scholarly journals The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

2020 ◽  
Author(s):  
Jef Vanhamel ◽  
Anke Rotsaert ◽  
Thijs Reyniers ◽  
Christiana Nöstlinger ◽  
Marie Laga ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Service Delivery ◽  
Scoping Review ◽  
Real World ◽  
Grey Literature ◽  
Hospital Setting ◽  
Potential Game ◽  
Key Populations ◽  
Service Delivery Models ◽  
Delivery Models

Abstract Background: Strengthening HIV prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential game changer because of its high clinical efficacy and the feasibility of its provision to different key populations. Documenting the existing experience with PrEP service delivery in a variety of real-world settings will inform how its uptake and usage can be maximised. Methods: We conducted a scoping review using the five-step framework provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing the implementation of real-world PrEP service delivery models reporting on four key components: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: This review included 33 articles for charting and analysing of the results. The identified service delivery models showed that PrEP services mainly targeted people at high risk of HIV acquisition, with some models targeting specific key populations, mainly men who have sex with men. PrEP was often delivered centralised and in a clinical or hospital setting. Yet also community-based as well as home-based PrEP delivery models were reported. Providers of PrEP were mainly clinically trained health professionals, but in some rare cases community workers and lay providers also delivered PrEP. In general, in-person visits were used to deliver PrEP. More innovative digital options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied in a minority of the service delivery models in mainly high-resource settings.Conclusions: A range of possible combinations was found between all four components of PrEP service delivery models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could be expanded and optimised to respond to key populations with unmet HIV prevention needs in different settings.

scholarly journals The Current Landscape of Pre-exposure Prophylaxis (PrEP) Service Delivery Models for Hiv Prevention: A Scoping Review

2020 ◽  
Author(s):  
Jef Vanhamel ◽  
Anke Rotsaert ◽  
Thijs Reyniers ◽  
Christiana Nöstlinger ◽  
Marie Laga ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Service Delivery ◽  
Health Care Providers ◽  
Scoping Review ◽  
Grey Literature ◽  
Target Population ◽  
Care Providers ◽  
Combination Prevention ◽  
Service Delivery Models ◽  
Delivery Models

Abstract Background: Strengthening HIV combination prevention is imperative given the continued high HIV incidence worldwide. The introduction of oral PrEP as a new biomedical HIV prevention tool can be a potential gamechanger because of its high clinical efficacy and the feasibility of making it available for different key populations.Experiences with different PrEP delivery models in a variety of settings and HIV epidemics will inform howits uptake and usage can be maximised.Methods: We conducted a scoping review using the five-step framework for conducting scoping studies provided by Arksey and O’Malley. We systematically searched the existing peer-reviewed international and grey literature describing four components of a PrEP service delivery model in real-world: the target population of PrEP services, the setting where PrEP was delivered, PrEP providers’ professionalisation and PrEP delivery channels. We restricted our search to English language articles. No geographical or time restrictions were set.Results: Following exclusion of ineligible records and removal of duplicates, 33 articles were retained for charting and analysing of the results. The target population of PrEP services was often described in terms of PrEP eligibility without targeting specific subgroups. If a specific target group was mentioned, PrEP was mainly offered to men who have sex with men (MSM). PrEP was often delivered centralisedin specialist clinics providing HIV, sexual health or STI care. Yet examples of de-centralised and community-based PrEP delivery have been reported. Health care providers delivering PrEP were mainly medical professionals, with task-shifting to non-traditional health professionals and lay providers identified in a minority of the studies. PrEP was mainly delivered through classic in-person visits. More innovative options using mHealth and telemedicine approaches to deliver specific parts of PrEP services are currently being applied.Conclusions: Within our scope for PrEP service delivery models, a range of possibilities was found for all components of such models. This reflects differentiation of care according to different contextual settings. More research is needed on how integration of services in these contexts could respond to the needs of different profiles of PrEPuserswithin a combination prevention approach.

scholarly journals The current landscape of pre-exposure prophylaxis service delivery models for HIV prevention: a scoping review

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jef Vanhamel ◽  
Anke Rotsaert ◽  
Thijs Reyniers ◽  
Christiana Nöstlinger ◽  
Marie Laga ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Service Delivery ◽  
Scoping Review ◽  
Service Delivery Models ◽  
Exposure Prophylaxis ◽  
Delivery Models

