|About this initiative...|
Identifying effective models of outreach to underserved HIV positive people not in care is a critical element in responding to the changing AIDS epidemic. Recent advances in the treatment of HIV/AIDS have slowed both AIDS death rates and the progression of disease for many individuals. However, certain vulnerable and marginalized groups of people are not benefiting as much from these advances.
Populations with the highest HIV infection rates have a correspondingly greater need for treatment, yet other behavioral and service delivery factors such as cultural and linguistic biases, racial and gender discrimination and lack of insurance have a profound influence on access to medical care. For instance, late HIV diagnoses and initiation of therapy are far more prevalent among African Americans, Latinos and intravenous drug users.
Creative and intensive outreach efforts are needed to assure early and continued treatment for people facing persistent access barriers. Outreach strategies that worked in the early years of the epidemic may not improve access for people who have been historically underserved and marginalized and who mistrust the medical care system. In response, medical and ancillary service providers have developed innovative outreach strategies that they believe are effective in engaging and retaining underserved individuals in care. They use various improvised outreach approaches, ranging from street outreach and mobile vans, to reach affected populations in rural areas and specific out-of-care segments of the population such as racial and ethnic minorities and individuals released from correctional systems. Outreach approaches have emerged that seek to engage clients by addressing them on their own terms, providing them with tangible benefits that meet their subsistence needs before addressing health care needs. In these frontline approaches, each incremental step that brings an individual closer to primary HIV care is seen as progress. Harm reduction and the stages of change model of behavior change are two theoretical frameworks used by several projects that are based on this client-centered approach.
The purpose of this grant initiative is to support multi-year projects that will refine and evaluate current outreach strategies for bringing HIV-positive individuals into comprehensive continual care. This initiative addresses two evaluation questions based on the priorities of the Ryan White CARE Act reauthorization bills.
The Outreach and Intervention initiative is a two phase five-year program. In September 2001, seventeen individual projects were funded for Phase 1 (project years 1-2). During this phase projects will continue to implement their current outreach and intervention programs, conduct a local evaluation of those strategies and plan activities to enhance or modify their programs for Phase 2 (project years 3-5). Grantee planning activities will include refining intervention models based on the findings of their local evaluation, adjust evaluation plans as needed, and participating in a cross-site evaluation. During the second year of Phase 1 the current grantees may submit competitive continuation applications for the Phase 2 during which their proposed models will be implemented.
The Center for Outreach and Evaluation (CORE ) is a part of the Health and Disabilities Working Group, a program of the Boston University School of Public Health in Boston, MA. The CORE will provide each project with program support and technical assistance including coordination of local and multi-site evaluation. The CORE will also coordinate the development of cross-site activities, including data collection instruments, outcome measures, and evaluation methodologies. The CORE will conduct the multi-site data analyses and provide leadership in the preparation and dissemination of the findings through reports, journal articles, community forums and conference presentations.
Grants for this initiative were awarded to the applicants listed below. The abstracts provide both contact information and a brief description of their project.
Project Period: 2002-2006
Target Population: Active substance abusers, commercial sex workers, individuals being released from jails and prisons, and other hard-to-reach individuals chronically not in care.
Description: This project will evaluate a current intervention that provides primary HIV care in community locations and links HIV infected individuals to social services. The goal will be to determine refinements during Phase 2 that could improve health outcomes. Current activities during phase 1 include Ainreach" to clients of partner agencies to ensure enrollment in care, provision of primary care health services, benefits counseling and referrals, and outreach to high-risk populations in the community. Intensive case management will be added and evaluated during phase 2. Organizational partners include a local needle exchange program, social service agency for commercial sex workers, an agency serving men who are leaving incarceration, a consortium of HIV case management programs in Northern Illinois, two drug treatment programs, an established AIDS service organization, and an emergency food cupboard for HIV infected persons. Findings will be disseminated via meetings with local HIV services planning bodies, educational sessions for case managers in the region, presentations at local and national conferences, and submission of manuscripts for publication in professional journals.
