: Emmert, Connor Avoundjian, Tigran Irvine, Mary Tapia-Munoz, Thamara Schenkel, Rachel Hernandez, Miguel Kozlowski, Sarah Nash, Denis Guarino, Honoria affil: New York City Department of Health and Mental Hygiene (NYC Department of Health), Bureau of Hepatitis, HIV, and STIs, Queens, New York, USA. sug: subj: Attitude of Health Personnel Evaluation HIV Infections Drug Therapy Continuity of Patient Care Program Implementation Funding Source New York Human Qualitative Studies Semi-Structured Interview Implementation Science Workload Burnout, Professional Community Health Centers Hospitals, Public Hospitals, Private Purposive Sample Interview Guides Audiorecording Content Analysis Thematic Analysis Male Female Adolescence Adult Middle Age Understaffing Personnel Turnover Support, Psychosocial Case Management Multidisciplinary Care Team Decision Making, Shared Medication Compliance Health Promotion Patient Centered Care Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: As HIV outcomes continue to improve, disparities in viral suppression and care engagement persist, exacerbated by socioeconomic inequities, mental health stressors, systemic racism, HIV-related stigma, and other forms of discrimination. HIV care coordination programs address structural and psychosocial barriers to care and treatment, but these interventions must adapt to the evolving circumstances and perspectives of those expected to participate in them to achieve and sustain maximal impact. In 2009, the New York City Department of Health implemented a Ryan White-funded HIV Care Coordination Program (CCP). The CCP has demonstrated effectiveness, particularly among those newly diagnosed with HIV and those out of care or unsuppressed in the prior year. However, implementation challenges prompted a 2018 redesign to increase provider and client engagement. We conducted 30 semi-structured interviews with providers from six agencies delivering the revised CCP to examine barriers and facilitators to implementation. Providers highlighted the revised CCP's flexible, client-centered approach as a strength, allowing for personalized care plans and improved client engagement. Additionally, they emphasized the contributions of driven, committed staff. However, providers noted several barriers associated with the revised model or its implementation context, including increased paperwork burden, unrealistic service expectations, understaffing, and burnout from uncompensated emotional labor. Our findings suggest the value of retaining a client-centered model while streamlining administrative processes, enhancing training and support for providers, and increasing staff–client ratios. Adjustments based on providers' experience with a complex intervention can improve the fit of the intervention to its intended delivery settings and promote sustainability. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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