Implementing an effective behavioral intervention for people living with HIV via video-groups: A RE-AIM evaluation

Introduction: Implementation science is needed to understand approaches to expanding access to effective behavioral interventions (EBIs) for people living with HIV (PLH) in underserved areas.

Methods: We explored Reach, Effectiveness, Adoption, Implementation and potential for Maintenance (RE-AIM) of one EBI, Healthy Relationships (HR), via video-conferencing groups (VGs) accessed at community agencies in a wait-list cross-over randomized controlled trial with women living with HIV (WLH). Quantitative and qualitative data were derived from intervention participants (N=71), implementing agency directors (N=5) and staff (N=91) at agencies serving PLH (ASPLH).

Results: REACH: HR-VG participants were primarily middle-aged WLH (M=42.9 years, SD=8.6) living in urban/suburban areas. EFFECTIVENESS: Statistically significant reductions in sexual risk behavior were found (as we published previously). Additionally, WLH perceived benefits of social support and learning from other WLH. ADOPTION: In a statewide survey, 53% of staff at ASPLH said their agency was likely to adopt HR-VG. Agencies not open to adoption lacked a private space and/or ability to install a dedicated Internet line. Agencies open to adoption cited benefits: joining an innovative initiative; expanding services; and affiliating with a university. IMPLEMENTATION: Challenges included scheduling, relative priority, and need for training/technical assistance. Organizational climate and leadership affected implementation success.  Potential for MAINTENANCE: Agencies expressed interest in maintaining HR-VG yet had funding concerns.

Conclusion: This is among the first studies of an EBI for PLH to apply RE-AIM. HR-VG shows promise for expanding access. To better address the implementation gap, additional strategies should be explored, including home-based VG delivery.