Evaluation Strategies: Evaluation during phase 1 will compare patient demographic and services utilization data using CDC's EpiInfo software, and conduct chart audits using a HRSA-created chart audit tool. The goal is to determine the individual and intervention characteristics associated with appropriate and successful primary care for the target population. The evaluation will assess (a) service penetration of HIV primary care programs with regard to the target population, (b) barriers to HIV primary care accessibility, and acceptance of risk reduction measures within the target population.
Project Period: 2002-2006
Target Population: Uninsured African-Americans living with HIV disease in rural Northeast Alabama
Description: This project will evaluate a current initiative that seeks to bring the target population into care via activities which educate about susceptibility and severity of HIV infection, potential benefits of enrollment into care, and strategies for overcoming barriers to care. Phase 1 activities will consist of: intensive counseling at intake regarding the experience of symptomatic HIV infection, viewing of an educational video regarding HAART, and counseling regarding management of therapeutic side effects, obtaining support services, and meeting survival needs. A phase 2 intervention will be designed to enhance enrollment and retention into care by deploying current clients as peer counselors and training them to become key influencers in local social networks. An organizational partner in the project is Jacksonville State University, located in the project's current geographic target area.
Evaluation Strategies: Evaluation activities during phase 1 will focus on compliance with the planned program model, monitoring and describing services provided, and documentation of outcomes with regard to the use of emergency medical services, keeping of medical appointments, adherence to medication regimens, and abstinence from substance abuse.
Project Period: 2002-2006
Target Population: HIV infected African-Americans living in St. Louis, MO, and East St. Louis, IL.
Description: This project will evaluate the current Case Finding Initiative that targets African-American neighborhoods in St. Louis and East St. Louis via augmented outreach, counseling and testing, and case management services. Phase 1 objectives are increase the number of persons enrolled in case management, improve client self-efficacy, enhance positive beliefs in health care services, improve knowledge of treatment regimens, and advance provider-client communications. Phase 2 will implement a refined Case Finding Initiative model based upon evaluation findings. Key organizational partners are local health departments in St. Louis, MO, and East St. Louis, IL, and St. Louis University. Results will be disseminated via a newsletter, web site, and brochure, and via presentations at SPNS national meetings.
Evaluation Strategies: Evaluation during both phases will examine the following questions: the accessibility of outreach services to clients, ability of outreach to facilitate access to primary care, effectiveness in reaching the target population, accessibility of ancillary services as a result of outreach, reduction in number of appointments not kept because of outreach, change in knowledge of treatment regimens, and change in health beliefs. Evaluation activities will examine client characteristics upon intake, and monitor activities and outcomes described in case management and medical records.
Project Period: 2002-2006
Target Population: African-American and Latino HIV-infected adults in the downtown, northeast, and HOML (Hialeah, Opa-Locha, and Miami Lakes) neighborhoods of Miami-Dade County, FL.
Description: This project will focus on an existing intervention of concentrated outreach and physician referrals that seek to increase use of services by persons not in care or sporadically in care and improve retention in care. During Phase 1 HIV infected persons not in care will be enrolled in a case management based treatment intervention via focused outreach, provider referral, and social marketing of the agency's program. A revised intervention will be developed for phase 2 with the intent of increasing the target population's (a) adherence to established care plans, (b) engagement in services as a result of referrals, (c) satisfaction with case management services, (d) participation in preventative health care services, and (e) ongoing participation in the program. An organizational partner in the project is the Department of Epidemiology and Public Health of the University of Miami. Results will be disseminated local HIV services planning bodies, and state and federal entities with an interest in retaining HIV infected persons in care.
Evaluation Strategies: Phase 1 activities will focus on incorporation of process measures to evaluate program fidelity, adding impact evaluation activities, enhancing data management and analysis, integrating process and impact evaluation efforts, and coordinating cross-site evaluations. Phase 2 evaluation will build on that of phase 1, intensively evaluating and comparing outputs and outcomes to the phase 1 experience.
Target Population: HIV infected persons of color, especially African-Americans and Latinos
Description: This project will evaluate an existing intervention in the grantee's OASIS clinic that uses HIV-infected peers to identify HIV-infected individuals and bring them into treatment and/or prevention interventions, as warranted. Activities during Phase 1 will consist of outreach to bring into case management services, enrollment in primary care, referral to outside support services to assist clients with overcoming barriers to care, and use of client incentives when engagement in care is maintained. Activities in Phase 2 will consist of implementing and evaluating a refined intervention that will seek to bring clients into treatment earlier, test and treat for co-morbidities, and increase treatment adherence. Findings will be disseminated via meetings with local HIV providers, presentations at professional conferences, and publications in professional journals.
