Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa
Identifieur interne : 000C86 ( Main/Exploration ); précédent : 000C85; suivant : 000C87Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa
Auteurs : Edwin Wouters [Belgique, Afrique du Sud] ; Frederik Le Roux Booysen [Afrique du Sud] ; Caroline Masquillier [Belgique]Source :
- PLoS ONE [ 1932-6203 ] ; 2016.
Abstract
Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors—such as age, health status and coping styles—our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family’s changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level.
Url:
DOI: 10.1371/journal.pone.0163963
PubMed: 27741239
PubMed Central: 5065171
Affiliations:
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The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa</title><author><name sortKey="Wouters, Edwin" sort="Wouters, Edwin" uniqKey="Wouters E" first="Edwin" last="Wouters">Edwin Wouters</name><affiliation wicri:level="4"><nlm:aff id="aff001"><addr-line>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Health Systems Research and Development, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Booysen, Frederik Le Roux" sort="Booysen, Frederik Le Roux" uniqKey="Booysen F" first="Frederik Le Roux" last="Booysen">Frederik Le Roux Booysen</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Economics, University of the Free State, Bloemfontein, Republic of South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Department of Economics, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Masquillier, Caroline" sort="Masquillier, Caroline" uniqKey="Masquillier C" first="Caroline" last="Masquillier">Caroline Masquillier</name><affiliation wicri:level="4"><nlm:aff id="aff001"><addr-line>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27741239</idno><idno type="pmc">5065171</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5065171</idno><idno type="RBID">PMC:5065171</idno><idno type="doi">10.1371/journal.pone.0163963</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">002920</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002920</idno><idno type="wicri:Area/Pmc/Curation">002919</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002919</idno><idno type="wicri:Area/Pmc/Checkpoint">000373</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000373</idno><idno type="wicri:Area/Ncbi/Merge">003A73</idno><idno type="wicri:Area/Ncbi/Curation">003A73</idno><idno type="wicri:Area/Ncbi/Checkpoint">003A73</idno><idno type="wicri:Area/Main/Merge">000C86</idno><idno type="wicri:Area/Main/Curation">000C86</idno><idno type="wicri:Area/Main/Exploration">000C86</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Who Should We Target? The Impact of Individual and Family Characteristics on the Expressed Need for Community-Based Treatment Support in HIV Patients in South Africa</title><author><name sortKey="Wouters, Edwin" sort="Wouters, Edwin" uniqKey="Wouters E" first="Edwin" last="Wouters">Edwin Wouters</name><affiliation wicri:level="4"><nlm:aff id="aff001"><addr-line>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation><affiliation wicri:level="1"><nlm:aff id="aff002"><addr-line>Centre for Health Systems Research and Development, University of the Free State, Bloemfontein, Republic of South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Centre for Health Systems Research and Development, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Booysen, Frederik Le Roux" sort="Booysen, Frederik Le Roux" uniqKey="Booysen F" first="Frederik Le Roux" last="Booysen">Frederik Le Roux Booysen</name><affiliation wicri:level="1"><nlm:aff id="aff003"><addr-line>Department of Economics, University of the Free State, Bloemfontein, Republic of South Africa</addr-line></nlm:aff><country xml:lang="fr">Afrique du Sud</country><wicri:regionArea>Department of Economics, University of the Free State, Bloemfontein</wicri:regionArea><wicri:noRegion>Bloemfontein</wicri:noRegion></affiliation></author><author><name sortKey="Masquillier, Caroline" sort="Masquillier, Caroline" uniqKey="Masquillier C" first="Caroline" last="Masquillier">Caroline Masquillier</name><affiliation wicri:level="4"><nlm:aff id="aff001"><addr-line>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp, Belgium</addr-line></nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Sociology and Centre for Longitudinal and Life Course Studies, University of Antwerp, Antwerp</wicri:regionArea><orgName type="university">Université d'Anvers</orgName><placeName><settlement type="city">Anvers</settlement><region>Région flamande</region><region type="district" nuts="2">Province d'Anvers</region></placeName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Reviews of impact evaluations of community-based health workers and peer support groups