Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study
| Autor(a) principal: | |
|---|---|
| Data de Publicação: | 2023 |
| Outros Autores: | , , , , , , , , |
| Tipo de documento: | Artigo de conferência |
| Idioma: | eng |
| Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
| Texto Completo: | https://www.arca.fiocruz.br/handle/icict/60913 |
Resumo: | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. |
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Cohen, MirianO'Malley, G.Castanheira, D.Benedetti, Marcos RenatoHoagland, BrendaPimenta, CristinaTrefiglio, R.Veloso, Valdiléa G.Grinsztejn, BeatrizTorres, Thiago Silva2023-10-25T15:30:24Z2023-10-25T15:30:24Z2023COHEN, Mirian et al. Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study. In: IAS CONFERENCE ON HIV SCIENCE, 12., Brisbane, Australia. [Abstracts...]. Australia, 2023. 1 p.https://www.arca.fiocruz.br/handle/icict/60913engInternational AIDS SocietyHIVPrEPCabotegravirPrevenção do HIVHIVPrEPCabotegravirHIV preventionProcess mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil studyMapeamento de processos para apoiar a entrega de cabotegravir injetável de ação prolongada para profilaxia de pré-exposição ao HIV nos sistemas de saúde pública: o estudo IMPREP CAB BRASILinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/conferenceObjectFundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.University of Washington. Schools of Medicine and Public Health. Department of Global Health. Seattle, USA.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Ministério da Saúde. Brasília, DF, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.Background: Although long-acting injectable cabotegravir (CAB-LA) PrEP has proven efficacious for HIV prevention in clinical trials, additional research is needed to evaluate effective implementation in real world settings. The ImPrEP CAB-Brasil study will evaluate the feasibility, acceptability, and effectiveness of delivering same-day CAB-LA for HIV prevention in six PrEP public health clinics. Process maps are a diagrammatic representation of organizational processes and are widely used in healthcare quality management and improvement; however, literature is sparse in describing their use to incorporate clinical innovations into routine practice. We used process mapping to operationalize plans for integrating injectable PrEP with existing oral PrEP services. Description: We used a four-step approach to process mapping: preparation, mapping and analyzing, customization and co-creation, and validation. We first conducted individual interviews with study sites health professionals. Based on these interviews, we created initial process maps, customized for each site. Then, we held online meetings with health professionals and peer educators from each site who were encouraged to provide honest and constructive opinions during the discussions, especially about possible barriers/risks to planned models of service delivery. Finally, we asked the same personnel to validate revised process maps and to ensure there were no missing steps. We applied Business Process Management discipline using Bigazi Modeler Software, version 4.0. Lessons Learned: We created three process maps for each site to describe the initial CAB-LA PrEP user visit, follow-up visits and laboratory flow (18 maps total). Main challenge identified during the process was the duration of visits due to great number of laboratory and HIV counseling steps for the same-day PrEP delivery. Solutions proposed included (1) use of point-of-care HIV rapid tests instead of laboratory tests, which sites expressed the need for additional training to perform it; (2) more staff performing counseling. Two sites identified the need to expanding clinic hours for the project to better serve the study population, also contributing to oral PrEP scale-up. Conclusions: Process modeling was a powerful tool for planning an injectable PrEP implementation study within Brazilian Public Health System. Continuous monitoring of the implementation of mapped processes will help identify further barriers and solutions to CAB-LA PrEP delivery.info:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/60913/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALProcess mapping_Thiago_Torres_2023.pdfProcess mapping_Thiago_Torres_2023.pdfapplication/pdf441256https://www.arca.fiocruz.br/bitstream/icict/60913/2/Process%20mapping_Thiago_Torres_2023.pdf9c2da78c307afa709cb030039b638679MD52icict/609132023-10-25 12:33:20.244oai:www.arca.fiocruz.br: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ório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-10-25T15:33:20Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false |
| dc.title.en_US.fl_str_mv |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| dc.title.alternative.en_US.fl_str_mv |
Mapeamento de processos para apoiar a entrega de cabotegravir injetável de ação prolongada para profilaxia de pré-exposição ao HIV nos sistemas de saúde pública: o estudo IMPREP CAB BRASIL |
| title |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| spellingShingle |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study Cohen, Mirian HIV PrEP Cabotegravir Prevenção do HIV HIV PrEP Cabotegravir HIV prevention |
| title_short |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| title_full |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| title_fullStr |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| title_full_unstemmed |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| title_sort |
Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study |
| author |
Cohen, Mirian |
| author_facet |
Cohen, Mirian O'Malley, G. Castanheira, D. Benedetti, Marcos Renato Hoagland, Brenda Pimenta, Cristina Trefiglio, R. Veloso, Valdiléa G. Grinsztejn, Beatriz Torres, Thiago Silva |
| author_role |
author |
| author2 |
O'Malley, G. Castanheira, D. Benedetti, Marcos Renato Hoagland, Brenda Pimenta, Cristina Trefiglio, R. Veloso, Valdiléa G. Grinsztejn, Beatriz Torres, Thiago Silva |
| author2_role |
author author author author author author author author author |
| dc.contributor.author.fl_str_mv |
Cohen, Mirian O'Malley, G. Castanheira, D. Benedetti, Marcos Renato Hoagland, Brenda Pimenta, Cristina Trefiglio, R. Veloso, Valdiléa G. Grinsztejn, Beatriz Torres, Thiago Silva |
| dc.subject.other.en_US.fl_str_mv |
HIV PrEP Cabotegravir Prevenção do HIV |
| topic |
HIV PrEP Cabotegravir Prevenção do HIV HIV PrEP Cabotegravir HIV prevention |
| dc.subject.en.en_US.fl_str_mv |
HIV PrEP Cabotegravir HIV prevention |
| description |
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil. |
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2023 |
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2023-10-25T15:30:24Z |
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2023-10-25T15:30:24Z |
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2023 |
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COHEN, Mirian et al. Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study. In: IAS CONFERENCE ON HIV SCIENCE, 12., Brisbane, Australia. [Abstracts...]. Australia, 2023. 1 p. |
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https://www.arca.fiocruz.br/handle/icict/60913 |
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COHEN, Mirian et al. Process mapping to support delivery of long-acting injectable cabotegravir for HIV pre-exposure prophylaxis within public health systems: the ImPrEP CAB Brasil study. In: IAS CONFERENCE ON HIV SCIENCE, 12., Brisbane, Australia. [Abstracts...]. Australia, 2023. 1 p. |
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International AIDS Society |
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International AIDS Society |
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