Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial

Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Pamela K. Kohler [verfasserIn] Cyrus Mugo [verfasserIn] Kate S. Wilson [verfasserIn] Hellen Moraa [verfasserIn] Alvin Onyango [verfasserIn] Kenneth Tapia [verfasserIn] Kenneth Pike [verfasserIn] Caren Mburu [verfasserIn] Margaret Nduati [verfasserIn] Brandon Guthrie [verfasserIn] Barbra A. Richardson [verfasserIn] Tamara Owens [verfasserIn] David Bukusi [verfasserIn] Irene Inwani [verfasserIn] Grace John-Stewart [verfasserIn] Dalton Wamalwa [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Übergeordnetes Werk:	In: PLOS Global Public Health - Public Library of Science (PLoS), 2022, 3(2023), 4
Übergeordnetes Werk:	volume:3 ; year:2023 ; number:4

Links:	Link aufrufen Link aufrufen Journal toc

Katalog-ID:	DOAJ089523822

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520			\|a Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900.
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allfields	(DE-627)DOAJ089523822 (DE-599)DOAJ6551bb30142f4888b7a89650750cbd26 DE-627 ger DE-627 rakwb eng RA1-1270 Pamela K. Kohler verfasserin aut Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Public aspects of medicine Cyrus Mugo verfasserin aut Kate S. Wilson verfasserin aut Hellen Moraa verfasserin aut Alvin Onyango verfasserin aut Kenneth Tapia verfasserin aut Kenneth Pike verfasserin aut Caren Mburu verfasserin aut Margaret Nduati verfasserin aut Brandon Guthrie verfasserin aut Barbra A. Richardson verfasserin aut Tamara Owens verfasserin aut David Bukusi verfasserin aut Irene Inwani verfasserin aut Grace John-Stewart verfasserin aut Dalton Wamalwa verfasserin aut In PLOS Global Public Health Public Library of Science (PLoS), 2022 3(2023), 4 (DE-627)177799649X (DE-600)3101394-6 27673375 nnns volume:3 year:2023 number:4 https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI kostenfrei https://doaj.org/toc/2767-3375 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2023 4
spelling	(DE-627)DOAJ089523822 (DE-599)DOAJ6551bb30142f4888b7a89650750cbd26 DE-627 ger DE-627 rakwb eng RA1-1270 Pamela K. Kohler verfasserin aut Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Public aspects of medicine Cyrus Mugo verfasserin aut Kate S. Wilson verfasserin aut Hellen Moraa verfasserin aut Alvin Onyango verfasserin aut Kenneth Tapia verfasserin aut Kenneth Pike verfasserin aut Caren Mburu verfasserin aut Margaret Nduati verfasserin aut Brandon Guthrie verfasserin aut Barbra A. Richardson verfasserin aut Tamara Owens verfasserin aut David Bukusi verfasserin aut Irene Inwani verfasserin aut Grace John-Stewart verfasserin aut Dalton Wamalwa verfasserin aut In PLOS Global Public Health Public Library of Science (PLoS), 2022 3(2023), 4 (DE-627)177799649X (DE-600)3101394-6 27673375 nnns volume:3 year:2023 number:4 https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI kostenfrei https://doaj.org/toc/2767-3375 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2023 4
allfields_unstemmed	(DE-627)DOAJ089523822 (DE-599)DOAJ6551bb30142f4888b7a89650750cbd26 DE-627 ger DE-627 rakwb eng RA1-1270 Pamela K. Kohler verfasserin aut Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Public aspects of medicine Cyrus Mugo verfasserin aut Kate S. Wilson verfasserin aut Hellen Moraa verfasserin aut Alvin Onyango verfasserin aut Kenneth Tapia verfasserin aut Kenneth Pike verfasserin aut Caren Mburu verfasserin aut Margaret Nduati verfasserin aut Brandon Guthrie verfasserin aut Barbra A. Richardson verfasserin aut Tamara Owens verfasserin aut David Bukusi verfasserin aut Irene Inwani verfasserin aut Grace John-Stewart verfasserin aut Dalton Wamalwa verfasserin aut In PLOS Global Public Health Public Library of Science (PLoS), 2022 3(2023), 4 (DE-627)177799649X (DE-600)3101394-6 27673375 nnns volume:3 year:2023 number:4 https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI kostenfrei https://doaj.org/toc/2767-3375 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2023 4
allfieldsGer	(DE-627)DOAJ089523822 (DE-599)DOAJ6551bb30142f4888b7a89650750cbd26 DE-627 ger DE-627 rakwb eng RA1-1270 Pamela K. Kohler verfasserin aut Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Public aspects of medicine Cyrus Mugo verfasserin aut Kate S. Wilson verfasserin aut Hellen Moraa verfasserin aut Alvin Onyango verfasserin aut Kenneth Tapia verfasserin aut Kenneth Pike verfasserin aut Caren Mburu verfasserin aut Margaret Nduati verfasserin aut Brandon Guthrie verfasserin aut Barbra A. Richardson verfasserin aut Tamara Owens verfasserin aut David Bukusi verfasserin aut Irene Inwani verfasserin aut Grace John-Stewart verfasserin aut Dalton Wamalwa verfasserin aut In PLOS Global Public Health Public Library of Science (PLoS), 2022 3(2023), 4 (DE-627)177799649X (DE-600)3101394-6 27673375 nnns volume:3 year:2023 number:4 https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI kostenfrei https://doaj.org/toc/2767-3375 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2023 4
allfieldsSound	(DE-627)DOAJ089523822 (DE-599)DOAJ6551bb30142f4888b7a89650750cbd26 DE-627 ger DE-627 rakwb eng RA1-1270 Pamela K. Kohler verfasserin aut Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900. Public aspects of medicine Cyrus Mugo verfasserin aut Kate S. Wilson verfasserin aut Hellen Moraa verfasserin aut Alvin Onyango verfasserin aut Kenneth Tapia verfasserin aut Kenneth Pike verfasserin aut Caren Mburu verfasserin aut Margaret Nduati verfasserin aut Brandon Guthrie verfasserin aut Barbra A. Richardson verfasserin aut Tamara Owens verfasserin aut David Bukusi verfasserin aut Irene Inwani verfasserin aut Grace John-Stewart verfasserin aut Dalton Wamalwa verfasserin aut In PLOS Global Public Health Public Library of Science (PLoS), 2022 3(2023), 4 (DE-627)177799649X (DE-600)3101394-6 27673375 nnns volume:3 year:2023 number:4 https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 kostenfrei https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI kostenfrei https://doaj.org/toc/2767-3375 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2014 GBV_ILN_2522 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 3 2023 4
