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Table 3 Relationship between Identified Barriers, Elements of the Chronic Care Model and Implementation Strategy

From: Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series

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
  1. • Provider activation is not, strictly speaking, a component of the CCM based implementation strategy, but was rather employed to augment the effectiveness of the other interventions [24;29;30].