CASE
STUDY ABSTRACT, OBJECTIVES & DESIGN
CASE
The Center for Adherence Support Evaluation
at the New York Academy of Medicine
Taxonomy of HIV Medication Adherence Support Models: Experience from the SPNS Cross-Site Evaluation
Background: HRSA's Special Projects of National
Significance (SPNS) sponsored 14 sites to evaluate local antiretroviral
adherence support interventions (i.e. peer programs and readiness training)
and the New York Academy of Medicine to conduct a cross-site evaluation
of these interventions. Because these SPNS sites differ in fundamental
ways, a challenge to the ongoing cross-site evaluation is to control for
differences to identify effective program components.
Objectives: Describe current models of HIV
medication adherence interventions. Develop a taxonomy allowing comparison
of adherence to antiretroviral medications and service provision in different
adherence programs.
Methods: A taxonomy of adherence support models with key program variables was developed based on data from site visits and qualitative interviews with clients and providers at each of the SPNS sites. These data were used to identify intervention elements that will serve as co-variates in the cross-site analyses of client-level outcomes.
Results: Commonalties were found in the types of services offered, while the populations served and style of service integration varied across sites. The data were used to develop comparative adherence support models that varied on multiple dimensions: population served, specific adherence services, intervention focus, guiding theoretical models, secondary intervention effects and features reported by providers and clients to be most effective in enhancing adherence.
Conclusions: Cross-site evaluation requires a detailed examination of program-level variables and their influence on client-level outcomes. Although each program is unique, commonalties among the sites create the opportunity to compare program components and to pool adherence data across sites to produce interpretable results.
Last updated: 4/11/02