Barriers and Facilitators to Enhancing HIV Testing in Publicly Funded Primary Care Clinics: Findings from San Francisco

2011 ◽  
Vol 23 (3_supplement) ◽  
pp. 84-95 ◽  
Author(s):  
Janet J. Myers ◽  
Kimberly A. Koester ◽  
Mi-Suk Kang Dufour
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
San Francisco ◽  
Barriers And Facilitators ◽  
Publicly Funded ◽  
Primary Care Clinics

Exploration of Barriers and Facilitators to Implementing Best Practice in Exercise Medicine in Primary Pediatric Care—Pediatrician Perspectives

2021 ◽  
pp. 1-8
Author(s):  
Kim D. Lu ◽  
Dan Cooper ◽  
Raluca Dubrowski ◽  
Melanie Barwick ◽  
Shlomit Radom-Aizik
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Barriers And Facilitators ◽  
Pediatric Care ◽  
Team Approach ◽  
Implementation Barriers ◽  
Primary Care Clinics ◽  
Exercise Medicine ◽  
Practice Variability ◽  
Facilitators And Barriers

Purpose: Despite the known health benefits of physical activity (PA), few primary care pediatricians discuss, evaluate, or prescribe PA for children. The goal of this study was to examine pediatricians’ thoughts and practices related to child PA and the perceived facilitators and barriers to implementing PA evaluation and prescription in pediatric primary care clinics. Methods: The Consolidated Framework for Implementation Research was used to explore implementation barriers and facilitators. A mixed-method design combined questionnaires and focus groups with 27 pediatricians. Results: Despite the pediatricians’ beliefs that PA is important for patients, there was wide practice variability in their approaches to discussing PA. Several perceived barriers to implementing PA evaluation and prescription were identified, including lack of knowledge and training, managing time for PA with multiple demands, the need for a team approach and simple PA tools and resources, support for patient tailoring of PA messaging, and a need for PA best practice champions. Conclusion: The identified barriers to implementing evidence in PA suggest several directions for improvement, including a care-team approach; quick, inexpensive, and simple PA tools; community PA partnerships; PA training in medical education; evidence-based strategies; and PA directories for families. These efforts could facilitate the implementation of PA best practices in pediatrics.

A randomized trial of computer-based reminders and audit and feedback to improve HIV screening in a primary care setting

2009 ◽  
Vol 20 (8) ◽  
pp. 527-533 ◽  
Author(s):  
V Sundaram ◽  
L C Lazzeroni ◽  
L R Douglass ◽  
G D Sanders ◽  
P Tempio ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Health Care ◽  
Hiv Testing ◽  
Health Care System ◽  
Control Group ◽  
Hiv Screening ◽  
Risk Behaviours ◽  
Primary Care Clinics ◽  
Computer Based

Despite recommendations for voluntary HIV screening, few medical centres have implemented screening programmes. The objective of the study was to determine whether an intervention with computer-based reminders and feedback would increase screening for HIV in a Department of Veterans Affairs (VA) health-care system. The design of the study was a randomized controlled trial at five primary care clinics at the VA Palo Alto Health Care System. All primary care providers were eligible to participate in the study. The study intervention was computer-based reminders to either assess HIV risk behaviours or to offer HIV testing; feedback on adherence to reminders was provided. The main outcome measure was the difference in HIV testing rates between intervention and control group providers. The control group providers tested 1.0% ( n = 67) and 1.4% ( n = 106) of patients in the preintervention and intervention period, respectively; intervention providers tested 1.8% ( n = 98) and 1.9% ( n = 114), respectively ( P = 0.75). In our random sample of 753 untested patients, 204 (27%) had documented risk behaviours. Providers were more likely to adhere to reminders to test rather than with reminders to perform risk assessment (11% versus 5%, P < 0.01). Sixty-one percent of providers felt that lack of time prevented risk assessment. In conclusion, in primary care clinics in our setting, HIV testing rates were low. Providers were unaware of the high rates of risky behaviour in their patient population and perceived important barriers to testing. Low-intensity clinical reminders and feedback did not increase rates of screening.

Routine HIV Testing in Primary Care Clinics: A Study Evaluating Patient and Provider Acceptance

2012 ◽  
Vol 23 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Sharon E. Valenti ◽  
Susan M. Szpunar ◽  
Louis D. Saravolatz ◽  
Leonard B. Johnson
Keyword(s):  
Primary Care ◽  
Hiv Testing ◽  
Primary Care Clinics ◽  
Routine Hiv Testing

scholarly journals Racial/ethnic and HIV risk category disparities in preexposure prophylaxis discontinuation among patients in publicly funded primary care clinics

AIDS ◽  
2019 ◽  
Vol 33 (14) ◽  
pp. 2189-2195 ◽  
Author(s):  
Hyman M. Scott ◽  
Matthew Spinelli ◽  
Eric Vittinghoff ◽  
Alicia Morehead-Gee ◽  
Anne Hirozawa ◽  
...  
Keyword(s):  
Primary Care ◽  
Hiv Risk ◽  
Risk Category ◽  
Publicly Funded ◽  
Primary Care Clinics ◽  
Preexposure Prophylaxis ◽  
Racial Ethnic

Home Collection Versus Publicly Funded HIV Testing in San Francisco: Who Tests Where?

2006 ◽  
Vol 21 (5) ◽  
pp. 417 ◽  
Author(s):  
Mari McQuitty ◽  
William McFarland ◽  
Timothy A. Kellogg ◽  
Edward White ◽  
Mitchell H. Katz
Keyword(s):  
Hiv Testing ◽  
San Francisco ◽  
Publicly Funded

Home Collection Versus Publicly Funded HIV Testing in San Francisco: Who Tests Where?

1999 ◽  
Vol 21 (5) ◽  
pp. 417 ◽  
Author(s):  
Mari McQuitty ◽  
William McFarland ◽  
Timothy A. Kellogg ◽  
Edward White ◽  
Mitchell H. Katz
Keyword(s):  
Hiv Testing ◽  
San Francisco ◽  
Publicly Funded

scholarly journals PreView: Development and Pilot Testing of an Interactive Video Doctor Plus Provider Alert to Increase Cancer Screening

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Millie Arora ◽  
Barbara Gerbert ◽  
Michael B. Potter ◽  
Ginny Gildengorin ◽  
Judith M. E. Walsh
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
San Francisco ◽  
Transtheoretical Model ◽  
Interactive Video ◽  
Primary Care Clinic ◽  
Pap Test ◽  
Screening Tests ◽  
Care Clinic ◽  
Primary Care Clinics

Background. Interventions to increase recommended cancer screening tests and discussions are needed. Methods. We developed the PREventive VIdeo Education in Waiting Rooms Program (PreView), a multimedia cancer prevention intervention for primary care clinics based on the Transtheoretical Model of Behavior Change. We pilot tested PreView, an interactive Video Doctor plus Provider Alert for feasibility and acceptability in primary care clinic settings in the San Francisco Bay Area , CA in 2009-2010. Results. Eighty participants (33 men and 47 women; more than half non-White) at 5 primary care clinics were included. After PreView, 87% of women were definitely interested in mammography when due, and 77% were definitely interested in a Pap test. 73% of participants were definitely interested in colorectal cancer screening when due, and 79% of men were definitely interested in a discussion about the PSA test. The majority indicated that they received an appropriate amount of information from PreView and that the information presented helped them decide whether or not to be screened. Conclusions. PreView was well received and accepted and potentially provides an innovative and practical way to support physicians' efforts to increase cancer screening.

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