BE FASTER Community of Practice to Increase Rapid Initiation of Antiretroviral Therapy in Houston, Texas: A Pre-Post Intervention Study.

BACKGROUND

Rapid initiation of antiretroviral therapy (Rapid ART) is a key strategy of the Ending the HIV Epidemic (EHE) initiative. The Baylor College of Medicine Extension for Community Healthcare Outcomes (ECHO) Facilitating Antiretroviral Start Earlier (BE FASTER) program was developed to address this call-to-action. The program uses the ProjectECHO tele-mentoring model as an implementation tool in Harris County, a priority EHE jurisdiction. The authors present results on the acceptability and feasibility of the BE FASTER program.

METHODS

Multidisciplinary health professionals from 5 Ryan White Part A funded agencies formed the community of practice. The BE FASTER program included 9 monthly virtual sessions, consisting of a brief didactic presentation and case-based discussions focused on Rapid ART implementation. Surveys to measure cross-agency collaboration, sense of professional support, organization efficacy, and self-knowledge and skills were administered at baseline and 9 months. Data were collected on the number of clients initiated on Rapid ART through EHE funding over the course of BE FASTER.

RESULTS

Overall, 64 unique participants attended the 9 ECHO sessions, with an average attendance of 26 participants. Self-knowledge and skills significantly increased at 9 months (3.63 vs 3.96, P < .01). Satisfaction scores were high; 80% of participants were "mostly" or "completely" satisfied with the program, and 97% of participants would "probably" or "definitely" recommend the program. The number of clients started on Rapid ART through EHE funding since BE FASTER started has increased each year of the program.

CONCLUSIONS

The BE FASTER community of practice is an acceptable and feasible intervention to bring organizations together to develop, disseminate, and adopt vital initiatives for Rapid ART.