Positive Deviance to Improve Retention in HIV Care HIV Care in South Africa
NCT ID: NCT06157281
Last Updated: 2025-04-02
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
75 participants
INTERVENTIONAL
2022-11-15
2024-10-31
Brief Summary
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The intervention, called "Connect," consists of several strategies within three domains, as follows:
Domain 1: Engage, Encourage, Support Staff
Strategy 1a: Monthly staff huddle with staff recognition activities and compassion-focused rounds
Strategy 1b: Compassion training
Domain 2: Create a welcome physical environment
Strategy 2a: Aesthetic improvements toward a warm, welcoming environment
Domain 3: Expedite and augment workflow practices
Strategy 3a: Pre-pull patient folders; hold folders for immediate tracking; map patients to identify locations
Strategy 3b: Integrate welcome-back services for those who miss follow-up appointments
HIV staff at three clinics with below-average retention rates who consent to participate will take part in intervention activities. Results will be compared to those of all other lower-retention clinics within the same health system.
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Detailed Description
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The main question this study aims to answer is: Does the intervention improve retention in HIV care for people with HIV (PWH)?
The intervention, called "Connect," consists of several strategies within three domains, as follows:
Domain 1: Engage, Encourage, Support Staff
Strategy 1a: Monthly staff huddle with staff recognition activities and compassion-focused rounds. Each clinic holds a monthly huddle toward team cohesion, support and a shared vision for retention. Consists of some core activities, such as "Rounds", staff recognition; and activities to build team cohesion and staff wellbeing.
Strategy 1b: Compassion training. Based on evidenced-based compassion training, train and support staff on interacting with other providers and patients in compassionate ways.
Domain 2: Create a welcome physical environment.
Strategy 2a: Aesthetic improvements toward a warm, welcoming environment. Examples include bright paint in waiting areas, murals on outside walls, plants, posters with positive messaging on walls.
Domain 3: Expedite and augment workflow practices.
Strategy 3a: Pre-pull patient folders; hold folders for immediate tracking; map patients to identify locations. Staff pull folders for next-day appointments, communicate no-shows with trackers, use mapping to have patients indicate approximate living areas to facilitate tracking.
Strategy 3b: Welcome-back services for those who miss follow-up appointments. Integrate specialized, patient-centered services for those who miss their 1-month or 3-month visit to re-enter care easily. The key elements of this are genuine concern for the patient, avoiding scolding or blaming the patients, checks on patient health and symptoms, and exploration of barriers including how to overcome these and facilitate ongoing treatment.
HIV staff at three clinics with below-average retention rates who consent to participate will take part in intervention activities. Results will be compared to those of all other lower-retention clinics within the same health system.
Conditions
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Study Design
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NON_RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
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Connect Intervention
HIV providers withing each clinic will participate in the Intervention. The intervention, called "Connect," consists of several strategies within three domains, as follows:
Domain 1: Engage, Encourage, Support Staff
Strategy 1a: Monthly staff huddle with staff recognition activities and compassion-focused rounds
Strategy 1b: Compassion training
Domain 2: Create a welcome physical environment
Strategy 2a: Aesthetic improvements toward a warm, welcoming environment
Domain 3: Expedite and workflow practices
Strategy 3a: Pre-pull patient folders; hold folders for immediate tracking; map patients to identify locations
Strategy 3b: Integrate welcome-back services for those who miss follow-up appointments
Connect
A multicomponent, clinic-level intervention consisting of strategies aimed at improving retention and viral load suppression by enhancing the patient and staff experience.
Control
Staff in control clinics will not receive an intervention.
No interventions assigned to this group
Interventions
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Connect
A multicomponent, clinic-level intervention consisting of strategies aimed at improving retention and viral load suppression by enhancing the patient and staff experience.
Eligibility Criteria
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Inclusion Criteria
* Administrator or other staff member of one of three participating clinics
Exclusion Criteria
18 Years
ALL
Yes
Sponsors
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National Institute of Mental Health (NIMH)
NIH
University of Stellenbosch
OTHER
Western Cape Department of Health and Wellness
UNKNOWN
RAND
OTHER
Responsible Party
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Allison Ober
Senior Health Policy Researcher
Principal Investigators
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Allison J Ober, PhD
Role: PRINCIPAL_INVESTIGATOR
RAND
Locations
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Western Cape Department of Health and Wellbeing CDH or CHC
Cape Town, Western Cape, South Africa
Countries
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Other Identifiers
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HCAAD058-1000
Identifier Type: -
Identifier Source: org_study_id
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