Online Program

Linkage to Care Specialists: Lessons learned during implementation of an intensive patient navigation program in Wisconsin

Sunday, November 1, 2015

Michelle Broaddus, PhD, Center for AIDS Intervention Research, Medical College of Wisconsin, Milwaukee, WI
Issues: Only half of people living with HIV/AIDS (PLWHA) in Wisconsin as of the end of 2011 were engaged in HIV medical care.

Description: Wisconsin’s Linkage to Care intervention, implemented by the Wisconsin Department of Health Services, is designed to increase linkage and retention in HIV-related medical care among PLWHA in Wisconsin’s areas of highest prevalence and incidence. Full-time “Linkage to Care Specialists” were hired in HIV medical clinics and community-based organizations to work with small caseloads of clients who have active or potential barriers preventing them from engaging in HIV medical care. They provide intensive, short-term support (6-9 months), addressing barriers to care through provision and coordination of services, referrals and appointments, attending appointments with clients, and navigation of health care systems.

Lessons Learned: During the pilot phase of the project, Specialists indicated the need for a well-defined protocol, especially given initial role confusion and the important distinction between Specialists and existing case managers, and necessary changes to the program that may have not been understood by clients. Specialists indicated during the implementation phase that the program’s strengths included Specialists’ flexibility to provide intensive, patient-centered care and personalized social support. However, clients are therefore resistant to discharge due to the relationship built.

Recommendations: Qualitative and quantitative analysis of effectiveness is currently being conducted. Preliminary evidence of success indicates the potential benefit of incorporating short-term, intensive intervention for some high-need clients within the existing case management system. Smooth transitions to long-term case management will be imperative for sustainability.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the lessons learned from implementation of an intensive patient navigation intervention designed to increase engagement in medical care for people living with HIV in Wisconsin.

Keyword(s): Case Management, HIV Interventions

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am currently conducting the qualitative evaluation of the Wisconsin Linkage to Care Program described in this abstract, and have been involved in research into HIV prevention and care for over ten years.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.