Search results for ‘Publisher:"taylor and francis"’ Sort:
Results 1 - 9 of 9
Reframing HIV adherence as part of the experience of illness
- Authors:
- GOLUB Sarit A., INDYK Debbie, WAINBERG Milton L.
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.167-188.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Understanding and enhancing adherence to HIV medications has been identified as a major challenge. The purpose of this study was to explore patterns and determinants of non-adherence among individuals receiving HIV care in a medical clinic. Seven focus groups were conducted with 42 HIV positive patients, and verbatim transcripts of focus group sessions were analyzed through a combination of ethnographic and content analysis. Of the participants currently on combination therapy, 68% reported at least one recent instance of non-adherence. The most commonly cited reasons for non-adherent behaviour were grouped into four categories: (1) problems with side effects; (2) conflicts with daily life activities; (3) feelings of aversion toward the medications themselves; and (4) deliberate alterations to the prescribed regimen. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Collecting data along the continuum of prevention and care a continuous quality improvement approach
- Authors:
- INDYK Leonard, INDYK Debbie
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.47-60.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
For the past 14 years, a team of applied social scientists and system analysts has worked with a wide variety of Community Based Organizations (CBO's), other grassroots agencies and networks, and Medical Center departments to support resource, program, staff and data development and evaluation for hospital and community-based programs and agencies serving HIV at-risk and affected populations. A by-product of this work has been the development, elaboration and refinement of an approach to Continuous Quality Improvement (CQI) which is appropriate for diverse community-based providers and agencies. A key component of our CQI system involves the installation of a sophisticated relational database management and reporting system (DBMS) which is used to collect, analyze, and report data in an iterative process to provide feedback among the evaluators, agency administration and staff. The database system is designed for two purposes: (1) to support the agency's administrative internal and external reporting requirements; (2) to support the development of practice driven health services and early intervention research. The body of work has fostered a unique opportunity for the development of exploratory service-driven research which serves both administrative and research needs. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Requisites, benefits, and challenges of sustainable HIV/AIDS system-building where theory meets practice
- Authors:
- INDYK Debbie, RIER David A.
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.93-110.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article is concerned with the rationale and major program elements of an approach to link community and tertiary sociomedical providers, clients/patients, sites, and systems into an integrated response to HIV/AIDS. It approach aims to improve sociomedical HIV/AIDS services for a hard-to-reach inner city population. This article first summarises the main advantages of this approach (e.g. greater efficiency; more realistic, effective programs with greater credibility among the community; stimulation of knowledge production and dissemination amongst players rarely formally engaged in such activities; creation of a platform useful for other applications). It then examines some of the main organizational challenges in conducting the work (involving issues such as personnel, coordination, funding, turf conflicts, sustainability). From this discussion emerge organizational requisites to conducting this work (e.g. development of key boundary-spanning figures; attention to the specific interests of potential linkage partners; translation efforts to demonstrate the value of participation; a continuous quality improvement approach featuring wide distribution of feedback in user-friendly form; flexibility, tact and patience), so that others can adapt and apply the linkage approach to manage HIV/AIDS or other problems. Finally, the authors explain how theory and practice have driven one another in this work. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The rationale of interorganizational linkages to connect multiple sites of expertise, knowledge production, and knowledge transfer an example from HIV/AIDS services for the inner city
- Authors:
- RIER David A., INDYK Debbie
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.7-27.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper presents the rationale for a long-running project in which various community-based and tertiary-based providers are being linked to each other in order to understand, reach, and engage high-risk, hard-to-reach inner-city residents for prevention, treatment, and management of HIV/AIDS. The work has developed into a more fundamental approach through which to build and maintain the infrastructure required to generate and sustain knowledge development and integration within and between systems. This work is grounded in the recognition that each type of provider, as well as patients and clients themselves, has a particular type of expertise. All forms of expertise are necessary to fight HIV/ AIDS. Different forms of expertise are necessary to diagnose, treat, prevent, and cure HIV/AIDS and its sequelae. This work suggests revisions in traditional approaches to expertise and to the content and geometry of dissemination networks, and ultimately challenges the very concepts of dissemination and the lay/scientific boundary. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
The shifting locus of risk-reduction the critical role of HIV infected individuals
- Authors:
- INDYK Debbie, GOLUB Sarit A.
