Provider Reports on the Ability to Implement Changes in Practice Following HIV-HCV Training

Abstract

The increased mortality among persons co-infected with HIV/AIDS and hepatitis C (HCV) is a concern that provider training on HCV-HIV co-infection may address. Medical and behavioral health providers were given training on co-infection. This study addresses two research questions: What changes, if any, did providers seek to effect in their practice after training? Of those providers desiring change in their practice, which, if any, did they implement? Surveys indicated that 82% planned to change their practice. Of those, 51% were reached 3 months later, and of those, 86% reported having enacted a change. Qualitative analysis found that planned changes fell into two domains: HCV Education and HCV Medical Actions. The most frequently intended and enacted changes involved patient education. Barriers to enact changes included lack of colleague support for HCV treatment and inadequate access to hepatitis A/B vaccine. Training on HIV-HCV co-infection should: engage multiple providers from the same site; address HCV treatment side effects; and support systems changes targeting vaccine and testing availability.

KEYWORDS:

• behavior change
• hepatitis C
• HIV
• medical providers
• training

This work was funded by a grant from the Healthy Community Access Program (HCAP) of the Bureau of Primary Health Care of the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (G92CSO2237-02-02).

We are grateful to the study's co-principal investigator, Beth Stringfield, for her establishment of an intervention training arm and her support for this research. We thank Rachel Blouin for assistance with instrument development and data collection, and to all of the providers who took the time to participate in this study.

Notes

^a One participant was a manager who could not be classified as either a BHP or medical provider. This participant had a single response regarding planning for more HCV training.

^a One participant was a manager who could not be classified as either a BHP or MP. This participant had a single response regarding planning for more HCV training.

^b “Gap” indicates the difference in the number of providers who intended to enact versus reported enacting the change (No. enacting minus No. intending).