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Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

BACKGROUND: A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programmin...

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Autores principales: Harding, Richard, Simms, Victoria, Penfold, Suzanne, McCrone, Paul, Moreland, Scott, Downing, Julia, Powell, Richard A, Mwangi-Powell, Faith, Namisango, Eve, Fayers, Peter, Curtis, Siân, Higginson, Irene J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955697/
https://www.ncbi.nlm.nih.gov/pubmed/20920241
http://dx.doi.org/10.1186/1471-2458-10-584
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author Harding, Richard
Simms, Victoria
Penfold, Suzanne
McCrone, Paul
Moreland, Scott
Downing, Julia
Powell, Richard A
Mwangi-Powell, Faith
Namisango, Eve
Fayers, Peter
Curtis, Siân
Higginson, Irene J
author_facet Harding, Richard
Simms, Victoria
Penfold, Suzanne
McCrone, Paul
Moreland, Scott
Downing, Julia
Powell, Richard A
Mwangi-Powell, Faith
Namisango, Eve
Fayers, Peter
Curtis, Siân
Higginson, Irene J
author_sort Harding, Richard
collection PubMed
description BACKGROUND: A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. METHODS/DESIGN: This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1) To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2) To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1) To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1) in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2) To conduct patient focus group discussions at each of these (Phase 1) to determine care received. 3) To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2). 4) To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2). 5) To undertake document analysis to appraise the clinical care procedures at each facility (Phase 2). 6) To determine principle cost drivers including staff, overhead and laboratory costs (Phase 2). DISCUSSION: This novel mixed methods protocol will permit transparent presentation of subsequent dataset results publication, and offers a substantive model of protocol design to measure and integrate key activities and outcomes that underpin a public health approach to disease management in a low-income setting.
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spelling pubmed-29556972010-10-16 Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol Harding, Richard Simms, Victoria Penfold, Suzanne McCrone, Paul Moreland, Scott Downing, Julia Powell, Richard A Mwangi-Powell, Faith Namisango, Eve Fayers, Peter Curtis, Siân Higginson, Irene J BMC Public Health Study Protocol BACKGROUND: A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. METHODS/DESIGN: This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1) To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2) To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1) To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1) in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2) To conduct patient focus group discussions at each of these (Phase 1) to determine care received. 3) To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2). 4) To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2). 5) To undertake document analysis to appraise the clinical care procedures at each facility (Phase 2). 6) To determine principle cost drivers including staff, overhead and laboratory costs (Phase 2). DISCUSSION: This novel mixed methods protocol will permit transparent presentation of subsequent dataset results publication, and offers a substantive model of protocol design to measure and integrate key activities and outcomes that underpin a public health approach to disease management in a low-income setting. BioMed Central 2010-09-29 /pmc/articles/PMC2955697/ /pubmed/20920241 http://dx.doi.org/10.1186/1471-2458-10-584 Text en Copyright ©2010 Harding et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Study Protocol
Harding, Richard
Simms, Victoria
Penfold, Suzanne
McCrone, Paul
Moreland, Scott
Downing, Julia
Powell, Richard A
Mwangi-Powell, Faith
Namisango, Eve
Fayers, Peter
Curtis, Siân
Higginson, Irene J
Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title_full Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title_fullStr Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title_full_unstemmed Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title_short Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol
title_sort multi-centred mixed-methods pepfar hiv care & support public health evaluation: study protocol
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955697/
https://www.ncbi.nlm.nih.gov/pubmed/20920241
http://dx.doi.org/10.1186/1471-2458-10-584
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