A5035813654- HIV/AIDS Research and Interventions
- Global Maternal and Child Health
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- HIV-related health complications and treatments
- Poverty, Education, and Child Welfare
- Adolescent and Pediatric Healthcare
- Mobile Health and mHealth Applications
- Family Caregiving in Mental Illness
- Family Support in Illness
- Primary Care and Health Outcomes
- Healthcare Systems and Practices
- Child Abuse and Trauma
- Health Policy Implementation Science
- Vaccine Coverage and Hesitancy
- COVID-19 Digital Contact Tracing
- Maternal Mental Health During Pregnancy and Postpartum
- Migration, Identity, and Health
- Emergency and Acute Care Studies
- Patient Satisfaction in Healthcare
- Interprofessional Education and Collaboration
- Clinical practice guidelines implementation
- Child Nutrition and Water Access
- Mental Health and Patient Involvement
- Diabetes Treatment and Management
Cleveland Clinic Lerner College of Medicine
2022-2024
Cleveland Clinic
2022-2024
Virginia Commonwealth University
2017-2023
Brown Foundation
2020
People living with HIV experience psychosocial needs that often are not addressed. We designed an innovative low-resource model of phone-based counseling (P-PSC). describe cohort characteristics, acceptability, feasibility and utilization P-PSC at health facilities supported by Baylor Foundation Malawi. Staff were virtually oriented 120 sites concurrently. From facility-based phones, people new diagnosis, high viral load, treatment interruption or mental concerns referred without...
Structural barriers to HIV care are particularly challenging in the US South, which has higher diagnosis rates, poverty, uninsurance, stigma, and rurality, fewer comprehensive public health programs versus other regions. Focusing on one structural barrier, we examined geographic accessibility comprehensive, coordinated (HIVCCC) South. We integrated publicly available data study travel time HIVCCC 16 Southern states District of Columbia. geocoded service locations estimated drive between...
Achieving US state and municipal benchmarks to end the HIV epidemic promote health equity requires access comprehensive care. However, this care may not be geographically accessible for all people living with (PLHIV). We estimated county-level drive time suboptimal geographic accessibility across contiguous US, assessing regional urban-rural differences. integrated publicly available data from four federal databases identify geocode sites providing in 2015, defined as co-located provision of...
Despite progress toward the Joint United Nations Programme on HIV/AIDS "95-95-95" targets (95% of HIV-positive persons tested, 95% tested treatment, and treated virally suppressed), a gap remains in achieving first target. Assisted contact tracing (ACT), which health workers support index clients to recruit their contacts (sexual partners children) for HIV testing, efficiently identifies need treatment. Although many countries, including Malawi, began implementing ACT, testing outcomes...
Background: Intimate partner violence (IPV) is associated with suboptimal HIV treatment outcomes, but its distribution and risk factors among certain subpopulations of people living in resource-limited settings are not well known. We examined the prevalence, incidence, recurrence IPV association adverse childhood experiences (ACEs) pregnant/breastfeeding women Malawi. Methods: This study used longitudinal data for 455 pregnant continuously enrolled VITAL Start trial. was assessed at baseline...
Introduction & Objective: Hospitalization may serve as an opportune time to address uncontrolled type 2 diabetes (T2D) in elderly patients. Our objective was examine hospitalist and primary care provider (PCP) experience caring for patients > age 65 with T2D during or after hospitalization. Methods: Utilizing the electronic medical record, we identified >65 A1c> 8%, hospital discharge November 2022-April 2023 hospitalists PCPs these Sixteen semi-structured interviews...
Introduction & Objective: The hospitalization period may be an opportunity for providers to initiate treatment changes patients with uncontrolled T2D. We examined factors associated medication and improved A1c levels among older adults T2D after hospitalization. Methods: This retrospective cohort study utilized electronic medical records of ≥65 years old ≥8% discharged home from 11 Cleveland Clinic Health System hospitals 11/2022-04/2023. Medication change was defined as a in regimen or...
Plan of Care Visits (POCV), including the patient, nurse, and hospital provider were implemented across an integrated health system to improve provider-patient communication during hospitalization patient outcomes.
The rigorous evaluation of the implementation evidence into routine practice in a health system requires strong alignment between research and clinical operational teams. Implementation researchers benefit from understanding processes contextual factors when designing data collection while teams gain an frameworks outcomes using both qualitative quantitative data. However, interventions to build capacity for these partnerships—particularly those tailored practitioners—are limited. We...
Background Viral load (VL) testing is critical to monitor response ART and optimize HIV treatment care outcomes. Unfortunately, VL coverage remains suboptimal in much of sub-Saharan Africa. With the COVID-19 pandemic significantly curtailing in-person supervision services delivery, low-cost scalable ways conducting remote are needed. We evaluated effects utilizing WhatsApp platform, a form highly applicable times COVID-19, on rural Malawi. Methods Remote via was introduced at all 36 health...
VITAL Start is a video-based intervention aimed to improve maternal retention in HIV care and adherence antiretroviral therapy (ART) Malawi. We explored the experiences of pregnant women living with (PWLHIV) not yet on ART who received before initiation assess intervention’s acceptability, feasibility, fidelity delivery, perceived impact. Between February September 2019, we conducted semi-structured interviews convenience sample 34 PWLHIV within one month receiving Start. The participants...
Background: Intervention effectiveness in a randomized controlled trial is attributed to intervention fidelity. Measuring fidelity has increasing significance research and validity. The purpose of this article describe systematic assessment for VITAL Start (Video Inspire Treatment Adherence Life)—a 27-minute video-based designed improve antiretroviral therapy adherence among pregnant breastfeeding women. Method: Research Assistants (RAs) delivered participants after enrolment. had three...
<sec> <title>BACKGROUND</title> Despite progress toward the Joint United Nations Programme on HIV/AIDS “95-95-95” targets (95% of HIV-positive persons tested, 95% tested treatment, and treated virally suppressed), a gap remains in achieving first target. Assisted contact tracing (ACT), which health workers support index clients to recruit their contacts (sexual partners children) for HIV testing, efficiently identifies need treatment. Although many countries, including Malawi, began...