客户和提供者对艾滋病毒护理协调计划特征的偏好是否一致? 在瑞安·怀特 (Ryan White) 部分A资助的纽约市护理协调计划中进行的离散选择实验
Rebecca Zimba1,2, Chunki Fong3, Madellena Conte3,4
1Institute for Implementation Science in Population Health, City University of New York, Graduate School of Public Health and Health Policy, New York, New York, USA rebecca.zimba@sph.cuny.edu.
BMJ open
|June 24, 2025
概括
客户和提供者对艾滋病毒护理协调服务的偏好有很大差异. 客户更喜欢低强度的支持,而提供者更喜欢高强度的服务,突出了艾滋病毒护理计划中合作决策的需要.
科学领域:
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
- 艾滋病毒/艾滋病 护理 护理
背景情况:
- 纽约市 (NYC) 的艾滋病毒护理协调计划 (CCP) 旨在降低照顾艾滋病毒感染者 (PWH) 的障碍.
- 了解客户和提供商的偏好对于优化CCP服务至关重要.
研究的目的:
- 为了比较纽约市艾滋病毒护理协调计划的关键组成部分的客户和提供者的偏好.
- 识别客户和提供商之间所感知需求和所需服务强度的差异.
主要方法:
- 使用一个离散选择实验来评估对四个CPT属性的偏好:ART坚持支持,初级保健预约协助,非初级保健问题支持和访问模式.
- 在纽约市25个CPT站点对152个提供商和181个客户进行了调查.
- 使用属性级别的相对重要性和实用性来分析偏好,并比较分析访问位置和旅行时间.
主要成果:
- 客户优先考虑遵守抗逆转录病毒疗法 (ART) 的帮助,以及程序访问发生的地方 (更喜欢电话/视频等远程选项).
- 提供者优先考虑了除初级保健 (专科护理连接) 之外的其他问题的帮助,以及对ART (直接观察治疗) 坚持的帮助.
- 发现了人口统计方面的差异,客户一般年龄较大,提供者年龄较小,种族/民族构成不同.
结论:
- 客户和提供商的偏好在CPT服务强度方面存在显著差异.
- 客户通常倾向于低强度服务,而提供商倾向于支持高强度干预.
- 让客户作为计划设计的合作伙伴参与,对于将服务与他们的价值观保持一致和改善护理参与是必不可少的.
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