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BMC Health Serv Res ; 24(1): 101, 2024 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-38238697


BACKGROUND: Alabama is one of seven priority states for the National Ending the HIV Epidemic Initiative due to a disproportionate burden of rural infections. To reverse growing infection rates, the state must increase its focus on prevention efforts, including novel strategies. One such approach is to utilize dashboards that visualize real-time data on the pre-exposure prophylaxis (PrEP) care continuum to assist in prioritizing evidence-based preventative care for those most vulnerable for HIV infection. METHODS: We conducted a mixed methods evaluation to ascertain stakeholders' perceptions on the acceptability, feasibility, appropriateness, and usability of a PrEP care continuum dashboard, as well as gain insight on ways to improve the activities necessary to sustain it. Clinicians, administrators, and data personnel from participating sites in Alabama completed surveys (n = 9) and participated in key informant interviews (n = 10) to better understand their experiences with the prototype data dashboard and to share feedback on how it can be modified to best fit their needs. RESULTS: Surveys and interviews revealed that all participants find the pilot data dashboard to be an acceptable, feasible, and appropriate intervention for clinic use. Overall, stakeholders find the pilot dashboard to be usable and helpful in administrative efforts, such as report and grant writing; however, additional refining is needed in order to reduce burden and optimize usefulness. Participants voiced concerns about their site's abilities to sustain the dashboard, including the lack of systematized PrEP protocols and limited funds and staff time dedicated to PrEP data collection, cleaning, and upload. CONCLUSION: Study participants from clinics providing HIV prevention services, including PrEP, in Alabama voiced interest in sustaining and refining a data dashboard that tracks clients across the PrEP care continuum. Despite viewing the platform itself as an acceptable, feasible, and appropriate intervention, participants agreed that efforts need to be focused on standardizing PrEP data collection protocols in order to ensure consistent, accurate data capture and that limited funds and staff time are barriers to the sustained implementation of the dashboard in practice.

Síndrome de Imunodeficiência Adquirida , Fármacos Anti-HIV , Infecções por HIV , Profilaxia Pré-Exposição , Humanos , Infecções por HIV/prevenção & controle , Infecções por HIV/tratamento farmacológico , Estudos de Viabilidade , Fármacos Anti-HIV/uso terapêutico , Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Sudeste dos Estados Unidos , Profilaxia Pré-Exposição/métodos
J Acquir Immune Defic Syndr ; 94(2S): S99-S107, 2023 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-37707856


BACKGROUND: Using the Asset Bundle Model, we sought to understand the social support assets and needs of underrepresented minority (URM) high school, undergraduate, and graduate students. SETTING: Study participants were or had participated in health sciences pathway programs at Birmingham City Schools and/or the University of Alabama at Birmingham. METHODS: We took a concurrent mixed methods approach to conduct an environmental scan of health science pathway programs in the Birmingham, AL area. Four focus groups were conducted between November 2022 and January 2023, and a 225-item online survey was administered between November 4, 2022, and February 4, 2023. Both tools collected data from high school, undergraduate, and graduate students to examine key components of existing health care pathways programs for URMs and identify barriers and facilitators to successful implementation of such programs. RESULTS: Twenty-two students participated in the focus groups, and 168 individuals responded to the survey. Both focus group participants and interview respondents were primarily URMs (eg, 68.2% and 65.7% identified as Black or African American, respectively). Survey responses and focus group discussions showed that, overall, undergraduate and graduate students programs develop more robust identities as future health care professionals through friendships and institutional supports, expand their networks more broadly through mentorship, and feel more supported by family members in their academic endeavors than high school students. CONCLUSIONS: Health science pathway programs for URMs should facilitate and bolster social supports for students, especially those in high school, to enhance persistence through education and into the workforce.

Infecções por HIV , Humanos , Alabama , Estudantes , Escolaridade , Apoio Social
Drug Alcohol Depend ; 244: 109777, 2023 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-36680808


INTRODUCTION: Buprenorphine can only be prescribed for opioid use disorder (OUD) by providers with a Controlled Substance Act waiver (X waiver) from the Substance Abuse and Mental Health Services Administration. This study examines what motivates physicians to become X waivered, as well as what facilitates and hinders physicians' abilities to prescribe buprenorphine to people with OUD. METHODS: This is a qualitative study of physicians in Birmingham, Alabama. We recruited physicians from the University of Alabama at Birmingham and Cahaba Medical Care to participate in semi-structured interviews and used a Framework-guided Rapid Qualitative Analysis technique to analyze the transcripts for themes aligned with the Social Cognitive Theory. RESULTS: A total of 27 physicians were interviewed between December 15th, 2021 and July 21st, 2022. The vast majority reported seeking to obtain an X waiver when their employers encouraged or mandated it. Most providers reported being eager to become waivered when first asked by their employers, while a few described some hesitancies. Essentially all participants agreed that having mentors is important when first prescribing buprenorphine and that support from social workers and counselors is needed. Most physicians discussed how stigma, administrative barriers, and a lack of community resources hinder buprenorphine prescription. CONCLUSIONS: Our findings suggest that employers are effective in encouraging X waiver certification and mentors and allied health professionals are important in ensuring providers continue buprenorphine prescription. Additionally, it is critical to address challenges to successful buprenorphine prescription, like stigma and administrative barriers.

Buprenorfina , Transtornos Relacionados ao Uso de Opioides , Médicos , Humanos , Buprenorfina/uso terapêutico , Tratamento de Substituição de Opiáceos , Motivação , Padrões de Prática Médica , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Prescrições de Medicamentos