Evaluation Strategies: Based upon a Total Quality Improvement model, the evaluation in Phase 1 will identify strengths and weaknesses of the current intervention and plan modifications. An evaluation team will identify programmatic activities and strategies, and conduct a process evaluation of the project by collecting, organizing, and analyzing meeting agendas, minutes, agency literature, and community activities. Client-level characteristics and outcomes will be evaluated through a review of contact logs and community level indicators with regard to outreach and contacts in the target population.
Project Period: 2002-2006
Target Population: HIV infected Men of Color who have sex with other men (especially those who do not identify as gay or bisexual), are commercial sex workers, are prisoners or ex-prisoners, are substance abusers, and/or are transgender or transsexual.
Description: This project will evaluate current case finding and outreach interventions that occur internally at the grantee or in conjunction with organizational partners. Phase 1 activities consist of outreach to persons who show evidence of high risk behavior and referral to the Center for risk reduction services, screening of all Center clients with regard to sexual and substance abuse histories to assess risk for HIV infection, counseling and testing of all persons with high risk profiles, referral into care for those who are HIV infected, prompt enrollment of referrals into case management, patient education by health care providers with regard to the nature of HIV infection, and telephone and/or in-person follow-up by case managers or outreach workers to those who miss appointments or who become lost to care. Phase 2 will refine the current intervention by strengthening staff capabilities to maintain patients in care and adding use of HIV infected peers in outreach work. Organizational partners in the project include Men of Color Against AIDS, Span, and Victory Programs.
Evaluation Strategies: Phase 1 will evaluate current activities to determine (a) their fidelity to best practices models, (b) process evaluation to ensure that program implementation is occurring according to plans, and (c) overall impact on participant level outcomes. Evaluation activities will consist of: assessment of programmatic interventions' fidelity to best practices models, process evaluation to ensure that implementation takes place according to the plan, and examination of case management and medical records with regard to client-level outcomes. Evaluation during Phase 2 will conduct more intensive evaluation of activities with regard to enrollment and retention into care.
Project Period: 2002-2006
Target Population: Injection Drug Users, Commercial Sex Workers, and Others at High Risk
Description: This project will evaluate the effectiveness of a continuum of street outreach, education, counseling and testing, transitional street side case management, and ongoing office-based care. Particular focus will be given to reaching those in the target population who face barriers of mental illness, extreme poverty, homelessness, and cultural blocks. Phase 1 will include street outreach to build rapport, assess risk, initiate risk reduction, and enroll in comprehensive HIV specialty care and case management. Specific objectives of this phase are to help the target population progressively reduce the incidence of risky behaviors, gain a more positive impression of the healthcare system and knowledge of how to use it, and remove logistical barriers to obtaining services. Phase 2 will continue these activities with an enhancement to provide easier access to medical care for people in remote neighborhoods and/or those with significant barriers. An organizational partner in the project is the Center for AIDS Research. Information will be disseminated through the local Title I planning council, the local AIDS Education and Training Center, and other HIV/AIDS organizations with which the grantee has working relationships.
Evaluation Strategies: The Phase 1 evaluation will seek to describe medical and psychosocial outcomes from the existing case management intervention (ASCRAP"), and identify strategies for improvement. Further, the Phase 1 evaluation will seek to create a standardized evaluation instrument for collecting qualitative data on the content of case management sessions, and develop an evaluation dataset based on socio-demographic, service delivery, and medical indicators currently being collected by project participants. Phase 2 evaluations will seek to monitor the effectiveness of the revised case management model with regard to improving long term health outcomes among those who are under served and/or not regularly engaged in care.
Project Period: 2002-2006
Target Population: Seropositive ex-offenders recently released from incarceration.
