categorise (and three days would you say that you missed sub-categorise) any of the dosages of your medicines?’; question types; general time frame (‘Now, have you missed quant analysis any?’); leading (‘So you haven’t missed any of frequency of HIV meds at all?’, or confronting with Q-type and rates evidence. of They examined sequential order of asking question-type, disclosures and which/when were most likely to elicit disclosure. following Q type, Question order and disclosure was non-significant. and regression to predict Main finding: non-adh disclosure was 3.64 higher for disclosure. negatively-frame questions compared with other Q types. So, substantial minority of providers did not ask or elicit disclosure. Negatively framed questions are most effective. The authors discuss various explanations (e.g. they are direct, normalizes non-adh). Other ‘missed’ questions can be interpreted in other ways (e.g. as about medication not adh, or simply invite minimal ‘fine’ answers) Graham et To determine US Quantitative Newly Of 178, 139 were linked within 90 days, 93 retained Unusual in being a al. (2015) if trust in (Houston, diagnosed at 12 months; 91/113 with low CD4 count initiated prospective study. physicians Texas) patients ART. Of these, 51 reported and only 41 Questionnaires. ≥95%, and (N=178) achieved undetectable viral load by 1 year. Problem with measuring Administered healthcare in physicians in general every 3 months, system rather than in a specific Univariate regression showed trust in physician (in predicted physician (due to testing general) was associated with retention in care. Measurements: subsequent before patient had one) Trust in healthcare system did not predict any outcome Self-reported linkage, variables. ART use retention and Qual research to see Multivariate analysis (adjusting for gender, Clinic adherence understanding of trust race/ethnicity and education) confirmed this attendance amongst would be helpful significant association. (through patients newly medical diagnosed Suggests trust is Discussion record with HIV multidimensional Higher trust in physicians predicts more – review). supports call for further successful retention in HIV care. Trust in research into this variable. physicians in general Trust in healthcare system Alcohol use
categorise (and sub-categorise) question types; quant analysis of frequency of Q-type and rates of disclosures following Q type, and regression to predict disclosure. three days would you say that you missed any of the dosages of your medicines?’; general time frame (‘Now, have you missed any?’); leading (‘So you haven’t missed any HIV meds at all?’, or confronting with evidence. They examined sequential order of asking question-type, and which/when were most likely to elicit disclosure. Question order and disclosure was non-significant. Main finding: non-adh disclosure was 3.64 higher for negatively-frame questions compared with other Q types. So, substantial minority of providers did not ask or elicit disclosure. Negatively framed questions are most effective. The authors discuss various explanations (e.g. they are direct, ‘missed’ normalizes non-adh). Other questions can be interpreted in other ways (e.g. as about medication not adh, or simply invite minimal ‘fine’ answers) Graham et al. (2015) To determine if trust in physicians and healthcare system predicted subsequent linkage, retention and adherence amongst patients newly diagnosed with HIV US (Houston, Texas) Quantitative Questionnaires. Administered every 3 months, Measurements: Self-reported ART use Clinic attendance (through medical record review). Trust in physicians in general Trust in healthcare system Alcohol use Newly diagnosed patients (N=178) Of 178, 139 were linked within 90 days, 93 retained at 12 months; 91/113 with low CD4 count initiated ART. Of these, 51 reported ≥95%, and only 41 achieved undetectable viral load by 1 year. Univariate regression showed trust in physician (in general) was associated with retention in care. Trust in healthcare system did not predict any outcome variables. Multivariate analysis (adjusting for gender, race/ethnicity and education) confirmed this significant association. Discussion Higher trust in physicians predicts more successful retention in HIV care. Unusual in being a prospective study. Problem with measuring in physicians in general rather than in a specific physician (due to testing before patient had one) Qual research to see understanding of trust would be helpful Suggests trust is multidimensional – supports call for further research into this variable.
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