CASE
HOMEPAGE

2002 HRSA RWC CONFERENCE

CASE STUDY ABSTRACT, OBJECTIVES & DESIGN

CASE STUDY AMENDMENT: IMPACT OF 9/11 ON PWH/As TAKING HAART

CASE STAFF & GRANTEE ROSTER

DATA COLLECTION TOOLS

CASE STUDY DATA ANALYSIS PLAN

DISSEMINATION ACTIVITIES

RESOURCES & LINKS

CASE
The Center for Adherence Support Evaluation
at the New York Academy of Medicine

Questions for Cross - Site Analysis

Data Analysis Plan

Questions for cross-site analysis include:

1. What is the effectiveness of different interventions in supporting adherence?
   
   • Outcomes: adherence measured as absolute rates of adherence, improvements from baseline, and proportions of patients with adherence scores above defined levels.
     
   • Measures of adherence will be validated using biological markers: CD4, viral load.
     
   • Adherence compared across programs and specific interventions.
   
   
2. What are appropriate levels of service utilization for supporting adherence?
   
   • Examination of dose effects (more contact leads to more adherence)
     
   • Examination of threshold effects (only a marginal benefit to more services).
   
   
3. What is the impact of different types of providers in supporting adherence?
   
   • Do characteristics such as provider licensure or training influence effectiveness?
     
   • Does provider-client demographic matching (in terms of HIV+ status, gender, age, ethnicity, language) influence effectiveness?
     
   • Does continuity of care with a specific provider matter?
     
   • Are adherence-specific practitioners more effective?
     
   • Analysis of numbers of patients seen by different staffing configurations and staffing costs to estimate costs per units of service in different models.
   
   
4. What is the duration of effectiveness of the different adherence support programs?
   
   • How long do participants in different programs continue at acceptable levels of adherence while engaged in the program?
     
   • How long do participants in different programs continue at acceptable levels of adherence after they complete the program?
   
   
5. What is the effectiveness of different programs in supporting adherence in different populations?
   
   • Populations defined in terms of: clinical status, gender, race/ethnicity, active substance use, transmission route, living situation, age, payer source.
   
   
6. What is the effectiveness of different programs in supporting adherence of populations facing different barriers to their adherence?
   
   • Barriers include: mental illness, responsibility for the care of others, perceived stress, active substance use, intercurrent illness, lack of social support, and homelessness.
   
   
7. Does the achievement of intermediate objectives affect adherence outcomes?
   
   • links to treatment for mental illness; or substance abuse;
     
   • links to entitlements access;
     
   • improved HIV knowledge;
     
   • improved appointment attendance.