Studying Differences across Case Managers, Counselors and Peer Educators in New York City As They Engage in Interprofessional Collaboration to Offer Integrated Services

Background and Purpose: Many individuals who may become exposed to HIV or infected, experience fragmented care in social and health services. Service integration, pivotal for the care continuum, depends on relationships among unique service providers and agencies offering HIV services. Case managers, counselors, and peer educators often work together to provide integrated services through interprofessional collaboration (IPC). Research is lacking about what factors influence case managers, counselors, and peer educators’ ability to engage in IPC. To better train and allocate professional development resources for case managers, counselors and peer educators, research is needed to understand differences in effects of provider demographics, intrapersonal factors and job characteristics on likelihood to engage in each domain of IPC (interdependence, professional activities, flexibility, collective ownership of goals, and reflection on process)

Method: Cross-sectional data was collected from counselors (n=77), peer educators (n=84), and case managers (n=100) in 36 NYC agencies. Descriptive and multiple regression analyses were performed. Two blocks of variables were entered into the multiple regression analysis. In the first stage, the control variables (sociodemographics) and nonmodifiable characteristics (provider type) were entered with the dependent variables (interprofessional collaboration: interdependence, professional activities, flexibility, collective ownership of goals, and reflection on process). In subsequent stages, interdependent variables (intrapersonal and job characteristics) were entered.

Results: Most of the HIV-service providers identified as black and female, and had been working for their agencies for a year. Among the three provider types, key differing factors that influence providers’ engagement in IPC include racial identity, professional licensure, HIV training, efficacy, knowledge, and understanding of the community. Peer educators and case managers who self-identified as Native American, Native Hawaiian, or Asian were marginally associated with exhibiting less flexibility (p-value < 0.1). Black case managers were found to engage in significantly fewer professional activities (p-value < 0.05) than black counselors. Compared to counselors, case managers (p-value < 0.05) and those peer educators with professional licenses (p-value < 0.1) were associated with less collective ownership.  Greater understanding of the community among case managers was associated with greater interdependence (p-value < 0.1), engagement with professional activities (p-value < 0.1) and reflection (p-value < 0.05).  compared with counselors. Case managers who received HIV-prevention training (p-value < 0.1) were less likely to engage in professional activities compared with counselors. Efficacy was positively associated with greater collective ownership of goals for everyone except case managers. Providers with greater knowledge had higher reflection scores (p-value < 0.05), with the exception of case managers, who had a marginally significant negative association between knowledge and reflection scores (p-value < 0.10).

Conclusions and Implications: Findings indicate that policy makers should assist agencies in developing human and financial resources to assist with professional social networking opportunities through which knowledge can be shared, racial sensitivity trainings can be delivered, and updated employee lists can be circulated.