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.111-132.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This article discusses the shifting locus of control over risk-reduction and examines its implications for the care and support of HIV-positive individuals. The authors begin by presenting a brief history of the continuum of HIV related risk, illustrating the ways in which advances in risk-assessment and intervention have led to this important shift. They go on to discuss the current state of risk assessment and intervention as it relates to three factors: (a) the point along the continuum of risk at which risk assessment and intervention occurs; (b) the locus of control over risk reduction; and (c) the distinction between primary and secondary risk reduction efforts. Finally, they discuss the meaning of HIV risk and the role of HIV-positive individuals in the new geometry of care that integrates treatment and prevention. How is HIV-risk defined and understood? Who is of risk to whom? Who is responsible for reducing risk? (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Shaping garments of care tools for maximizing adherence potential
- Authors:
- BOYER Ann, INDYK Debbie
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.151-166.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
There is a tendency in health care to treat clients' maladies in accordance with two basic premises: (1) the medical needs of the client (as perceived by the clinician) can be successfully addressed by focusing solely on that aspect of the client's life and (2) if the client is not able or ready, then there will be someone in the client's support system to take responsibility for administering prescribed therapy. In many cases these assumptions hold true, but for certain sub-populations they do not, notably: individuals with substandard/chaotic lives, those with multiple confounding diagnoses (mental health, substance abuse, disability, addiction, domestic violence) who have neither personal adherence ability nor adequate support systems. They are rarely seen in ambulatory care settings, engaging with the health care system only through emergency rooms and hospital admissions. Such a group makes up a large proportion of urban, HIV positive clients. For them, successful adherence can only be accomplished by rethinking what constitutes 'care' and 'tailoring' that care to the individual. In this context adherence requires the interweaving of three sets of needs: (1) needs perceived by the client, (2) client needs as observed by an objective recorder and assessed for impact on the client's ability and willingness to be adherent and (3) medical needs identified by a clinician. Extensive work with this population has led to the creation of a Cluster of Tools (HIVCOT), designed to quantitatively assess the severity of the varied needs (Health Importance Level or HIL), the adherence ability of the client (Adherence Functional Level or AFL) and how difficult it is to adhere to a given treatment (Level of Adherence Difficulty or LAD). Through the application of these tools it becomes possible for the medical providers to make individual adjustments to the design of care so that it closely fits the needs and abilities of the client. In this way the likelihood of adherence is maximized. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
HIV-infected individuals as partners in prevention a redefinition of the partner notification process
- Authors:
- GOLUD Sarit A., INDYK Debbie
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.225-235.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
The advances that have turned HIV into a chronic illness have also highlighted the importance of integrating prevention and care in the fight against the epidemic. This integration involves not only the creation of new programs, but also a re-examination of the process through which services and supports are provided. In this article, HIV partner notification (a process by which individuals who may have been exposed to HIV or another sexually transmitted infection are notified of their potential exposure) is used as a case example; the discussion includes: the shifting time frame within which partner notification occurs; the expanding role of HIV-positive individuals in effecting both disease management and prevention goals; the connection between partner-notification and behaviourally-based risk reduction; and the ethical implications of advances on the partner notification process. The authors argue that partner notification services must be located in the context of overall treatment for infected individuals, and demonstrate how a redefinition of the partner notification process can serve as a spring-board for ongoing prevention counselling and support.
Wiring the HIV/AIDS system building interorganizational infrastructure to link people, sites, and networks
- Authors:
- INDYK Debbie, RIER David A.
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.29-45.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper presents a case example of the new “geometry of care”, by examining selected examples from five facets of a program developed by the lead author and in operation since 1989. This program is designed to understand, build, revise, and maintain the organizational infrastructure with which to link diverse players and sites, and combine these into a web for producing, assessing, and exchanging the information needed to combat HIV/AIDS. Each example demonstrates how opportunities were exploited for developing and linking resources within and between systems of care and prevention. The program began as an iterative and systems approach to improve access of high-risk, hard-to-reach inner city New York populations to HIV/AIDS services, treatment, and research. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).
Flexible rigidity supporting HIV treatment adherence in a rapidly-changing treatment environment
- Authors:
- RIER David A., INDYK Debbie
- Journal article citation:
- Social Work in Health Care, 42(3/4), 2006, pp.133-150.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
This paper examines adherence to AIDS treatment, focusing on the challenges posed by rapidly changing treatment protocols. The authors examine the evolving views of treatment adherence, and endorse the “concordance” approach. This emphasizes collaboration and negotiation between provider and patient to formulate and maintain a manageable treatment regimen tailored to what the patient is ready, willing, and able to tolerate. Given the extreme rapidity with which treatment guidelines are revised or even reversed, the persistent uncertainty surrounding treatment risks and benefits, and the great variability in individuals' ability to tolerate a given regimen, the authors propose the term “flexible rigidity” to describe the type of adherence best suited to AIDS treatment. They then present an organizational approach to supporting the type of provider-patient relationships needed to improve treatment adherence that features treatment readiness assessment and custom-tailoring of treatment for those at all stages of the treatment-readiness continuum. It is noted that this model could be applied as well to prevention and management of other chronic diseases. (Copies of this article are available from: Haworth Document Delivery Centre, Haworth Press Inc., 10 Alice Street, Binghamton, NY 13904-1580).