Table 3 Key measures and methods for Evaluating the Implementation and Replication of Bundled Interventions to Improve Care and Treatment Coordination for Black women with HIV

Pre-implementation

Complexity and Relative advantage of intervention

System readiness

System antecedents

Diffusion

Adoption/Assimilation

Outer context

• Innovation- bundled interventions and key characteristics of women and organizations

• Organizational factors: Readiness and absorptive capacity; infrastructure, leadership, organizational assets, culture, and climate, supervision and referral systems; partner networks; quality improvement and data systems for feedback;

• Structural factors: poverty, racism, intimate partner violence; services and policies

• Key informant interviews Year 1 35–40 (3/ per site)

• TA Needs Assessment

• Organizational Readiness for Implementation Change (ORIC)

Implementation

Implementation process

Adoption/Assimilation

Diffusion and Dissemination

Outer Context

• Leadership, dedicated resources, internal and external communications and collaboration and feedback mechanisms on progress.

• Facilitators and barriers to implementation (staff turnover, funding, training/TA)

• Adaptations to intervention bundles

• Documentation of implementation strategies

• Structural factors

• Annual Key informant interviews (Yr. 3) site staff

• Staff intervention encounter form (ongoing-Years 1–3)

• Monthly call forms in REDCap

(ongoing Years 1–3)

Outcome Evaluation

Post

implementation

Implementation

Outcomes

• Penetration: Socio-demographics and social risks (food security, housing and employment, health literacy,) of Black women with HIV and types of organizations

• Adoption: Number and type of interventions for Black women with HIV adapted across the 12 sites (quantitative);

• Fidelity to the selected intervention (e.g., Peers/Patient Navigators trained, supervision and referral systems (qualitative); dose, duration and types of activities (quantitative)

• Sustainability: # of sites sustaining interventions; # of policies adopted to promote health for Black women with HIV

• Cost: Fixed vs. variable: Personnel, Materials, Staff client transportation, Agency indirect rates; start up and implementation from Provider Perspective

• Client baseline survey

• Enrollment reports

• Monthly call forms and Site visits

• Staff Intervention encounter form

• Program Sustainability Tool and Survey (PSAT)

• Cost analysis worksheet-Annual Fiscal and administrative records

• Client /Community case studies of experience with intervention

• Barriers and facilitators for seeking and maintaining intervention

Community Participatory Research In-depth client interviews (Photovoice)

Focused studies

Service Outcomes

HIV care and behavioral health care: Timely linkage and retention in care;

Unmet needs for services, barriers to care (personal beliefs, organizational, structural) Alcohol and substance use, mental health, HIV stigma, gender-race discrimination, Violence and trauma, Social support and networks, Resilience; health literacy; perceived quality of women-centered care

Medical Chart review, Client survey

Baseline, 6 and 12 months

Client outcomes

HIV care outcomes: ART adherence, viral suppression

Other health outcomes: co-morbidities (diabetes, depression)

Patient experience with care, quality of life (physical and mental health functioning, life satisfaction;

Medical Chart review, Client survey

Baseline, 6 and 12 months