A Qualitative Study of Community-Based HIV/AIDS Prevention Interventions, Programs, and Projects for Rural and Remote Regions in Canada: Implementation Challenges and Lessons Learned

• Published in: Journal of Public Health Management and Practice
• Main Authors: Worthington, Catherine, Mollison, Ashley, Herman, Tamara, Johnston, Christine, Masching, Renée, Pooyak, Sherri, Lee, Rebecca, Loutfy, Mona
• Format: Article in Journal/Newspaper
• Language: English
• Published: Ovid Technologies (Wolters Kluwer Health) 2020
• Subjects: Public Health, Environmental and Occupational Health; Health Policy; Nunavut; Prince Edward Island
• Online Access: http://dx.doi.org/10.1097/phh.0000000000000878; https://journals.lww.com/10.1097/PHH.0000000000000878

Context: Fifteen percent to 20% of the Canadian and American populations live outside urban areas, and despite growing regional HIV/AIDS–related health disparities, there is little published research specific to rural or remote (rural/remote) HIV/AIDS prevention programming. Objective: To document implementation challenges, lessons learned, and evaluation approaches of promising and proven HIV/AIDS prevention programs and interventions developed and delivered by organizations with rural/remote catchment areas in Canada to provide a foundation for information sharing among agencies. Design: Qualitative study design, using a community-based participatory research approach. We screened Canadian community-based organizations with an HIV/AIDS prevention mandate to determine whether they offered services for rural/remote populations and invited organizational representatives to participate in semistructured telephone interviews. Interviews were audio-recorded and transcribed. Content analysis was used to identify categories in the interview data. Setting: Canada, provinces (all except Prince Edward Island), and territories (all except Nunavut). Participants: Twenty-four community-based organizations. Results: Screening calls were completed with 74 organizations, of which 39 met study criteria. Twenty-four (62%) interviews were conducted. Populations most frequently served were Indigenous peoples (n = 13 organizations) and people who use drugs (n = 8 organizations) (categories not mutually exclusive). Key lessons learned included the importance of involving potential communities served in program development; prioritizing community allies/partnerships; building relationships; local relevancy and appropriateness; assessing community awareness or readiness; program flexibility/adaptability; and addressing stigma. Evaluation activities were varied and used for funder reporting and organizational learning. Conclusions: Rural/remote HIV/AIDS programs across Canada expressed similar challenges and lessons learned, suggesting ...