RESUMO
Although care coordination (CC; i.e., the organization of care activities between professionals to facilitate appropriate service delivery; McDonald et al., 2007) has yet to be studied extensively within schools, preliminary research suggests coordinating school mental health supports can be beneficial (Francis et al., 2021) and that interprofessional and interagency collaboration is warranted to meet student needs (McClain et al., 2022). We examined the perceptions of school mental health providers (SMHPs) regarding importance, quality, and engagement with within-district transition CC practices within a multitiered system of support framework. Participants were 163 SMHPs who endorsed being involved in designing, providing, or implementing mental health services in a U.S. school district. The three scales used to measure engagement with CC practices were based on the Care Coordination Measures Atlas (McDonald et al., 2014) and were found to have promising preliminary psychometrics. Descriptive statistics indicated SMHPs endorsed CC as very important but perceived school and district personnel to view it as less important, reported their own quality of CC was slightly above that of their school and district, and regularly engaged in broad CC practices. Moreover, bivariate correlations indicated SMHP's personal views of CC importance were not associated with the quality of school and district CC, yet engagement in broad CC activities was associated with transition facilitation practices, and attitudes about CC were associated with engagement in broad CC activities. Implications of findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
RESUMO
Economic strengthening interventions are needed to support HIV outcomes among persons living with HIV (PLWH). The Baton Rouge Positive Pathway Study (BRPPS), a mixed method implementation science study, was conducted to assess key RE-AIM components tied to the provision of conditional financial incentives among PLWH in Baton Rouge, Louisiana. Seven hundred and eighty-one (781) PLWH enrolled at four HIV clinic sites were included in the final analyses. Participants completed an initial baseline survey, viral load test, and were contacted at 6 and 12 months (±1 month) post-enrollment for follow-up labs to monitor viral load levels. Participants received up to USD140 in conditional financial incentives. The primary analyses assessed whether participation in the BRPPS was associated with an increase in the proportion of participants who were: (a) engaged in care, (b) retained in care and (c) virally suppressed at baseline to 6 and 12 months post-baseline. We constructed a longitudinal regression model where participant-level outcomes at times t0 (baseline) and t1 (6- or 12-month follow-up) were modeled as a function of time. A secondary analysis was conducted using single-level regression to examine which baseline characteristics were associated with the outcomes of interest at 12-month follow-up. Cost analyses were also conducted with three of the participating clinics. Most participants identified as Black/African American (89%). Fewer than half of participants reported that they were unemployed or made less than USD5000 annually (43%). Over time, the proportion of participants engaged in care and retained in care significantly increased (70% to 93% and 32% to 64%, p < 0.00). However, the proportion of virally suppressed participants decreased over time (59% to 34%, p < 0.00). Implementation costs across the three sites ranged from USD17,198.05 to USD396,910.00 and were associated with between 0.37 and 1.34 HIV transmissions averted at each site. Study findings provide promising evidence to suggest that conditional financial incentives could help support engagement and retention in HIV care for a high need and at risk for falling out of HIV care population.