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Identifying Implementation Strategies That Address Barriers and Facilitate Implementation of Digital Interventions in HIV Primary Care Settings: Results from the Pilot Implementation of Positive Health Check

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Abstract

We used the 1-month pilot implementation of Positive Health Check, a brief web-based video counseling intervention that supports patients with HIV attending HIV primary care clinics, to exemplify how studying implementation strategies earlier in the evidence-generation process can improve implementation outcomes in later pragmatic trials. We identified how implementation strategies were operationalized and the barriers and facilitators these strategies addressed using multiple data sources, including adapted implementation procedures and weekly structured interviews conducted with 9 key stakeholders in 4 HIV primary care clinics. Nineteen of 73 discrete implementation strategies for clinical innovations were used in the pilot implementation of Positive Health Check. Clinic staff reported 17 barriers and facilitators related to the clinic environment, patient population, intervention characteristics, and training and technical assistance. Identifying the link between strategies, barriers, and facilitators helped plan for a subsequent larger multisite pragmatic trial.

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Acknowledgements

This work was supported by a U.S. Centers for Disease Control and Prevention contract 200-2007-20016, Task Order 0025 to RTI International and a Cooperative Agreement from the Centers for Disease Control and Prevention (U18PS004967) to Megan Lewis, Principal Investigator, RTI International. The findings and conclusions of this analysis are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Authors and Affiliations

  1. RTI International, 3040 E. Cornwallis Rd., Research Triangle Park, NC, 27709, USA

    Brittany A. Zulkiewicz, Olivia Burrus, Alexa Ortiz & Bryan R. Garner

  2. Centers for Disease Control and Prevention, Atlanta, GA, USA

    Camilla Harshbarger

  3. RTI International, 119 S. Main St., Suite 220, Seattle, WA, 98104, USA

    Megan A. Lewis

Authors
  1. Brittany A. Zulkiewicz
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  2. Olivia Burrus
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  3. Camilla Harshbarger
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  4. Alexa Ortiz
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  5. Bryan R. Garner
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  6. Megan A. Lewis
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Correspondence to Megan A. Lewis.

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Zulkiewicz, B.A., Burrus, O., Harshbarger, C. et al. Identifying Implementation Strategies That Address Barriers and Facilitate Implementation of Digital Interventions in HIV Primary Care Settings: Results from the Pilot Implementation of Positive Health Check. AIDS Behav 25, 154–166 (2021). https://doi.org/10.1007/s10461-020-02944-9

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