Description: This project will evaluate an existing intervention (Project Bridge) with ex-offenders to assess use of primary care and barriers to care, current health outcomes, and the impact of available support services. Phase 1 activities seek to: reduce relapse among substance abusers, increase the use of clinical services, and teach new skills that will help to stabilize life situations. A phase 2 intervention will refine the current one by adding skills-building groups focusing on health-seeking behaviors, motivational interviewing for engaging in substance abuse treatment, and extension of the current enrollment period to cover brief periods of reincarceration. The Phase 2 intervention will also add detainees in the local jail to the target population. Collaborators include: AIDS Care Ocean State, the AIDS Project of Rhode Island, the Brown University AIDS Program, the Stanley Street Treatment and Resource Center, the local Traveler's Aid Society, and Family Services, Inc. Findings will be disseminated through journal articles, published brochures, and presentations at local, regional, and national conferences.
Evaluation Strategies: Evaluation activities during Phases 1 and 2 will consist of consultation among service providers, evaluation of existing client data, examining outcome data contained in medical records, individual interviews with provider staff, and surveying and interviewing clients.
Project Period: 2002-2006
Target Population: Residents of Single Room Occupancy Hotels
Description: This project will evaluate and refine a current program of integrated harm reduction and medical outreach occurring in Bronx, NY which seeks to transform sporadic health care users into regular and continual users, and to retain participants in care. Phase 1 objectives are to: engage the target population in services, create a complete initial patient medical data base, and develop treatment plan for those enrolled. Phase 2 activities will focus on revising pre-engagement outreach activities, expand in-home medical and mental health services, and retain participants once they are permanently housed. Goals for Phase 2 include increasing participant "stability" in adherence to treatment, improve mental health outcomes, reduce disease progression, and improve overall quality of life. Montefiore Medical Center's Department of Family Medicine and Community Health and CitiWide Harm Reduction, Inc., will be organizational partners in the project. Dissemination of results will occur via presentations at professional meetings and conferences, preparation of manuscripts for publication, participation in local training activities, and participation in ongoing HRSA activities.
Evaluation Strategies: The Phase 1 evaluation focus on determining outcomes from the existing intervention and identifying strategies for improvement. 150 current participants will be interviewed three times during a six month period, using survey formats already available at SPNS-related web sites, to which a limited number of local items will be added. Data from these surveys will be supplemented by clinical and case management data currently in a database managed by CitiWide Harm Reduction. Finally, the grantee plans to develop a "stability index" that can be used in Phase 2 to measure participant changes during the course of the project, and identify additional areas for project quality improvement.
Target Population: Persons living with HIV infection or AIDS who have not received care within six months of diagnosis or who have fallen out of care.
Description: This project will evaluate the effectiveness of Care Link, an outreach intervention that uses peers to contact individuals, break down barriers to care, and motivate individuals to seek care. Phase 1 activities will evaluate the Care Link model and conduct a community planning process to determine refinements that can be implemented and evaluated during phase 2. Objectives during phase 1 include increasing: client knowledge about HIV and treatment options, client self-efficacy, client self-support, client skills and motivation, and readiness to enroll in services. The organizational partner in this project is the Cascade AIDS Project. Results will be disseminated via publications in journals and presentations at professional conferences.
Evaluation Strategies: Evaluation activities during Phase 1 will seek to validate the program theory of Care Link, develop profiles of HIV infected individuals who are out of care, and (via the multi-site evaluation) estimate the impact of Care Link on out-of-care individuals in relation to other outreach models. The evaluation will examine case management and clinical data, and gather qualitative data via interviews and surveys with clients and staff.
Target Population: Seropositive women and children who are not in care or are underserved in the Miami Family Care Program (MFCP) of the Univ. of Miami/Jackson Memorial Medical Center.
