Identifying Health Services Preferences for a Community-Based HIV Status-Neutral Mobile Clinic Among Marginalized Populations in Oakland, CA: A Maximum-Difference Analysis

针对加州奥克兰市边缘化人群,采用最大差异分析法确定其对社区艾滋病毒感染状况中立型移动诊所的健康服务偏好。

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Abstract

Leveraging patient preferences can improve patient satisfaction and engagement in intentional health services. We explored desired health services preferences of marginalized populations accessing HIV-related care engagement to inform the implementation of an HIV prevention and treatment mobile clinic model. We conducted a maximum-difference survey with 154 people at community events and homeless encampments in Oakland, CA. Participants ranked 32 items in differentials of importance on a tablet, which were analyzed with Hierarchical Bayesian modeling. Fourteen services were prioritized, including housing, mental health counseling and screening, drug overdose prevention, personal hygiene, and food assistance. Participants indicated preferences for services that address basic physiological and safety needs (i.e., housing services, food, personal hygiene supplies, drug overdose treatment, and mental health support and engagement), physical examinations, screenings, and medication refills. Incorporating community-informed preferences into the development of services may improve engagement in care alongside a syndemic approach toward ending the HIV epidemic.

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