scholarly journals Adapting a community-based ART delivery model to the patients’ needs: a mixed methods research in Tete, Mozambique

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Freya Rasschaert ◽  
Tom Decroo ◽  
Daniel Remartinez ◽  
Barbara Telfer ◽  
Faustino Lessitala ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Research ◽  
Community Based ◽  
Delivery Model ◽  
Community Based Art ◽  
Art Delivery

scholarly journals Alcohol consumption increases non-adherence to ART among people living with HIV enrolled to the community-based care model in rural northern Uganda

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242801
Author(s):  
Norbert Adrawa ◽  
John Bosco Alege ◽  
Jonathan Izudi
Keyword(s):  
Alcohol Consumption ◽  
Psychosocial Support ◽  
Statistical Significance ◽  
Binary Logistic Regression Analysis ◽  
Northern Uganda ◽  
People Living With Hiv ◽  
Community Based ◽  
Delivery Model ◽  
Community Based Art ◽  
Art Delivery

Background Non-adherence to anti-retroviral therapy (ART) is associated with considerable morbidity and mortality among people living with Human Immunodeficiency Virus (PLHIV). Community-based ART delivery model offers a decentralized and patient-centered approach to care for PLHIV, with the advantage of improved adherence to ART hence good treatment outcomes. However, data are limited on the magnitude of non-adherence to ART among PLHIV enrolled to the community-based ART model of care. In this study, we determined the frequency of non-adherence to ART and the associated factors among PLHIV enrolled to the community-based ART delivery model in a large health facility in rural northern Uganda. Methods This analytic cross-sectional study randomly sampled participants from 21 community drug distribution points at the AIDS Support Organization (TASO) in Gulu district, northern Uganda. Data were collected using a standardized and pre-tested questionnaire, entered in Epi-Data and analyzed in Stata at univariate, bivariate, and multivariate analyses levels. Binary logistic regression analysis was used to determine factors independently associated with non-adherence to ART, reported using odds ratio (OR) and 95% confidence level (CI). The level of statistical significance was 5%. Results Of 381 participants, 25 (6.6%) were non-adherent to ART and this was significantly associated with alcohol consumption (Adjusted (aOR), 3.24; 95% CI, 1.24–8.34). Other factors namely being single/or never married (aOR, 1.97; 95% CI, 0.62–6.25), monthly income exceeding 27 dollars (aOR, 1.36; 95% CI, 0.52–3.55), being on ART for more than 5 years (aOR, 0.60; 95% CI, 0.23–1.59), receipt of health education on ART side effects (aOR, 0.36; 95% CI, 0.12–1.05), and disclosure of HIV status (aOR, 0.37; 95% CI, 0.04–3.20) were not associated with non-adherence in this setting. Conclusion Non-adherence to ART was low among PLHIV enrolled to community-based ART delivery model but increases with alcohol consumption. Accordingly, psychosocial support programs should focus on alcohol consumption.

Expanding the Transformative Explanatory Sequential Mixed Methods Design Archetype in a Cross-Cultural Context: The Polemics of African Refugee Livelihoods in Places of Resettlement

2020 ◽  
pp. 155868982093637
Author(s):  
Arati Maleku ◽  
Youn Kyoung Kim ◽  
Njeri Kagotho ◽  
Younghee Lim
Keyword(s):  
Mixed Methods ◽  
Participatory Research ◽  
Cultural Context ◽  
Mixed Methods Research ◽  
Community Based Participatory Research ◽  
Cross Cultural ◽  
Mixed Methods Design ◽  
Community Based ◽  
Sequential Mixed Methods ◽  
African Refugee

Transformative sequential mixed methods design in a cross-cultural context is seldom straightforward. Using a community-based participatory research approach as the transformative lens in an African refugee context in the southern United Status, we explored: (a) the intersection of culture, financial stress, and financial self-efficacy and (b) tested the efficacy of financial literacy as the focus of a culturally responsive solution grounded in community-identified priorities. Through a three-phased explanatory sequential mixed methods design, we demonstrate how the addition of a third phase of analysis that focuses on convergence and expansion of quantitative and qualitative data integration and cyclical processes of dissemination and action can strengthen the utility of transformative mixed methods research in a cross-cultural context. Our study offers a unique contribution to the long-standing methodological dialogue between the design elements of mixed methods research, community-based participatory research, and migration studies by expanding the transformative explanatory sequential design archetype in a cross-cultural context.

scholarly journals Acceptability of point-of-care viral load testing to facilitate differentiated care: a qualitative assessment of people living with HIV and nurses in South Africa

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Lindani Msimango ◽  
Andrew Gibbs ◽  
Hlengiwe Shozi ◽  
Hope Ngobese ◽  
Hilton Humphries ◽  
...  
Keyword(s):  
Point Of Care ◽  
Task Shifting ◽  
People Living With Hiv ◽  
Community Based ◽  
Community Based Art ◽  
Professional Nurses ◽  
Living With Hiv ◽  
Differentiated Care ◽  
Art Delivery ◽  
And Task

