Table 3 |
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Relationship between Identified Barriers, Elements of the Chronic Care Model and Implementation Strategy |
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Barrier to HIV testing |
Content of implementation intervention |
Relationship to Chronic Care Model* |
|
|
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|
Lack of knowledge of HIV risk factors. |
HIV Testing Clinical Reminder |
Decision support |
|
VA providers regard HIV testing and counseling work to be the responsibility of specially trained HIV counselors. |
Audit/feedback reports Training to use revised VA HIV Consent Form Academic detailing, social marketing |
Clinical information system Delivery system design Provider activation |
|
Lack time required to fulfill counseling processes. |
Provider training regarding streamlined counseling Nurse-based pre-test counseling Academic detailing, social marketing |
Delivery system design Provider activation |
|
Face-to-face post-test counseling is difficult to arrange within two weeks of the test. |
Telephonic notification of negative test results. Academic detailing, social marketing |
Delivery system design Provider activation |
|
Anxiety about post-test counseling for positive test results. |
Assistance provided by HIV counseling services. Academic detailing, social marketing |
Delivery system design Provider activation |
|
|
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• Provider activation is not, strictly speaking, a component of the CCM based implementation strategy, but was rather employed to augment the effectiveness of the other interventions [24;29;30]. |
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Goetz et al. Implementation Science 2008 3:16 doi:10.1186/1748-5908-3-16 |
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