Description: This project will conduct a structural, process, output, and outcome evaluation of the current MFC program and to develop a new or refined intervention (ACaring Connections " that will improve enrollment and participation in HIV care. The current (phase 1) intervention is based upon a social work case management model. Its objectives for women are to (a) enroll in primary care within six weeks of receiving a diagnosis of HIV infection, (b) maintain in care via a minimum of three primary care visits yearly, (c) re-enroll those lost to care, and (d) reconnect with women who may be Alost in the system" because they are receiving care from other providers in the HIV care system. Objectives for children in Phase 1 are to enroll in care within six weeks of receiving a diagnosis of HIV infection, and screen and monitor children born to HIV infected mothers via a minimum of three primary care visits yearly. The Phase 2 intervention will be derived from CDC models for HIV prevention that emphasize stages of behavioral change. Objectives for this phase are to increase the minimum number of primary care visits for each target population to four, increase adherence to medication regimes and scheduled appointments, and increase the percentage of pregnant women who adhere to ZDV protocols before and after giving birth. The grantee's Departments of Psychiatry and Behavioral Sciences, Obstetrics and Gynecology, and Pediatrics will be the main organizational entities for the project. Community participants will include: the local Salvation Army, a homeless services provider, two African-American churches, Mujer, Inc., two Haitian community organizations, and local substance abuse treatment providers. Results will be disseminated via reports, papers, and presentations at local and national meetings, and via professional journal articles.
Evaluation Strategies: Evaluation during Phases 1 and 2 will consist of analysis of existing data collected from outreach activities and clinical service providers, chart reviews of clients with regard to certain biological markers that show slowing or progression of disease and notes on patient behavior (whether recommended treatments were accepted, etc.), interviews with clients that have been lost to care, and client satisfaction data currently collected.
Target Population: Commercial sex workers, runaway youth, the homeless, undocumented workers, gang members, teen parents, women of childbearing age, adult and adolescent MSMs of color and transgendered/transsexual persons of color in the South Central, Hollywood, West Hollywood, East LA, and downtown neighborhoods of Los Angeles.
Description: This project will evaluate an existing intervention (phase 1) that provides testing, counseling, and care services to the target population, with the objectives of increasing (a) positive attitudes toward health care, belief in the efficacy of treatment, (c) perceived availability of health care services, and (d) use of health care services. Once evaluated, the grantee will develop and implement a refined intervention (phase 2) featuring enhanced outreach and case-management, with the goal of improving access to care and health outcomes as a result of services provided. An organizational partner for the project is Drew University's Mobile HIV Outreach Program (MoHOP). Results will be disseminated via conference calls, presentations at local and national meetings, and reports to other SPNS program grantees.
Evaluation Strategies: Evaluation during Phases 1 and 2 will be conducted using existing intake and medical record data with regard to client characteristics, services provided, and client level outcomes. Particular attention will be given to identifying barriers to care and strategies that could be or have been employed to remove such.
Target Population: HIV African-American and Latino Men of Color in San Antonio, TX, who are Sexually Active with other Men (MSM)
Description: This project will evaluate an existing intervention that seeks to identify and bring the target population into care, especially medical care. The phase 1 intervention uses HIV infected MSM of color to link persons not in care into the existing medical care and social services system, and reestablish links to persons who have been lost to care. The goal is to bring such persons into services earlier in their disease stage and maintain their participation in the care system. Specific objectives are to enhance client perceptions about the importance of early entry into care, and improve coordination between outreach, counseling and testing, and medical care. Phase 2 of the project will refine the existing intervention based upon evaluation findings. BEAT AIDS, a local service provider, and FFACTS, a local clinic, will be organizational partners in the project. Findings will be initially disseminated via presentations to local service providers, to be followed by presentations at regional and national meetings and conferences.
Evaluation Strategies: Evaluation during both phases will analyze process and client level data collected via intake and case management tracking forms, review medical chart data, and conduct feedback via interviews with clients and service providers. Evaluation will center around out-of-care client characteristics, primary care needs, barriers to care, the impact of peer-based outreach interventions, characteristics of program interventions and service system structures, and links between primary care services and quality of care measures.
Target Population: Seropositive adults of color who are not enrolled in primary care, or are sporadic users of primary care.
Description: This project will evaluate a current community-based intervention, Konnect II, which uses Client Advocates and Peer Supporters to engage the target population in care. The objectives of engagement in care via Konnect II are improved health status, reduction of high-risk behaviors, and improved functioning in areas of personal relationships and employment. The Phase 2 intervention will implement new or refined strategies to address the unmet needs and barriers to primary care identified in the Phase 1 evaluation, using an Assertive Community Treatment team approach. Enhanced services envisioned for Phase 2 include additional community nursing, psychiatric services, and specialized medicine. The major organizational partner in the project is the People of Color Against AIDS Network, which conducts the current Konnect II intervention. Dissemination of results will occur at local service provider planning meetings, at professional conferences, and at meetings of grantees in this SPNS initiative.
