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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Jeffrey D. Capizzi, ABD1, Cheryl Merzell, DrPH2, Tracey E. Wilson, PhD3, Linda M. Mundy, MD4, S Findley, PhD5, Dan Ciccarone, MD, MPH6, Ricardo Alvarez, MD7, Ruth Finkelstein, ScD8, Joanne E. Mantell, PhD, MSPH8, Theresa Cassidy, MPH8, Barbara Aranda-Naranjo, PhD9, Bruce Agins, MD, MPH10, Stephen Bowen, MD, MPH11, Barbara Hannah, MD12, Lisa R. Hirschhorn, MD, MPH13, Ilse Levin, MPHTM14, Sharon B. Mannheimer, MD15, Richard Moore, MD16, and Victoria Sharp, MD17. (1) Multnomah County Health Department, 426 S.W. Stark St., Portland, OR 97204, 503-988-3056, jeffrey.d.capizzi@co.multnomah.or.us, (2) Columbia University, 600 West 168th St., New York, NY 10032, (3) Preventive Medicine, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 1240, Brooklyn, NY 11203, (4) Washington University School of Medicine, 660 S. Euclid, Campus box 8051, St. Louis, MO 63110, (5) Northern Manhattan Start Right Coalition, Columbia University, 60 Haven Avenue, Heilbrunn Center for Population and Family Health, New York, NY 10032, (6) Urban Health Study, Dept. of Family and Community Medicine, University of California, San Francisco, 3180 18th St. Suite 302, Campus Box 1304, San Francisco, CA 94110, (7) Mission Neighbor Health Center, 240 Shotwell Street, San Francisco, CA 94110, (8) Office of Special Populations, New York Academy of Medicine, 1216 Fifth Avenue, New York, NY 10029, (9) HIV/AIDS Bureau, Health Resources and Services Administration, US Department of Health and Human Services, 5600 Fishers, Lane, Room 7C-07, Rockville, MD 20857, (10) Office of the Medical Director, New York State Department of Health AIDS Institute, 5 Penn Plaza, New York, NY 10001, (11) North Broward Hospital District, 1625 SE 3rd Avenue, 5th Floor, Ft. Lauderdale, FL 33316, (12) AIDS Services Center, Inc., PO Box 1392, Anniston, AL 36202, (13) JSI Research and Training Institute, 44 Farnsworth Street, Boston, MA 02210, (14) Chase Brexton Health Services, Inc., 1001 Cathedral Street, Baltimore, MD 21201, (15) Harlem Hospital Center, Columbia University College of Physicians and Surgeons, 506 Lenox Avenue rm 3101-A, New York, NY 10037, (16) Johns Hopkins University School of Medicine, 1830 East Monument Street, Rm. 8059, Baltimore, MD 21287, (17) Center for Comprehensive Care, St. Luke's Roosevelt Hospital Center, 1000 Tenth Avenue, New York, NY 10019
Background: HRSA’s Special Projects of National Significance (SPNS) sponsored 14 sites to evaluate local antiretroviral adherence support interventions (i.e. peer programs and readiness training) and the New York Academy of Medicine to conduct a cross-site evaluation of these interventions. Because these SPNS sites differ in fundamental ways, a challenge to the ongoing cross-site evaluation is to control for differences to identify effective program components.
Objectives: Describe current models of HIV medication adherence interventions. Develop a taxonomy allowing comparison of adherence to antiretroviral medications and service provision in different adherence programs.
Methods: A taxonomy of adherence support models with key program variables was developed based on data from site visits and qualitative interviews with clients and providers at each of the SPNS sites. These data were used to identify intervention elements that will serve as co-variates in the cross-site analyses of client-level outcomes.
Results: Commonalties were found in the types of services offered, while the populations served and style of service integration varied across sites. The data were used to develop comparative adherence support models that varied on multiple dimensions: population served, specific adherence services, intervention focus, guiding theoretical models, secondary intervention effects and features reported by providers and clients to be most effective in enhancing adherence.
Conclusions: Cross-site evaluation requires a detailed examination of program-level variables and their influence on client-level outcomes. Although each program is unique, commonalties among the sites create the opportunity to compare program components and to pool adherence data across sites to produce interpretable results.
Learning Objectives:
Keywords: Adherence, HIV/AIDS
Related Web page: case.nyam.org
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.