Implementing Web-Based Interventions in HIV Primary Care Clinics: Pilot Implementation Evaluation of Positive Health...

Area of Science:

• Digital health interventions
• HIV primary care
• Implementation science

Background:

• Web-based interventions show promise for improving outcomes in people with HIV.
• Integrating digital tools into HIV clinics faces implementation challenges.
• Clinician perspectives on feasibility are crucial for adoption.

Purpose of the Study:

• To assess the acceptability, appropriateness, and feasibility of the Positive Health Check (PHC) web-based tool for HIV primary care staff.
• To evaluate PHC's integration into existing clinic workflows.

Main Methods:

• Multiple-case study of PHC pilot implementation in four US primary care clinics.
• Structured interviews with nine clinic staff before, during, and after implementation (n=54).
• Analysis of patient intervention use metrics (n=104) and completion rates (n=68).

Main Results:

• Clinicians found PHC acceptable and appropriate, noting its potential to enhance provider-patient communication and patient engagement.
• The tailored, interactive design of PHC contributed to patient engagement.
• Feasibility was generally good, though workflow and physical environment adjustments were necessary.

Conclusions:

• HIV clinic staff perceived the Positive Health Check intervention as acceptable and appropriate.
• Implementation feasibility presented challenges requiring clinic-specific management strategies.
• Lessons learned can inform larger trials assessing both implementation and clinical outcomes.