An EMR-based alert with brief provider-led ART adherence counseling in Haiti: effects on information, motivation, and behavioral skills (IMB) and patient-provider communication (PPC)

ABSTRACT

We examined the secondary effects of an antiretroviral therapy (ART) adherence intervention on information, motivation, and behavioral skills (IMB) and patient-provider communication (PPC). Data were from a sample of 116 patients enrolled in a quasi-experimental mixed-methods study at two large ART clinics in Haiti. We examined changes in IMB and PPC scores after the intervention and the association between baseline PPC and endline IMB.

The intervention was associated with increased scores in information (ß = 0.89, 95% CI [0.07, 1.70]) and motivation (ß = 2.55, 95% CI [0.38, 4.72]) but a decreased score in behavioral skills (ß = –2.39, 95% CI [–4.29, –0.49]), after controlling for demographic and clinical variables. Baseline PPC was associated with higher endline IMB total scores (ß = 0.17, 95% CI [0.02, 0.31]), controlling for demographic variables, clinical variables, and baseline IMB score. At the subscale level, baseline PPC was associated with higher endline motivation score (ß = 0.09, 95% CI [0.01, 0.17]), marginally associated with higher endline information score (ß = 0.04, 95% CI [0.00, 0.08]), after controlling for demographic and clinical variables.

The intervention was beneficial to patients’ adherence related motivation. Favorable patient-provider communication is associated with more motivation to adhere to ART.

KEYWORDS:

• Haiti
• HIV
• antiretroviral therapy
• adherence
• information
• motivation
• and behavioral skills (IMB)
• patient-provider communication (PPC)

Acknowledgements

The authors would like to acknowledge the participation of clinic patients and assistance from the clinic staff.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research was supported by NIH grants 5R34MH112378 and AI027757. MKR was funded through NIH [F31MH122034; years 2019–2021].