Table 1 Measurement domains, variables, and data source by Ecological System and RE-AIM outcomes for patient, provider and geographic analyses
Indicator/domain | Variable(s) | Measurement source |
|---|---|---|
Patient level: Person (MICRO): Reach, Efficacy, Maintenance | ||
Demographic Characteristics | Age, race/ethnicity, sex, gender, marital status, living situation, dependents, education and income, insurance, legal, immigration status, religion and spirituality, medical history | AFA Survey |
Primary Outcome: Viral load suppression | Durable Suppression: two consecutive tests with ≤ 200 HIV-1 RNA copies per mL of plasma | HIV Surveillance Registry |
Viral Suppression: most recent test with ≤ 200 HIV-1 RNA copies per mL of plasma | ||
Secondary Outcome: Linkage | Occurrence of first CD4/VL test date after study enrollment | HIV Surveillance Registry |
Secondary Outcome: ART Initiation | ART regimen initiated | AFA Survey |
Secondary Outcome: Treatment retention | Sustained engagement or regular care, ≥ 1 primary care visit in each 6 month interval | HIV Surveillance Registry |
Secondary Outcome: HIV medication (ART) Adherence | Adherent at threshold (≥90 %) for all ART medications | |
Secondary Outcome: Quality of Life | Health-related quality of life | EQ-5D EuroQoL [75] |
Secondary Outcome: Sexual and Drug Use Risk | Sexual partners, unprotected sex acts, needle/works sharing | Modified Risk Assessment Battery and Risk Behavior Scale [76, 77] |
Predictor: Substance Use | Illicit drug use (days), alcohol (days, # drinks), substance use disorder severity | TLFB [78]; QuickTox 8-panel Drug Screen Dipcard; Fagerstrom Test for Nicotine Dependence [79]; DSM-V Checklist for Substance Use Disorders [80] |
Predictor: Mental Health | Psychological distress | Kessler10 [81], Personality Inventory for DSM-V Brief Form [82]; Posttraumatic Stress Symptom Screener [80] |
Predictor: Social Support | Social network size/quality; disclosure of HIV to family/friends | MOS Social Support Survey [83]; HIV Disclosure Status Questionnaire [84] |
Predictor: Service Utilization | Medical, substance abuse treatment, mental health, case management, Ryan White-funded services | Modified Treatment Services Review [85] |
Predictor: Attitudes | Attitudes towards primary HIV provider professional | Attitudes Towards HIV Health Care Providers Scale [86]; Medical Mistrust Index [87] |
Predictor: ART Barriers | Barriers to ART adherence | Adherence Barriers Questionnaire [88] |
Predictor: Stigma | Experiences and perceived discrimination and stigma | MIDUS Daily Discrimination Scale [89]; Social Impact Scale [90] |
Predictor: Knowledge | HIV treatment knowledge | |
PROVIDER/PRIMARY CARE LEVEL (MESO): Adoption, Implementation, Maintenance | ||
Professional Characteristics | Age, sex, race/ethnicity, education, years since terminal degree, HIV care (years in current position/providing HIV care, caseload) | AFA Survey |
Predictor: Organizational characteristics | Location, service type, size, staffing, service flexibility, impact of ACA, staff attributes, organizational culture and climate | Perceived Environmental Uncertainty (unpublished measure, D’Aunno, 2013); Change Survey [93, 94]; Survey of Organizational Attributes for Primary Care [95]; Medical Group Practice Culture [96] |
Predictor: Knowledge | Knowledge of ART guidelines; perceived self-efficacy to follow ART guidelines | AFA Survey |
Predictor: Attitudes | Attitudes and ideology toward patients and the provider/patient relationship, including patients with substance use problems | Attitudes About Patients with Substance Use Disorders [97, 98]; Patient-Practitioner Orientation Scale [99] |
NEIGHBORHOOD/GEOGRAPHIC LEVEL (EXO): Reach, Efficacy, Maintenance | ||
Predictor: Socioeconomic Conditions | Poverty rate; median income; unemployment rate; educational attainment; percent of residents who are non-Hispanic White | 2011 American Community Survey, 5-year estimate [100] |
Predictor: Health Service | Spatial access to HIV primary care | 2013 Data pull from HIVMA, AAHIVM, NYSDOH AIDS Institute Provider Database |
Predictor: Social Disorder | Off-premises alcohol outlet density; vacant housing | 2009–2012 U.S. Census Bureau’s Zip Code Business Patterns [101–103]; 2009–2010, 2012 USPS Delivery Stats Product [104–106] |
Predictor: Social Cohesion | % of housing units leased; % households that moved into the neighborhood in last year | 2011 American Community Survey, 5-year estimate [107] |