Due to escalating demand and barriers to care in our in our rural minority population, in 1996 HRSA funded a test of an innovative delivery model designed to assess the impact of (1) "System-level" changes and (2) "Client-level" behavioral interventions. The positive results of the "System-level" changes have been reported and include: improved CD4 counts, reduced viral load, and increased access to necessary medical and supportive care services. This new analysis demonstrates the additional positive impacts from skill-building enrichment interventions. METHODOLOGY: The project is a quasi-random, longitudinal study with 3 patient groups: a control group (n=28) who received customary care (CC); treatment group "A" (n=46) who received CC and enhanced-case-management (ECM), and treatment group "B" (n=43) who received CC, ECM and mental health/psycho-social services and skill building activities. Follow-up occured at 6 month intervals. Data to be reported will emphasize changes between baseline and the 12 month follow-up. RESULTS: The statistical significance of the changes was assessed through t-test and chi-squared analysis. Further, logistic regression was utilized to identify the unique relationships between suppressed viral load (% < 400) and various demographic, socio-economic, access, clinical, and psychosocial variables. The significant benefits of skill-building enrichment activities include: improved self worth, social skills, independence, return-to-work, clinic visit adherence, and medication regimen adherence. While the final specifications of the logistic models were problematic because of multi-colinearity, participation in enrichment activities improved the behavioral measures; these behavioral changes increased adherence and return-to-work; behavioral change and improved adherence each had positive impacts on clinical outcomes.
Learning Objectives: 1) Attendees will learn effective delivery system enhancements to impact HIV+ individuals. 2) Attendees will learn which skill-building activities are most effective for individuals with HIV/AIDS. 3) Attendees will be able to discuss ways to overcome barriers to providing effective delivery system changes for HIV+ individuals.
Keywords: HIV/AIDS, HRSA
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Jefferson Comprehensive Care System, Inc.
Disclosure not received
Relationship: Not Received.