language	English
source	In PLOS Global Public Health 3(2023), 4 volume:3 year:2023 number:4
sourceStr	In PLOS Global Public Health 3(2023), 4 volume:3 year:2023 number:4
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institution	findex.gbv.de
topic_facet	Public aspects of medicine
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container_title	PLOS Global Public Health
authorswithroles_txt_mv	Pamela K. Kohler @@aut@@ Cyrus Mugo @@aut@@ Kate S. Wilson @@aut@@ Hellen Moraa @@aut@@ Alvin Onyango @@aut@@ Kenneth Tapia @@aut@@ Kenneth Pike @@aut@@ Caren Mburu @@aut@@ Margaret Nduati @@aut@@ Brandon Guthrie @@aut@@ Barbra A. Richardson @@aut@@ Tamara Owens @@aut@@ David Bukusi @@aut@@ Irene Inwani @@aut@@ Grace John-Stewart @@aut@@ Dalton Wamalwa @@aut@@
publishDateDaySort_date	2023-01-01T00:00:00Z
hierarchy_top_id	177799649X
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callnumber-first	R - Medicine
author	Pamela K. Kohler
spellingShingle	Pamela K. Kohler misc RA1-1270 misc Public aspects of medicine Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
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topic_title	RA1-1270 Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
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title	Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
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title_full	Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
author_sort	Pamela K. Kohler
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author_browse	Pamela K. Kohler Cyrus Mugo Kate S. Wilson Hellen Moraa Alvin Onyango Kenneth Tapia Kenneth Pike Caren Mburu Margaret Nduati Brandon Guthrie Barbra A. Richardson Tamara Owens David Bukusi Irene Inwani Grace John-Stewart Dalton Wamalwa
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author-letter	Pamela K. Kohler
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title_sort	simulated patient training to improve youth engagement in hiv care in kenya: a stepped wedge cluster randomized controlled trial
callnumber	RA1-1270
title_auth	Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
abstract	Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900.
abstractGer	Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900.
abstract_unstemmed	Youth living with HIV (YLHIV) report that negative interactions with health care workers (HCWs) affects willingness to return to care. This stepped wedge randomized trial evaluated effectiveness of a standardized patient actor (SP) HCW training intervention on adolescent engagement in care in Kenya. HCWs caring for YLHIV at 24 clinics received training on adolescent care, values clarification, communication, and motivational interviewing, with 7 SP encounters followed by facilitated feedback of videotaped interactions. Facilities were randomized to timing of the intervention. The primary outcome was defined as return within 3 months after first visit (engagement) among YLHIV who were either newly enrolled or who returned to care after <3 months out of care. Visit data was abstracted from electronic medical records. Generalized linear mixed models adjusted for time, being newly enrolled, and clustering by facility. YLHIV were surveyed regarding satisfaction with care. Overall, 139 HCWs were trained, and medical records were abstracted for 4,595 YLHIV. Median YLHIV age was 21 (IQR 19–23); 82% were female, 77% were newly enrolled in care, and 75% returned within 3 months. Half (54%) of trained HCWs remained at their clinics 9 months post-training. YLHIV engagement improved over time (global Wald test, p = 0.10). In adjusted models, the intervention showed no significant effect on engagement [adjusted Prevalence Ratio (aPR) = 0.95, 95% Confidence Interval (CI): 0.88–1.02]. Newly enrolled YLHIV had significantly higher engagement than those with prior lapses in care (aPR = 1.18, 95%CI: 1.05–1.33). Continuous satisfaction with care scores were significantly higher by wave 3 compared to baseline (coefficient = 0.38, 95%CI: 0.19–0.58). Despite provider skill improvement, there was no effect of SP training on YLHIV engagement in care. This may be due to temporal improvements or turnover of trained HCWs. Strategies to retain SP-training benefits need to address HCW turnover. YLHIV with prior gaps in care may need more intensive support. Registration CT #: NCT02928900. https://clinicaltrials.gov/ct2/show/NCT02928900.
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title_short	Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial
url	https://doaj.org/article/6551bb30142f4888b7a89650750cbd26 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10115282/?tool=EBI https://doaj.org/toc/2767-3375
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author2	Cyrus Mugo Kate S. Wilson Hellen Moraa Alvin Onyango Kenneth Tapia Kenneth Pike Caren Mburu Margaret Nduati Brandon Guthrie Barbra A. Richardson Tamara Owens David Bukusi Irene Inwani Grace John-Stewart Dalton Wamalwa
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up_date	2024-07-03T23:31:06.127Z
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Simulated patient training to improve youth engagement in HIV care in Kenya: A stepped wedge cluster randomized controlled trial

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