Form 2 Attachment B2 - Client_Interview_Protocols

APPENDIX B
RWHAP CLIENT PROTOCOL

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RWHAP Client Protocol (30 minutes)

Thank you very much for speaking with me. I’m [NAME] and I work for [MATHEMATICA POLICY RESEARCH/MISSION ANALYTICS GROUP]. Before we start, here is our thank you for your time today [GIVE GIFT CARD].

We are working on a project for the Ryan White HIV/AIDS Program that includes speaking to people about the HIV medical care they receive. We are hoping to learn more about your experience with the doctor’s office or clinic that helps you manage your HIV. Your doctor could also be a nurse or physician assistant. For some people, it’s difficult to get regular HIV medical care, so we are also hoping to hear about what may make it difficult and how doctor’s offices, clinics, or the Ryan White Program can make it easier. Understanding your experience will help improve services for other people living with HIV.

I want you to know that this is a safe space, there are no right or wrong answers, and there is no judgment here. Everything that you tell me will be kept private and confidential. To protect your privacy, we won’t connect your name with anything that you say.

I’ll be talking with a lot of people over the next couple days, and I want to make sure I remember what everyone tells me. To help me take good notes, I would like to record our talk so that I can make sure my notes are accurate. No one other than our project team will listen to the recording, and it will be destroyed at the end of our study. Also, if you want to say something that you don’t want recorded, please let me know and I can pause the recorder. We can also skip any questions you don’t want to answer.

[GET VERBAL CONSENT. TURN RECORDER ON]

Do you have any questions for me before we get started?

1. How long have you been coming to this site for services? How did you first hear about this site?

2. How long have you been living with HIV? What services do you get here? [Interviewer note: Give client handout with description of services. Assess if client is receiving HIV medical services, OR support services (case management, transportation, nutrition counseling, housing assistance, etc.), OR both medical and support services at this site. If client indicates that they receive medical services at this site, skip to question 5]

3. Do you see a doctor or HIV specialist to check in on your physical health or medicines related to HIV? [If no, ask 3a – 3c and end interview]

1. After your HIV diagnosis, did you ever go to a doctor for HIV medical care? How long do you think it’s been since you have seen a doctor for HIV medical care?

2. What are some of the reasons why you don’t go to a doctor for HIV medical care? (Probe: Does your health insurance [or lack of] affect your ability to regularly see an HIV doctor? Is your doctor in a location that’s easy for you to get to? Is it difficult to schedule an appointment or get an appointment that is convenient for you? Is it difficult for you to find the time to attend these appointments?)

3. What would make it easier or more likely for you to see a doctor for HIV medical care?

3. Where do you go for your HIV medical care? How long have you been going there?

4. Why did you decide to [come here/go there] for HIV medical care? Are there other places you have or could have gone?

1. [If client gets support services at a site that also provides HIV medical care that the client doesn’t use]: Can you talk about why you don’t use the same site for medical care?

3. How often does your doctor recommend that you come in for HIV medical care (e.g., every month, three months, six months, annually)? [Interviewer note: These are visits with a doctor, physician assistant, nurse who can conduct a physical exam and prescribe HIV medicines; these do not include visits only for lab draws, prescription pick-up, or case management]

1. How often have you been in the last 12 months?

2. When was the last time you saw [your/an] HIV doctor?

3. Do you get appointment reminders or other help with tracking your medical appointments? If yes: Please describe.

4. What may make it difficult for you to get to your appointments? (Probe: transportation/location, health insurance, scheduling.)

5. When you see your doctor, what makes the experience a good experience? (Probe: Do you see the same doctor every time you go in? Do you feel respected by your doctor? Can you ask them questions?)

6. Does your doctor talk to you about your labs? Do you know what being undetectable means? [If respondent does not understand the question, use the following explanation: Being undetectable means that the amount of the virus in your blood (or viral load) is very low.] Are you undetectable?

7. Has your doctor prescribed HIV medicines (sometimes called antiretroviral therapy, or ART) for you? [If no, confirm that client is not currently on ART and go to question 17]

8. What helps you remember to take your HIV medicines? Do you get support services that help you keep on track (e.g., Ryan White case management)? Please describe.

9. Many people find it hard to take their HIV medicines exactly as prescribed. Is there anything that makes it hard to remember to take your medications? Please describe.

   1. How many doses have you missed in the last 7 days?

   2. How many doses have you missed in the last 30 days?

10. Over the last 7 days, on a scale of 1 (very poor) to 5 (very good), how would you rate your ability to take your HIV medicines?

    1. Over the last 30 days, on a scale of 1 (very poor) to 5 (very good), how would you rate your ability to take your HIV medicines?

11. Is there anything that you would change to make it easier for you to remember to take your HIV medicines? Please describe.

12. Are there any services or supports that would help you manage your HIV that you don’t currently get? [If so: Please describe what those are and how they would help.]

13. Lastly, some clients find it helpful to receive their medical care and support services at the same place and some do not.

• [If client gets supportive services at a RWHAP provider and medical care at a different location]: Can you talk about what you like and don’t like about getting your care at different locations?

• [If client gets supportive services and medical care from a RWHAP medical provider]: Can you talk about what you like and don’t like about getting all your care at the same place?

Those are all the questions I have for you. Is there anything else you would like to add before we finish?

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