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báo cáo khoa học: " A comparative evaluation of the process of developing and implementing an emergency department HIV testing program"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: A comparative evaluation of the process of developing and implementing an emergency department HIV testing program | Christopoulos et al. Implementation Science 2011 6 30 http www.implementationscience.eom content 6 1 30 IMPLEMENTATION SCIENCE Implementation Science RESEARCH Open Access A comparative evaluation of the process of developing and implementing an emergency department HIV testing program 1.2 2 1.2 2 2 2 Katerina A Christopoulos 1 Kim Koester Sheri Weiser1 Tim Lane Janet J Myers and Stephen F Morin Abstract Background The 2006 Centers for Disease Control and Prevention CDC HIV testing guidelines recommend screening for HIV infection in all healthcare settings including the emergency department ED . In urban areas with a high background prevalence of HIV the ED has become an increasingly important site for identifying HIV infection. However this public health policy has been operationalized using different models. We sought to describe the development and implementation of HIV testing programs in three EDs assess factors shaping the adoption and evolution of specific program elements and identify barriers and facilitators to testing. Methods We performed a qualitative evaluation using in-depth interviews with fifteen key informants involved in the development and implementation of HIV testing in three urban EDs serving sizable racial ethnic minority and socioeconomically disadvantaged populations. Testing program HIV prevalence ranged from 0.4 to 3.0 . Results Three testing models were identified reflecting differences in the use of existing ED staff to offer and perform the test and disclose results. Factors influencing the adoption of a particular model included whether program developers were ED providers HIV providers or both whether programs took a targeted or non-targeted approach to patient selection and the extent to which linkage to care was viewed as the responsibility of the ED. A common barrier was discomfort among ED providers about disclosing a positive HIV test result. Common facilitators were a commitment to underserved populations the perception that .