Evaluating a Training Intervention to Improve Interprofessional Collaboration and Access to the HIV Continuum of Care

Background: Interprofessional Collaboration (IPC) is a measurable concept indicating the degree to which service providers (social workers, health educators, navigators, etc.) come together to exchange resources to benefit their clients. IPC has been shown to improve access to, and quality of care, reduce costs and service duplication. This paper reports the results of an evaluation of a training program aimed to improve IPC and access to HIV Continuum of Care services – HIV testing, primary care, counseling, and Pre-Exposure Prophylaxis (PrEP).

Methods: Project ICI (ICI) training model was created based on a multidisciplinary theoretical framework comprised of Diffusion of Innovations, Reasoned Action and Planned Behavior, and institutional theories to activate and promote Interprofessional Collaboration (IPC) among a diverse sample of HIV service providers in 28 organizations across New York City. ICI training goals included: (1) to increase knowledge, positive attitudes, willingness, self-efficacy, and intention to engage in IPC, and (2) to identify institutional barriers to IPC. The training content focused on professional development in evidence-based practices (EBPs), HIV testing, care and treatment, and an orientation to IPC. Strategic knowledge of IPC was activated through four strategies: (1) Finding common ground, (2) Locating resources, (3) Exchanging resources, and (4) Tracking and sustaining IPC. Participants completed a survey before (pre) and after (post) the training. The survey consisted of a 12-item questionnaire about IPC knowledge and attitudes related to the four strategies above. We ran paired sample t-tests to inspect changes before and after training. Cronbach’s Alpha were calculated when combining the four subcategories of ICI training questions. We also use logistic regression to examine whether ICI influenced linkages to HIV services.

Results: Sample: 229 providers participated in ICI training; 64% female; 51% black, 37% Hispanic, 26% white, 23% Asian/mixed; 72% held an Associate’s or higher. Cronbach’s alpha scores are as follows: overall mean scores (Cronbach’s alpha=0.89), finding common ground (Cronbach’s alpha=0.90), locating resources (Cronbach’s alpha=0.48), exchanging resources (Cronbach’s alpha=0.63), and collaboration (Cronbach’s alpha=0.84). Effect sizes of changes after trainings ranged from 0.12 to 0.32. Providers showed significant improvements in all subcategories and overall scores. We found associations between IPC and linkages to HIV testing (not significant) and primary care (p<0.01).

Implications: Our findings suggest that didactic training combined with skills building strategies can strengthen positive perceptions of, and willingness to, pursue IPC. Providers significantly improved their ability to locate resources, intention and willingness to find common ground, exchange resources, and collaborate with colleagues across agencies. Participants found the experience rewarding, overall. Given the urgent need to improve access to, and retention in HIV care and treatment, combined with the global demand for effective online professional development resources, this study illustrates a promising intervention that is scalable and adaptable. Future research must establish the impact of training on provider IPC practices and client outcomes.