Reimbursement and Telepractice

2013 ◽  
Vol 3 (2) ◽  
pp. 35-40
Author(s):  
Carol Dudding
Keyword(s):  
Service Delivery ◽  
Healthcare Services ◽  
Speech Language Pathology ◽  
Delivery Method ◽  
Quality Healthcare ◽  
Service Delivery Models ◽  
Private Lives ◽  
Language Pathology ◽  
Delivery Models

Whether in our professional or private lives, we are all aware of the system wide efforts to provide quality healthcare services while containing the costs. Telemedicine as a method of service delivery has expanded as a result of changes in reimbursement and service delivery models. The growth and sustainability of telehealth within speech-language pathology and audiology, like any other service, depends on the ability to be reimbursed for services provided. Currently, reimbursement for services delivered via telehealth is variable and depends on numerous factors. An understanding of these factors and a willingness to advocate for increased reimbursement can bolster the success of practitioners interested in the telehealth as a service delivery method.

scholarly journals Service Delivery Models to Maximize Quality of Life for Older People at the End of Life: A Rapid Review

2019 ◽  
Vol 97 (1) ◽  
pp. 113-175 ◽  
Author(s):  
CATHERINE J. EVANS ◽  
LUCY ISON ◽  
CLARE ELLIS‐SMITH ◽  
CAROLINE NICHOLSON ◽  
ALESSIA COSTA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Service Delivery ◽  
Older People ◽  
End Of Life ◽  
Rapid Review ◽  
Service Delivery Models ◽  
Delivery Models

scholarly journals Eye care delivery models to improve access to eye care for Indigenous peoples in high-income countries: a scoping review

2021 ◽  
Vol 6 (3) ◽  
pp. e004484
Author(s):  
Helen Burn ◽  
Lisa Hamm ◽  
Joanna Black ◽  
Anthea Burnett ◽  
Matire Harwood ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Service Delivery ◽  
Indigenous Peoples ◽  
Indigenous Communities ◽  
High Income ◽  
Eye Care ◽  
Service Delivery Models ◽  
Care Services ◽  
Delivery Models ◽  
Improve Access

PurposeGlobally, there are ~370 million Indigenous peoples. Indigenous peoples typically experience worse health compared with non-Indigenous people, including higher rates of avoidable vision impairment. Much of this gap in eye health can be attributed to barriers that impede access to eye care services. We conducted a scoping review to identify and summarise service delivery models designed to improve access to eye care for Indigenous peoples in high-income countries.MethodsSearches were conducted on MEDLINE, Embase and Global Health in January 2019 and updated in July 2020. All study designs were eligible if they described a model of eye care service delivery aimed at populations with over 50% Indigenous peoples. Two reviewers independently screened titles, abstracts and full-text articles and completed data charting. We extracted data on publication details, study context, service delivery interventions, outcomes and evaluations, engagement with Indigenous peoples and access dimensions targeted. We summarised findings descriptively following thematic analysis.ResultsWe screened 2604 abstracts and 67 studies fulfilled our eligibility criteria. Studies were focused on Indigenous peoples in Australia (n=45), USA (n=11), Canada (n=7), New Zealand (n=2), Taiwan (n=1) and Greenland (n=1). The main disease focus was diabetic retinopathy (n=30, 45%), followed by ‘all eye care’ (n=16, 24%). Most studies focused on targeted interventions to increase availability of services. Fewer than one-third of studies reported involving Indigenous communities when designing the service. 41 studies reflected on whether the model improved access, but none undertook rigorous evaluation or quantitative assessment.ConclusionsThe geographical and clinical scope of service delivery models to improve access to eye care for Indigenous peoples in high-income countries is narrow, with most studies focused on Australia and services for diabetic retinopathy. More and better engagement with Indigenous communities is required to design and implement accessible eye care services.

Serving transgender people: clinical care considerations and service delivery models in transgender health

The Lancet ◽  
2016 ◽  
Vol 388 (10042) ◽  
pp. 401-411 ◽  
Author(s):  
Kevan Wylie ◽  
Gail Knudson ◽  
Sharful Islam Khan ◽  
Mireille Bonierbale ◽  
Suporn Watanyusakul ◽  
...  
Keyword(s):  
Service Delivery ◽  
Clinical Care ◽  
Transgender People ◽  
Transgender Health ◽  
Service Delivery Models ◽  
Delivery Models
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