Evaluation Strategies: The goal of the Konnect II evaluation is to determine barriers to care and strategies to overcome barriers, demonstrate the programs facility in establishing long term relationships with service providers, and improve the Konnect II staffs technical ability to conduct program evaluation. Phase 1 evaluation will be conducted using instruments disseminated by the SPNS program during 2000. Client level characteristics and client-level outcomes will be assessed.
Wayne State University
Evaluating the Horizons Project's Targeted HIV Outreach and Interventions
Children's Hospital Department of Psychiatry
3901 Beaubien Blvd.
Detroit, MI 48201
Project Period: 2002-2006
Target Population: HIV Infected Youth who are not enrolled in primary care
Description: This project will evaluate the Horizons Project, currently funded by SPNS, in which outreach activities, peer advocacy, individualized case management, and mental health services are provided to decrease levels of mental health distress and substance abuse among HIV infected youth and improve their overall health and well-being. Specific objectives for phase 1 are to increase the number of HIV infected youth who are reached via outreach, increase the number of such youth who enroll with Horizons for case management and peer advocacy, and increase the number of youth lost to care who are contacted via outreach activities. Phase 2 activities will consist of implementing a revised phase 1 model and adding the treatment mechanism of motivational interviewing, with the goal of enhancing engagement in treatment. Key organizational players in the project are the Children's Hospital of Michigan and the Michigan Department of Community Health. Results will be disseminated via local meetings with providers, presentations at national conferences, and submission of articles for publication.
Evaluation Strategies: The phase 1 evaluation will focus on comprehensively describing outreach contacts, medical and psycho-social outcomes, and qualitatively describing barriers to care. This will be supplemented by data from focus groups of clients and of staff. Process evaluation will be conducted by entering data from logbooks, and medical and case management records into HRSA's CAREware.
Target Population: HIV infected women who have been lost to follow-up in health care, and are predominantly substance abusers, mentally ill, African-American, living in poverty, and/or facing other barriers to obtaining health care.
Description: This project will evaluate the Personalized Nursing LIGHT model as it helps women cope with barriers to care and sustain involvement in care. During phase 1, the grantee will evaluate the model's impact in two existing projects, an HIV adherence study and a sex worker study, funded from other sources. The goal is to identify correlates and antecedents of success and weakness in the current programs, and to refine an intervention to be used in a revised Phase 2 intervention, which will undergo more intensive evaluation. The phase 2 intervention seeks to improve the recruitment rate of the target population, increase the number of woemn retained in the project, improve mental heatlh, decrease substance abuse, and improve individual overall well being. Partners in the project are the Infectious Disease Clinic at the Wayne State University School of Medicine, Detroit Central City Community Mental Health, Inc., and the Detroit LIGHT House Substance Abuse Treatment Program. Results will be presented to local and national audiences that have an interest and need to reach the same or similar target population.
Evaluation Strategies: A core assessment battery used in the existing HIV adherence study will be used to conduct outcome evaluation with regard to physical health, mental health, substance abuse, sexual practices, and use of services. Process evaluation will be conducted via reviews of AIndividual Service Records" maintained by clinical staff. Indices constructed from these records will assess fidelity to the intervention and intervention "dosage" variables as they relate to outcomes.
Target Population: Adult Latinos/Latinas who are seeking HIV-oriented primary care, and African-American adults who know of their HIV infection, but only sporadically seek or have dropped out of primary care.
Description: This project will evaluate two current interventions: an Adherence Clinic, and a Latino/Latina Care project. Currently, the project will seek to: Phase 1 activities will include pre-appointment phone calls to assess and remove barriers to service that may exist, telephone and in-person follow-up by staff when appointments are missed, outreach to clients being seen in emergency rooms, outreach to other HIV service organizations that do not provide clinical services, monitoring of paperwork related to ADAP, Medicaid, and SSI, client advocacy, and accompanying clients to appointments for support services. Phase 1 activities will also include planning to refine the current interventions (based upon evaluation findings), and recruitment of additional participants to implement a refined intervention. Phase 2 will include implementation of the refined intervention, with an emphasis on meeting mental health and addictions treatment needs. Findings will be disseminated at local conferences and through abstracts and papers submitted to national conferences.
