Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique.
Identifieur interne : 000A08 ( PubMed/Curation ); précédent : 000A07; suivant : 000A09Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique.
Auteurs : Carolyn M. Audet [États-Unis] ; José Salato [Mozambique] ; Sten H. Vermund [États-Unis] ; K Rivet Amico [États-Unis]Source :
- Implementation science : IS [ 1748-5908 ] ; 2017.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Antiviraux (usage thérapeutique), Femelle, Humains, Infections à VIH (), Infections à VIH (traitement médicamenteux), Jeune adulte, Mozambique, Mâle, Médecine traditionnelle africaine (), Observance thérapeutique (), Population rurale, Services de santé communautaires, Soutien social, Évaluation de programme.
- MESH :
- traitement médicamenteux : Infections à VIH.
- usage thérapeutique : Antiviraux.
- Adulte, Adulte d'âge moyen, Femelle, Humains, Infections à VIH, Jeune adulte, Mozambique, Mâle, Médecine traditionnelle africaine, Observance thérapeutique, Population rurale, Services de santé communautaires, Soutien social, Évaluation de programme.
English descriptors
- KwdEn :
- Adult, Antiviral Agents (therapeutic use), Community Health Services, Female, HIV Infections (drug therapy), HIV Infections (therapy), Humans, Male, Medicine, African Traditional (methods), Middle Aged, Mozambique, Patient Compliance (statistics & numerical data), Program Evaluation, Rural Population, Social Support, Young Adult.
- MESH :
- chemical , therapeutic use : Antiviral Agents.
- drug therapy : HIV Infections.
- methods : Medicine, African Traditional.
- statistics & numerical data : Patient Compliance.
- therapy : HIV Infections.
- Adult, Community Health Services, Female, Humans, Male, Middle Aged, Mozambique, Program Evaluation, Rural Population, Social Support, Young Adult.
Abstract
Systematic adaptation of evidence-informed interventions that increase retention in care and improve adherence to antiretroviral therapy (ART) are essential to ending the HIV epidemic in rural sub-Saharan Africa. We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system.
DOI: 10.1186/s13012-017-0582-z
PubMed: 28407813
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We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28407813</PMID><DateCreated><Year>2017</Year><Month>04</Month><Day>14</Day></DateCreated><DateCompleted><Year>2017</Year><Month>11</Month><Day>02</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>09</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1748-5908</ISSN><JournalIssue CitedMedium="Internet"><Volume>12</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>04</Month><Day>13</Day></PubDate></JournalIssue><Title>Implementation science : IS</Title><ISOAbbreviation>Implement Sci</ISOAbbreviation></Journal><ArticleTitle>Adapting an adherence support workers intervention: engaging traditional healers as adherence partners for persons enrolled in HIV care and treatment in rural Mozambique.</ArticleTitle><Pagination><MedlinePgn>50</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13012-017-0582-z</ELocationID><Abstract><AbstractText Label="BACKGROUND">Systematic adaptation of evidence-informed interventions that increase retention in care and improve adherence to antiretroviral therapy (ART) are essential to ending the HIV epidemic in rural sub-Saharan Africa. We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system.</AbstractText><AbstractText Label="METHODS">Adaption followed a theoretically driven approach to intervention adaption: the Assessment-Decision-Administration-Production-Topical Experts-Integration-Training-Testing (ADAPT-ITT) model. Three rounds of performance feedback, based on theater presentations of the adapted intervention for stakeholders and idea generation, were completed with 12 groups from March to July 2016 to develop the final model. We offered healer support to 180 newly diagnosed HIV-infected patients.</AbstractText><AbstractText Label="RESULTS">Traditional healers were an acceptable group of community health workers to assist with patient adherence and retention. Traditional healers, clinicians, and interested community members suggested novel strategies to tailor the adherence support worker intervention, revealing a local culture of HIV denialism, aversion to the health system, and dislike of healthcare providers, as well as a preference for traditional treatments. Proposed changes to the intervention included modifications to the training language and topics, expanded community-based activities to support acceptability of an HIV diagnosis and to facilitate partner disclosure, and accompaniment to the health facility by healers to encourage delivery of respectful clinical care. PLHIV, healers, and clinicians deemed the intervention socially acceptable during focus groups. We subsequently recruited 180 newly diagnosed HIV-infected patients into the program: 170 (94%) accepted.</AbstractText><AbstractText Label="CONCLUSIONS">Systematic translation of interventions, even between regions with similar social and economic environments, is an important first step to successful program implementation. Efforts previously limited to community health workers can be tailored for use by traditional healers-an underutilized and often maligned health workforce. It proved feasible to use theater-based performances to demonstrate delivery of the intervention in low-literacy populations, generating discussions about social norms, community concerns, and the merits of an acceptable strategy to improve retention and adherence to ART.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Audet</LastName><ForeName>Carolyn M</ForeName><Initials>CM</Initials><AffiliationInfo><Affiliation>Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA. carolyn.m.audet@vanderbilt.edu.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Departments of Health Policy, Vanderbilt University Medical Center, Nashville, TN, USA. carolyn.m.audet@vanderbilt.edu.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Salato</LastName><ForeName>José</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Friends in Global Health, Quelimane, Mozambique.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Friends in Global Health, Maputo, Mozambique.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vermund</LastName><ForeName>Sten H</ForeName><Initials>SH</Initials><AffiliationInfo><Affiliation>Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Departments of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Amico</LastName><ForeName>K Rivet</ForeName><Initials>KR</Initials><AffiliationInfo><Affiliation>Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>K01 MH107255</GrantID><Acronym>MH</Acronym><Agency>NIMH NIH HHS</Agency><Country>United States</Country></Grant><Grant><GrantID>P30 AI110527</GrantID><Acronym>AI</Acronym><Agency>NIAID NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D052061">Research Support, N.I.H., Extramural</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>04</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Implement Sci</MedlineTA><NlmUniqueID>101258411</NlmUniqueID><ISSNLinking>1748-5908</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000998">Antiviral Agents</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections 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adaptation</Keyword><Keyword MajorTopicYN="Y">Mozambique</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>08</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>04</Month><Day>06</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>4</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>4</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>11</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28407813</ArticleId><ArticleId IdType="doi">10.1186/s13012-017-0582-z</ArticleId><ArticleId IdType="pii">10.1186/s13012-017-0582-z</ArticleId><ArticleId 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