Enhancing Patient Navigation with Contingent Incentives to Improve Healthcare Behaviors and Viral Load Suppression of Persons with HIV and Substance Use
This secondary analysis compares health behavior outcomes for two groups of HIV+ substance users randomized in a 3-arm trial [1] to receive Patient Navigation with (PN+CM) or without (PN) contingent financial incentives (CM). Mean age of participants was 45 years; the majority was male (67%), African American (78%), unemployed (35%), or disabled (50%). Behaviors incentivized for PN+CM were (1) attendance at HIV care visits and (2) verification of an active HIV medication prescription. Incentives were associated with shorter time to treatment initiation and higher rates of behaviors during the 6-month intervention with exception of month 6 HIV care visits. Median HIV care visits were 3 (IQR 2-4) for PN+CM versus 1.5 (IQR 0-3) for PN (Wilcoxon p < 0.001); median validated medication checks were 4 (IQR 2-6) for PN+CM versus 1 (IQR 0-3) for PN (Wilcoxon p < 0.001). Viral suppression rates at end of treatment were not significantly different for the two groups but were directly related to the number of behaviors completed for both care visits (χ2(1) = 7.69, p = 0.006) and validated medication (χ2(1) = 8.49, p = 0.004). Results support use of incentives to increase performance of key healthcare behaviors. Adjustments to the incentive program may be needed to achieve greater rates of sustained health behavior change that result in improved viral load outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2018 |
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| Erschienen: |
2018 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:32 |
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| Enthalten in: |
AIDS patient care and STDs - 32(2018), 7 vom: 25. Juli, Seite 288-296 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Stitzer, Maxine L [VerfasserIn] |
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| Links: |
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| Themen: |
Contingency management |
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| Anmerkungen: |
Date Completed 04.07.2019 Date Revised 07.12.2022 published: Print-Electronic ClinicalTrials.gov: NCT01612169 Citation Status MEDLINE |
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| doi: |
10.1089/apc.2018.0014 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM285278967 |
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| 245 | 1 | 0 | |a Enhancing Patient Navigation with Contingent Incentives to Improve Healthcare Behaviors and Viral Load Suppression of Persons with HIV and Substance Use |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a ClinicalTrials.gov: NCT01612169 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a This secondary analysis compares health behavior outcomes for two groups of HIV+ substance users randomized in a 3-arm trial [1] to receive Patient Navigation with (PN+CM) or without (PN) contingent financial incentives (CM). Mean age of participants was 45 years; the majority was male (67%), African American (78%), unemployed (35%), or disabled (50%). Behaviors incentivized for PN+CM were (1) attendance at HIV care visits and (2) verification of an active HIV medication prescription. Incentives were associated with shorter time to treatment initiation and higher rates of behaviors during the 6-month intervention with exception of month 6 HIV care visits. Median HIV care visits were 3 (IQR 2-4) for PN+CM versus 1.5 (IQR 0-3) for PN (Wilcoxon p < 0.001); median validated medication checks were 4 (IQR 2-6) for PN+CM versus 1 (IQR 0-3) for PN (Wilcoxon p < 0.001). Viral suppression rates at end of treatment were not significantly different for the two groups but were directly related to the number of behaviors completed for both care visits (χ2(1) = 7.69, p = 0.006) and validated medication (χ2(1) = 8.49, p = 0.004). Results support use of incentives to increase performance of key healthcare behaviors. Adjustments to the incentive program may be needed to achieve greater rates of sustained health behavior change that result in improved viral load outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a HIV healthcare | |
| 650 | 4 | |a contingency management | |
| 650 | 4 | |a medication adherence | |
| 650 | 4 | |a patient navigation | |
| 650 | 4 | |a substance users | |
| 650 | 4 | |a viral suppression | |
| 700 | 1 | |a Hammond, Alexis S |e verfasserin |4 aut | |
| 700 | 1 | |a Matheson, Tim |e verfasserin |4 aut | |
| 700 | 1 | |a Sorensen, James L |e verfasserin |4 aut | |
| 700 | 1 | |a Feaster, Daniel J |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Rui |e verfasserin |4 aut | |
| 700 | 1 | |a Gooden, Lauren |e verfasserin |4 aut | |
| 700 | 1 | |a Del Rio, Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Metsch, Lisa R |e verfasserin |4 aut | |
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