Evaluation Strategies: The evaluation in phase 1 will seek to determine the effectiveness of these interventions in improving client's lives and health status. Process evaluation will be based on periodic comparisons of project records and the project work plan. Outcome evaluation will be based upon weekly project team reviews, periodic client satisfaction surveys, and comparisons of data with regard to client self-care behavior and self-efficacy at baseline enrollment to data collected at six and twelve month intervals after enrollment.
Outlaw A, Naar-King S, Green-Jones M, Wright K, Condon K, Sherry L, & Janisse H. (2010) Brief Report: Predictors of Optimal HIV Appointment Adherence in Minority Youth: A Prospective Study.
Journal of Pediatric Psychology, e-published ahead of print, February 8, 2010.
Naar-King S, Outlaw A, Green-Jones M, Wright K, & Parsons JT. (2009) Motivational interviewing by peer outreach workers: a pilot randomized clinical trial to retain adolescents and young adults in HIV care. AIDS Care, 21 (7): 868-873.
Rajabiun S, Rumptz MH, Felizzola J, Frye A, Relf M, Yu G, & Cunningham WE. (2008) The Impact of Acculturation on Latinos’ Perceived Barriers to HIV Primary Care. Ethnicity & Disease, 18 (4): 403-408.
Drainoni ML, Rajabiun S, Rumptz M, Welles SL, Relf M, Rebholz C, Holmes L, Dyl A, Lovejoy T, Dekker D, & Frye A. (2008) Health literacy of HIV-infected individuals enrolled in an outreach intervention: Results of a cross-site analysis. Journal of Health Communication, 13 (3): 287-302.
Sacajiu G, Fox A, Ramos M, Sohler N, Heller D, & Cunningham C.(2007) The evolution of HIV illness representation among marginally housed persons. AIDS Care, 19 (4): 539-545.
Tobias C, Cunningham WE, Cunningham CO, & Pounds MB (2007) Making the Connection: The Importance of Engagement and Retention in HIV Medical Care. AIDS Patient Care & STDs, 21, Supplement 1: S3-S8
Rajabiun S, Cabral H, Tobias C, & Relf M (2007) Program Design and Evaluation Strategies for the Special Projects of National Significance Outreach Initiative. AIDS Patient Care & STDs, 21, Supplement 1: S9 - S19.
Rajabiun S, Mallinson RK, McCoy K, Coleman S, Drainoni ML, Rebholz C, Holbert T (2007) “Getting Me Back on Track”: The Role of Outreach Interventions in Engaging and Retaining People Living with HIV/AIDS in Medical Care. AIDS Patient Care & STDs, 21, Supplement 1: S20-S29.
Rumptz MH, Tobias C, Rajabiun S, Bradford J, Cabral H, Young R, & Cunningham WE (2007) Factors Associated with Engaging Socially Marginalized HIV-Positive Persons in Primary Care. AIDS Patient Care & STDs, 21, Supplement 1: S30-S39.
Naar-King S, Bradford J, Coleman S, Green-Jones M, Cabral H., & Tobias C (2007) Retention in Care of Persons Newly Diagnosed with HIV: Outcomes of the Outreach Initiative. AIDS Patient Care & STDs, 21, Supplement 1: S40-S48.
Bradford J, Coleman S, & Cunningham W. (2007) HIV System Navigation: An Emerging Model To Improve HIV Care Access. AIDS Patient Care & STDs, 21, Supplement 1: S49-S58.
Cabral HJ, Tobias C, Rajabiun S, Sohler N, Cunningham C, Wong M, & Cunningham W. (2007) Outreach Program Contacts: Do They Increase the Likelihood of Engagement and Retention in HIV Primary Care for Hard-to-Reach Patients? AIDS Patient Care & STDs, 21, Supplement 1: S59-S67.
Sohler NL, Wong MD, Cunningham WE, Cabral H, Drainoni ML, Cunningham CO (2007) Type and Pattern of Illicit Drug Use and Access to Health Care Services for HIV-Infected People. AIDS Patient Care & STDs, 21, Supplement 1: S68-S76.
