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A Longitudinal Mixed-Methods Examination of Positive Health Check: Implementation Results From a Type 1

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Positive Health Check, an evidence-based intervention, improved HIV care outcomes. While fitting well in clinics, implementation climate fluctuated, requiring attention to engagement and priorities.

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Area of Science:

  • Implementation Science
  • Public Health
  • Clinical Interventions

Background:

  • Positive Health Check is an evidence-based video intervention for people with HIV.
  • It aims to improve medication adherence, retention in care, and viral load suppression.

Purpose of the Study:

  • To assess implementation constructs of the Positive Health Check intervention over 23 months.
  • To evaluate innovation-values fit, organizational readiness for change, and implementation climate.

Main Methods:

  • A type 1 hybrid trial with a mixed-methods approach was used.
  • Quantitative mixed-effects regression and qualitative analyses were conducted.
  • Three key implementation constructs were longitudinally assessed.

Main Results:

  • Innovation-values fit and organizational readiness for change remained high and stable.
  • A significant curvilinear change was observed in implementation climate over time.
  • Qualitative data indicated a decline in implementation climate due to reduced champion engagement and conflicting priorities.

Conclusions:

  • The Positive Health Check intervention is suitable for HIV primary care settings, though logistical challenges exist.
  • Significant, nonlinear changes in implementation climate are expected during effectiveness trials.
  • Sustained engagement and alignment of priorities are crucial for successful implementation.