Table 3 Relationship between Identified Barriers, Elements of the Chronic Care Model and Implementation Strategy
Barrier to HIV testing | Content of implementation intervention | Relationship to Chronic Care Model* |
|---|---|---|
Lack of knowledge of HIV risk factors. | HIV Testing Clinical Reminder | Decision support |
VA providers regard HIV testing and counseling work to be the responsibility of specially trained HIV counselors. | Audit/feedback reports Training to use revised VA HIV Consent Form Academic detailing, social marketing | Clinical information system Delivery system design Provider activation |
Lack time required to fulfill counseling processes. | Provider training regarding streamlined counseling Nurse-based pre-test counseling Academic detailing, social marketing | Delivery system design Provider activation |
Face-to-face post-test counseling is difficult to arrange within two weeks of the test. | Telephonic notification of negative test results. Academic detailing, social marketing | Delivery system design Provider activation |
Anxiety about post-test counseling for positive test results. | Assistance provided by HIV counseling services. Academic detailing, social marketing | Delivery system design Provider activation |