Mallinson RK, Rajabiun S, & Coleman S (2007) The Provider Role in Client Engagement in HIV Care. AIDS Patient Care & STDs, 21, Supplement 1: S77-S76.
Bradford, J. (2007) The promise of Outreach for Engaging and Retaining Out of Care Persons in HIV Treatment. AIDS Patient Care & STDs, 21, Supplement 1: S85-S91.
Wong MD, Sarkisian CA, Davis C, Kinsler J, Cunningham WE (2007) The Association between Life Chaos, Health Care Use, and Health Status among HIV-infected Persons. Journal of General Internal Medicine, 22 (9): 1286-1291.
Coleman S, Boehmer U, Kanaya F, Grasso C, Tan J, & Bradford J. (2007) Retention Challenges for a Community-Based HIV Primary Care Clinic and Implications for Intervention. AIDS Patient Care & STDs, 21, (9): 691-701.
Kinsler JJ, Wong MD, Sayles JN, Davis C, & Cunningham WE. (2007) The effect of perceived stigma from a health care provider on access to care among a low-income HIV-positive population. AIDS Patient Care & STDs, 21, (8): 584-592.
Tobias C, Cunningham W, Cabral H, Cunningham CO, Eldred L, Naar-King S, Bradford J, Sohler NL, Wong MD, & Drainoni ML (2007) Living with HIV But Without Medical Care: Barriers to Engagement. AIDS Patient Care & STDs, 21, (6): 426-434.
Andersen M, Hockman E, Smereck G, Tinsley J, Milfort D, Wilcox R, Smith T, Connelly C, Adams L, & Thomas R. (2007) Retaining women in HIV medical care. Journal of the Association of Nurses in AIDS Care, 18 (3): 33-41.
Cunningham CO, Sohler NL, Wong MD, Relf M, Cunningham W, Drainoni ML, Bradford J, Pounds MB, & Cabral HD (2007) Utilization of Health Care Services in Hard-to-Reach Marginalized HIV-Infected Individuals. AIDS Patient Care & STDs, 21, (3): 177-186.
Cunningham WE, Sohler NL, Tobias C, Drainoni ML, Bradford J, Davis C, Cabral HJ, Cunningham CO, Eldred L, & Wong MD (2006) Health Services Utilization for People with HIV Infection – Comparison of a Population Targeted for Outreach with the US Population in Care. Medical Care, 44 (11): 1038-1047.
Naar-King S, Green M, Wright K, Outlaw A, Wang B, & Liu H. (2007) Ancillary services and retention of youth in HIV care. AIDS Care,19 (2): 248-251.
Cunningham CO, Sohler NL, McCoy K, Heller D, & Selwyn PA (2005) Health Care Access and Utilization Patterns in Unstably Housed HIV-Infected Individuals in New York City. AIDS Patient Care & STDs, 19 (10): 690-695.
Mallinson RK, Relf MV, Dekker D, Dolan K, Darcy A, & Ford A. (2005) Maintaining Normalcy: A Grounded Theory of Engaging in HIV-oriented Primary Medical Care. Advances in Nursing Science, 28 (3): 265-277.
The SPNS program began with some of the first Federal grants to target adolescents and women living with HIV, and over the years, initiatives have been developed to reflect the evolution of the epidemic and the health care arena.
Part F - SPNS Products and Publications
HIT Capacity Building Initiative for Ryan White HIV/AIDS Program AIDS Drug Assistance Program (ADAP) Grantees
Deadline: February 14, 2013
Culturally Appropriate Interventions of Outreach, Access and Retention among Latino/a Populations – Demonstration Sites
Deadline: March 18, 2013
Culturally Appropriate Interventions of Outreach, Access and Retention among Latino/a Populations – Evaluation and Technical Assistance Center
Deadline: March 18, 2013
The above information is subject to change. See Grants.gov for the most current information or to apply for these grants.
acajina at hrsa.gov
Public Health Analyst
pbelton at hrsa.gov
Public Health Analyst
rboyd at hrsa.gov
Public Health Analyst
knguyen at hrsa.gov
Public Health Analyst
nsolomon at hrsa.gov
Public Health Analyst
mtinsley1 at hrsa.gov
Public Health Analyst
jxavier at hrsa.gov