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Examining the Implementation of Conditional Financial Incentives Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to Improve HIV Outcomes among Persons Living with HIV (PLWH) in Louisiana

Author

Listed:
  • Sarah Chrestman

    (Louisiana Public Health Institute, New Orleans, LA 70130, USA)

  • Tejal Patel

    (School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA)

  • Katherine Lass

    (The Policy & Research Group (PRG), New Orleans, LA 70118, USA)

  • Catherine Maulsby

    (Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA)

  • Hayley Alexander

    (Louisiana Department of Health, Bureau of Planning and Performance, Baton Rouge, LA 70821, USA)

  • Charlie Schwanz

    (Louisiana Public Health Institute, New Orleans, LA 70130, USA)

  • Kimberley O’Brien

    (AHF Baton Rouge Healthcare Centers, Baton Rouge, LA 70809, USA)

  • Waref Azmeh

    (AHF Baton Rouge Healthcare Centers, Baton Rouge, LA 70809, USA)

  • Austin Matthews

    (Social Research and Evaluation Center, Louisiana State University, Baton Rouge, LA 70803, USA)

  • Latoya Decuir

    (CareSouth Medical and Dental, Baton Rouge, LA 70806, USA)

  • Dionne Bell

    (CareSouth Medical and Dental, Baton Rouge, LA 70806, USA)

  • Julie Cacioppo

    (Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA)

  • Tina Martinez

    (Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA)

  • Julie D. Doyle

    (Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA)

  • Angie J. Brown

    (Our Lady of the Lake Regional Medical Center, Baton Rouge, LA 70808, USA)

  • Shamekia Wave

    (Multispecialty Care Clinic, Baton Rouge, LA 70806, USA)

  • Rubina Abrol

    (The Medical Affairs Company, Kennesaw, GA 30144, USA)

  • Tammeka Evans

    (ViiV Healthcare, Research Triangle Park, Durham, NC 27709, USA)

  • Russell Brewer

    (Department of Medicine, University of Chicago, Chicago, IL 60637, USA)

Abstract

Economic strengthening interventions are needed to support HIV outcomes among persons living with HIV (PLWH). The Baton Rouge Positive Pathway Study (BRPPS), a mixed method implementation science study, was conducted to assess key RE-AIM components tied to the provision of conditional financial incentives among PLWH in Baton Rouge, Louisiana. Seven hundred and eighty-one (781) PLWH enrolled at four HIV clinic sites were included in the final analyses. Participants completed an initial baseline survey, viral load test, and were contacted at 6 and 12 months (±1 month) post-enrollment for follow-up labs to monitor viral load levels. Participants received up to USD140 in conditional financial incentives. The primary analyses assessed whether participation in the BRPPS was associated with an increase in the proportion of participants who were: (a) engaged in care, (b) retained in care and (c) virally suppressed at baseline to 6 and 12 months post-baseline. We constructed a longitudinal regression model where participant-level outcomes at times t 0 (baseline) and t 1 (6- or 12-month follow-up) were modeled as a function of time. A secondary analysis was conducted using single-level regression to examine which baseline characteristics were associated with the outcomes of interest at 12-month follow-up. Cost analyses were also conducted with three of the participating clinics. Most participants identified as Black/African American (89%). Fewer than half of participants reported that they were unemployed or made less than USD5000 annually (43%). Over time, the proportion of participants engaged in care and retained in care significantly increased (70% to 93% and 32% to 64%, p < 0.00). However, the proportion of virally suppressed participants decreased over time (59% to 34%, p < 0.00). Implementation costs across the three sites ranged from USD17,198.05 to USD396,910.00 and were associated with between 0.37 and 1.34 HIV transmissions averted at each site. Study findings provide promising evidence to suggest that conditional financial incentives could help support engagement and retention in HIV care for a high need and at risk for falling out of HIV care population.

Suggested Citation

  • Sarah Chrestman & Tejal Patel & Katherine Lass & Catherine Maulsby & Hayley Alexander & Charlie Schwanz & Kimberley O’Brien & Waref Azmeh & Austin Matthews & Latoya Decuir & Dionne Bell & Julie Caciop, 2022. "Examining the Implementation of Conditional Financial Incentives Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Framework to Improve HIV Outcomes among Persons Livi," IJERPH, MDPI, vol. 19(15), pages 1-17, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9486-:d:878456
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    References listed on IDEAS

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    1. Glasgow, R.E. & Vogt, T.M. & Boles, S.M., 1999. "Evaluating the public health impact of health promotion interventions: The RE-AIM framework," American Journal of Public Health, American Public Health Association, vol. 89(9), pages 1322-1327.
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