Barriers and facilitators to implementing the HEADSS psychosocial screening tool for adolescents living with HIV/AIDS in teen club program in Malawi: health care providers perspectives.
Adherence
Adolescents
Barriers
CFIR
Depression
Facilitators
HIV
Journal
International journal of mental health systems
ISSN: 1752-4458
Titre abrégé: Int J Ment Health Syst
Pays: England
ID NLM: 101294224
Informations de publication
Date de publication:
31 Jan 2022
31 Jan 2022
Historique:
received:
04
08
2021
accepted:
13
01
2022
entrez:
1
2
2022
pubmed:
2
2
2022
medline:
2
2
2022
Statut:
epublish
Résumé
Adolescents living with HIV (ALHIV) are at high risk of experiencing mental health problems. Depression is a major contributor to the burden of HIV-related disease amongst ALHIV and is significantly linked to non-adherence to anti-retroviral therapy (ART), yet it is under-recognized. In 2015, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) recommended that the psychosocial screening tool Home, Education, Activities, Drugs, Sexuality, Suicide/Depression (HEADSS) be used to screen ALHIV in Malawi who were part of an adolescent antiretroviral therapy program termed "Teen Club". However, the HEADSS tool has been substantially under-utilized. This study assessed barriers and facilitators to implementing HEADSS for ALHIV attending Teen Club Program in four selected health facilities in Malawi. We conducted a qualitative study using semi-structured interviews at four program sites (one district hospital and one health center each in two districts) between April and May 2019. Twenty key informants were purposively selected to join this study based on their role and experiences. We used the five domains of the Consolidated Framework for Implementation Research (CFIR) to guide the development of the interview guides, analysis and interpretation of results. Barriers included inadequate planning for integration of the HEADSS approach; concerns that the HEADSS tool was too long, time consuming, lacked appropriate cultural context, and increased workload; and reports by participants that they did not have knowledge and skills to screen ALHIV using this tool. Facilitators to implementing the screening were that health care providers viewed screening as a guide to better systematic counselling, believed that screening could build better client provider relationship, and thought that it could fit into the existing work practice since it is not complex. A culturally adapted screening tool, especially one that can be used by non-clinicians such as lay health workers, would improve the ability to address mental health needs of ALHIV in many primary care and social service settings where resources for professional mental health staff are limited. These findings are a springboard for efforts to culturally adapt the HEADSS screening tool for detection of mental and risky behaviors among ALHIV attending ART program in Malawi.
Sections du résumé
BACKGROUND
BACKGROUND
Adolescents living with HIV (ALHIV) are at high risk of experiencing mental health problems. Depression is a major contributor to the burden of HIV-related disease amongst ALHIV and is significantly linked to non-adherence to anti-retroviral therapy (ART), yet it is under-recognized. In 2015, the Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) recommended that the psychosocial screening tool Home, Education, Activities, Drugs, Sexuality, Suicide/Depression (HEADSS) be used to screen ALHIV in Malawi who were part of an adolescent antiretroviral therapy program termed "Teen Club". However, the HEADSS tool has been substantially under-utilized. This study assessed barriers and facilitators to implementing HEADSS for ALHIV attending Teen Club Program in four selected health facilities in Malawi.
METHODS
METHODS
We conducted a qualitative study using semi-structured interviews at four program sites (one district hospital and one health center each in two districts) between April and May 2019. Twenty key informants were purposively selected to join this study based on their role and experiences. We used the five domains of the Consolidated Framework for Implementation Research (CFIR) to guide the development of the interview guides, analysis and interpretation of results.
RESULTS
RESULTS
Barriers included inadequate planning for integration of the HEADSS approach; concerns that the HEADSS tool was too long, time consuming, lacked appropriate cultural context, and increased workload; and reports by participants that they did not have knowledge and skills to screen ALHIV using this tool. Facilitators to implementing the screening were that health care providers viewed screening as a guide to better systematic counselling, believed that screening could build better client provider relationship, and thought that it could fit into the existing work practice since it is not complex.
CONCLUSIONS
CONCLUSIONS
A culturally adapted screening tool, especially one that can be used by non-clinicians such as lay health workers, would improve the ability to address mental health needs of ALHIV in many primary care and social service settings where resources for professional mental health staff are limited. These findings are a springboard for efforts to culturally adapt the HEADSS screening tool for detection of mental and risky behaviors among ALHIV attending ART program in Malawi.
Identifiants
pubmed: 35101066
doi: 10.1186/s13033-022-00520-3
pii: 10.1186/s13033-022-00520-3
pmc: PMC8805413
doi:
Types de publication
Journal Article
Langues
eng
Pagination
8Subventions
Organisme : NIMH NIH HHS
ID : U19 MH113202
Pays : United States
Organisme : NIMH NIH HHS
ID : NIMH U19 MH113202
Pays : United States
Informations de copyright
© 2022. The Author(s).
Références
Pediatr Nurs. 2010 Mar-Apr;36(2):103-11
pubmed: 20476512
Malawi Med J. 2016 Jun;28(2):37-42
pubmed: 27895826
JMIR Form Res. 2019 May 09;3(2):e11890
pubmed: 31094333
J Int AIDS Soc. 2017 May 16;20(Suppl 3):21497
pubmed: 28530045
BMC Health Serv Res. 2012 Dec 13;12:455
pubmed: 23234504
BMC Psychiatry. 2015 Oct 26;15:264
pubmed: 26503291
PLoS One. 2017 May 18;12(5):e0177026
pubmed: 28545038
Evid Based Nurs. 2019 Jul;22(3):67-68
pubmed: 31201209
J Clin Nurs. 2016 Oct;25(19-20):2786-97
pubmed: 27273150
Eur J Gen Pract. 2018 Dec;24(1):120-124
pubmed: 29202616
Glob Ment Health (Camb). 2019 Jun 03;6:e10
pubmed: 31258924
AIDS Res Treat. 2019 Mar 3;2019:8056382
pubmed: 30941210
Evid Based Nurs. 2013 Oct;16(4):98
pubmed: 23943076
J Med Internet Res. 2015 Nov 18;17(11):e262
pubmed: 26582138
Pediatrics. 2012 Aug;130(2):e321-7
pubmed: 22826567
Psychiatr Serv. 2016 Jun 1;67(6):636-41
pubmed: 26876655
Health Educ Res. 2006 Feb;21(1):34-42
pubmed: 15947022
BMC Health Serv Res. 2020 Jun 5;20(1):513
pubmed: 32503525
Implement Sci. 2017 Feb 10;12(1):15
pubmed: 28187747
AIDS Res Ther. 2018 Nov 17;15(1):20
pubmed: 30445984
AIDS Res Ther. 2020 Jun 22;17(1):35
pubmed: 32571375
Int J Health Policy Manag. 2021 Jun 07;:
pubmed: 34273919
Ther Adv Infect Dis. 2020 May 7;7:2049936120920177
pubmed: 32523693
Implement Sci. 2009 Aug 07;4:50
pubmed: 19664226
BMC Public Health. 2021 Jan 20;21(1):172
pubmed: 33472607
Acad Emerg Med. 2004 Jun;11(6):648-55
pubmed: 15175203
Ann Gen Psychiatry. 2018 Jul 10;17:29
pubmed: 30002721
Qual Quant. 2018;52(4):1893-1907
pubmed: 29937585
Qual Saf Health Care. 2007 Dec;16(6):409-14
pubmed: 18055883
J Int AIDS Soc. 2017 Mar 30;20(1):21437
pubmed: 28406275
J Int AIDS Soc. 2014 Jul 30;17:18965
pubmed: 25085002