Table 4.
Significant CFIR constructs and their related barriers or facilitators for integrated HTN/HIV care
CFIR Domain | CFIR Construct | Barrier or facilitator | Explanation of facilitators and barriers |
---|---|---|---|
Intervention characteristics | Relative advantage | Facilitator | Integrated HTN/HIV care saves time and costs on patient transport and improves patient retention. Patients receive both HTN and HIV care in the same clinic on the same appointment date. |
Adaptability | Facilitator | HTN/HIV integration fits within routine care in HIV clinics. HTN services can be tailored and refined to meet health needs of PLHIV. | |
Complexity | Facilitator | Healthcare providers perceived provision of HTN care services in HIV clinics as straight forward and not complex. | |
Inner setting | Implementation climate | ||
Compatibility | Facilitator | HTN/HIV integration was compatible and would fit within the existing workflows at the HIV clinics. | |
Organizational incentives and rewards | Barrier | Lack of functional BP machines and medicines for HTN treatment in HIV clinics hinder HTN/HIV integration. | |
Readiness for implementation | |||
Available Resources | Barrier | Lack of functional BP machines, inadequate medicines to treat HTN, and extra work load to limited healthcare providers arising from offering HTN services hinder HTN service provision in HIV clinics. | |
Access to knowledge and information | Barrier | Many PLHIV are not aware of HTN services at HIV clinics, hence low demand. Lack of training and continuing medical education for healthcare providers on HTN care hinders HTN/HIV integration. | |
Characteristics of individuals | Knowledge and beliefs about the intervention | Barrier | Some healthcare providers lacked knowledge and skills to screen and treat HTN in the HIV clinics. |
Self-efficacy | Barrier | Some healthcare providers lacked confidence in their own ability to screen and prescribe medicines for HTN in HIV clinics. | |
Process of implementation | Planning | Barrier | Inadequacies in preparation and planning for integrated HTN/HIV care: healthcare provider and patient orientation to integrated HTN/HIV care were generally suboptimal. |