highlight the considerable variability in the effectiveness of such support in improving antiretroviral treatment (ART) outcomes. Evidence indicates that community-based support interventions targeting patients known to be at risk will probably display better results than generic interventions aimed at the entire population of people living with HIV. It is however difficult to identify these at-risk populations, rendering knowledge on the characteristics of patients groups who are in need of community-based support a clear research priority. The current study aims to address the knowledge gap by exploring the predictors of the willingness to (1) receive the support from a community-based health worker or (2) to participate in a support group in public sector ART programme of the Free State Province of South Africa. Based on the Individual-Family-Community framework for HIV research, the study employs a comprehensive approach by not only testing classical individual-level but also family-level predictors of the willingness to receive community-based support. In addition to individual-level predictors—such as age, health status and coping styles—our analysis demonstrated the importance of family characteristics. The results indicated that discrepancies in the family’s changeability level were an important predictor of the demand for community-based support services. Conversely, the findings indicated that patients living in a family more flexible than deemed ideal are more likely to require the support of a community health worker. The current study expands theory by indicating the need to acknowledge all social ecological levels in the study of chronic HIV care. The detection of both individual level and family level determinants of the expressed need for community-based support can inform health policy to devise strategies to target scarce resources to those vulnerable patients who report the greatest need for this support. In this way, the study results are a first step in an attempt to move away from generic, broad based community-based interventions towards community support that is tailored to the patient needs at both the individual and family level.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Bor, J" uniqKey="Bor J">J Bor</name></author><author><name sortKey="Herbst, Aj" uniqKey="Herbst A">AJ Herbst</name></author><author><name sortKey="Newell, M L" uniqKey="Newell M">M-L Newell</name></author><author><name sortKey="B Rnighausen, T" uniqKey="B Rnighausen T">T Bärnighausen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Johnson, Lf" uniqKey="Johnson L">LF Johnson</name></author><author><name sortKey="Mossong, J" uniqKey="Mossong J">J Mossong</name></author><author><name sortKey="Dorrington, Re" uniqKey="Dorrington R">RE Dorrington</name></author><author><name sortKey="Schomaker, M" uniqKey="Schomaker M">M 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uniqKey="Catley D">D Catley</name></author><author><name sortKey="Berkley Patton, J" uniqKey="Berkley Patton J">J Berkley-Patton</name></author><author><name sortKey="Gerkovich, M" uniqKey="Gerkovich M">M Gerkovich</name></author><author><name sortKey="Williams, K" uniqKey="Williams K">K Williams</name></author><author><name sortKey="Banderas, J" uniqKey="Banderas J">J Banderas</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Talukdar, A" uniqKey="Talukdar A">A Talukdar</name></author><author><name sortKey="Talukdar, Ps" uniqKey="Talukdar P">PS Talukdar</name></author><author><name sortKey="Ghosal, Mk" uniqKey="Ghosal M">MK Ghosal</name></author><author><name sortKey="Bal, R" uniqKey="Bal R">R Bal</name></author><author><name sortKey="Ghosh, P" uniqKey="Ghosh P">P Ghosh</name></author><author><name sortKey="Goswami, Dn" uniqKey="Goswami D">DN Goswami</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Belgique</li></country><region><li>Province d'Anvers</li><li>Région flamande</li></region><settlement><li>Anvers</li></settlement><orgName><li>Université d'Anvers</li></orgName></list><tree><country name="Belgique"><region name="Région flamande"><name sortKey="Wouters, Edwin" sort="Wouters, Edwin" uniqKey="Wouters E" first="Edwin" last="Wouters">Edwin Wouters</name></region><name sortKey="Masquillier, Caroline" sort="Masquillier, Caroline" uniqKey="Masquillier C" first="Caroline" last="Masquillier">Caroline Masquillier</name></country><country name="Afrique du Sud"><noRegion><name sortKey="Wouters, Edwin" sort="Wouters, Edwin" uniqKey="Wouters E" first="Edwin" last="Wouters">Edwin Wouters</name></noRegion><name sortKey="Booysen, Frederik Le Roux" sort="Booysen, Frederik Le Roux" uniqKey="Booysen F" first="Frederik Le Roux" last="Booysen">Frederik Le Roux Booysen</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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