METHODS: We conducted a sequential explanatory mixed methods study. In the quantitative strand, we administered a survey to health workers who provide care to PLH to identify barriers and facilitators. In the qualitative strand, we conducted in-depth interviews informed by the theoretical domains framework (TDF) with health workers and with PLH to explain our quantitative findings. Qualitative and quantitative data were merged to create meta-inferences.
RESULTS: Twenty health workers from 8 clinics in 9 cities in Ontario took the survey. Nine PLH and 10 health workers participated in the qualitative interviews. Clinics in Ontario implemented all the effective interventions identified from the literature for initiation of treatment, adherence to ART, and retention in care despite concerns about resources. Barriers to physical and financial access to care, the workload for tailored care, and expertise were identified by both health workers and PLH. Key facilitators were virtual care and client preparedness through education and peer support.
CONCLUSIONS: Clinics in Ontario appear to implement several evidence-based strategies to improve PLH engagement. There is a need for more health workers with skills to address unique PLH needs. Virtual care is beneficial to both health workers and PLH.
方法:我们进行了一项连续的解释性混合方法研究。在定量链中,我们对向PLH提供护理的卫生工作者进行了一项调查,以确定障碍和促进者.在定性链中,我们根据理论领域框架(TDF)对卫生工作者和PLH进行了深入访谈,以解释我们的定量结果.将定性和定量数据合并以创建元推断。
结果:来自安大略省9个城市的8个诊所的20名卫生工作者参加了这项调查。9名PLH和10名卫生工作者参加了定性访谈。安大略省的诊所实施了从文献中确定的所有有效干预措施,用于开始治疗,坚持ART,尽管担心资源,但仍保留在护理中。物理和财务上获得护理的障碍,定制护理的工作量,卫生工作者和PLH都确定了专业知识。主要促进者是通过教育和同伴支持进行虚拟护理和客户准备。
结论:安大略省的诊所似乎实施了几种基于证据的策略来提高PLH参与度。需要更多具有技能的卫生工作者来满足独特的PLH需求。虚拟护理对卫生工作者和PLH都有益。