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Priority Population
People with HIV not currently accessing HIV care or in need of support to continue taking their HIV medication -
Setting
Health Department -
Location
Detroit, MI -
Intervention Focus
Linkage, Re-engagement, and Retention -
Study Period
2019-2020
Summary
Link-Up Rx is a data to care (D2C) program that aims to increase retention in care and viral suppression among people with HIV by using prescription refill information to decrease the length of time between refills and reduce antiretroviral therapy (ART) interruption. The Detroit Health Department implemented Link-Up Rx in partnership with the Michigan Department of Health and Human Services and MedCart Specialty Pharmacy in July 2018. Link-Up Rx applies many of the same principles and strategies of traditional D2C while significantly reducing the time before the health department intervenes to reconnect a client to ART. Before implementing Link-Up Rx, it would take months before a client appeared on the ‘not in care’ list for D2C. Link-Up Rx’s model ensures that the intervention team receives a notification two weeks after a client has not picked up their ART.
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About the Equity in Evaluation Project
The Center for Innovation and Engagement (CIE) identifies, catalogs, and disseminates evidence-informed interventions. Interventions within the CIE compendium were identified through literature reviews of academic journals, key informant interviews, conference abstract reviews, and requests for information (RFI) surveys. In collaboration with Northwestern University, an evidence rubric based on the CDC’s Prevention Research Synthesis (PRS) criteria was developed to gauge the effectiveness of interventions in improving patient outcomes. Interventions that met the inclusion criteria were reviewed by an Evidence and Dissemination Expert Panel (EDEP), which consisted of experts working across various HIV services and specialties. Each intervention received an “impact score,” measuring its relevance, acceptability, appropriateness, feasibility, transferability, and sustainability. The EDEP selected 16 interventions for the CIE team to include in the compendium. Most of the interventions chosen were published in academic journals.
Following the intervention identification process, the CIE team recognized that a number of innovative intervention models were excluded from the compendium because they lacked the necessary evaluation resources to meet evidence criteria. Using a research equity approach, the CIE team identified three additional promising interventions from the RFI list that did not meet the established evidence threshold and were not identified in the academic literature review process. These interventions were selected to be a part of the CIE Equity in Evaluation Project. This project aims to provide organizations that developed innovative service delivery models with evaluation support. Interventions chosen for the project include the Detroit Health Department’s Link-Up Rx program, Whitman Walker Health’s Mobile Outreach Retention and Engagement (MORE) program, and the Rhode Island Executive Office of Health and Human Services (RI EOHHS) TAVIE Red program.
Intervention teams were paired with consultants who have experience conducting a rigorous evaluation of programs serving people with HIV. Consultants prepared evaluation reports for the three interventions outlining key evaluation findings (e.g., program effectiveness, specific sub-population data) and strategies to sustain or expand future evaluation efforts. The intent was for organizations to use the findings from the analysis to enhance their programs, disseminate their innovative service delivery models, and add to the field of evidence-informed approaches that link, retain, and re-engage people with HIV in care. The inclusion of these three interventions in the Equity in Evaluation Project aims to highlight the need to (1) Increase capacity for health departments and community-based organizations to evaluate and demonstrate the impact of their programs in improving health outcomes for people with HIV, (2) Integrate equity frameworks to improve research and evaluation efforts, (3) Prioritize the work of agencies who may not have the capacity for highlevel data management and analysis or who have limited funding to conduct rigorous analysis and disseminate findings, (4) Highlight and disseminate the work of agencies providing services to priority populations experiencing inequitable outcomes in HIV care and retention (e.g., transgender and nonbinary people, people who use drugs, Black gay, bisexual, and other men who have sex with men).