Abstract Background Providing viral load (VL) results to people living with HIV (PLHIV) on antiretroviral therapy (ART) remains a challenge in low and middle-income countries. Point-of-care (POC) VL testing could improve ART monitoring and the quality and efficiency of differentiated models of HIV care. We assessed the acceptability of POC VL testing within a differentiated care model that involved task-shifting from professional nurses to less highly-trained enrolled nurses, and an option of collecting treatment from a community-based ART delivery programme. Methods We undertook a qualitative sub-study amongst clients on ART and nurses within the STREAM study, a randomized controlled trial of POC VL testing and task-shifting in Durban, South Africa. Between March and August 2018, we conducted 33 semi-structured interviews with clients, professional and enrolled nurses and 4 focus group discussions with clients. Interviews and focus groups were audio recorded, transcribed, translated and thematically analysed. Results Amongst 55 clients on ART (median age 31, 56% women) and 8 nurses (median age 39, 75% women), POC VL testing and task-shifting to enrolled nurses was acceptable. Both clients and providers reported that POC VL testing yielded practical benefits for PLHIV by reducing the number of clinic visits, saving time, travel costs and days off work. Receiving same-day POC VL results encouraged adherence amongst clients, by enabling them to see immediately if they were ‘good’ or ‘bad’ adherers and enabled quick referrals to a community-based ART delivery programme for those with viral suppression. However, there was some concern regarding the impact of POC VL testing on clinic flows when implemented in busy public-sector clinics. Regarding task-shifting, nurses felt that, with extra training, enrolled nurses could help decongest healthcare facilities by quickly issuing ART to stable clients. Clients could not easily distinguish enrolled nurses from professional nurses, instead they highlighted the importance of friendliness, respect and good communication between clients and nurses. Conclusions POC VL testing combined with task-shifting was acceptable to clients and healthcare providers. Implementation of POC VL testing and task shifting within differentiated care models may help achieve international treatment targets. Trial registration NCT03066128, registered 22/02/2017.

Designing community-based mixed methods research.

2012 ◽  
pp. 41-59 ◽  
Author(s):  
Manijeh Badiee ◽  
Sherry C. Wang ◽  
John W. Creswell
Keyword(s):  
Mixed Methods ◽  
Mixed Methods Research ◽  
Community Based

Addressing Youth-Focused Research Questions in a Community Context: Collecting and Integrating Mixed Methods Data at Multiple Ecological Levels With the PhotoStories Project

2020 ◽  
pp. 155868982097291
Author(s):  
Amanda NeMoyer ◽  
Kiara Alvarez ◽  
Ravali Mukthineni ◽  
Shalini Tendulkar ◽  
Margarita Alegría
Keyword(s):  
Social Justice ◽  
Mixed Methods ◽  
Mixed Methods Research ◽  
Well Being ◽  
Lessons Learned ◽  
Community Context ◽  
Marginalized Youth ◽  
Community Based ◽  
Real World Application ◽  
Research Designs

Research seeking to understand and improve social conditions for marginalized youth would benefit from merging complex mixed methods research designs emphasizing multilevel data and participatory social justice principles. We contribute to mixed methods research by introducing a novel framework that accomplishes this task and by illustrating its real-world application via PhotoStories, a multistage study aimed at understanding youths’ community-based experiences and emotional well-being. During the project’s three phases (preparation, training, and dissemination) we obtained and integrated quantitative and qualitative data at multiple ecological levels. Additionally, we examined youth perceptions about their participation, an important outcome given our focus on participatory social justice. We also provide lessons learned and recommendations for investigators seeking to use a similar approach for youth-focused research.

Intersection of Mixed Methods and Community-Based Participatory Research: A Methodological Review

2018 ◽  
Vol 13 (4) ◽  
pp. 481-502 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Robin Lindquist-Grantz ◽  
Sinem Toraman ◽  
Kristen Haddad ◽  
Lisa M. Vaughn
Keyword(s):  
Mixed Methods ◽  
Participatory Research ◽  
Mixed Methods Research ◽  
Community Based Participatory Research ◽  
Community Based ◽  
Methodological Review ◽  
Research Findings ◽  
Research Questions ◽  
Advanced Applications

Although mixed methods research (MMR) and community-based participatory research (CBPR) have been employed to investigate complex research questions to improve the reach, rigor, and relevance of research, little is understood about the intersection of the approaches. We conducted a methodological review of studies ( n = 129) using both MMR and CBPR, an advanced application we refer to as mixed methods community-based participatory research (MMCBPR). We systematically examined published MMCBPR studies to identify the methodological features and use in current research. Findings demonstrate that the components of MMR were not adequately described although some detail was provided about the use of CBPR. This study contributes to the evolution of advanced applications, and we offer recommendations for future applications of MMCBPR.

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