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Table 1 Construct definitions and survey items

From: Exploring the heterogeneity of factors that may influence implementation of PrEP in family planning clinics: a latent profile analysis

Construct/definition

Survey items

Intervention characteristics

Complexity: Perceived difficulty of implementing PrEP services in their clinica

1. Providing PrEP at my clinic seems easy to doc

Relative advantage: Perceived advantages of implementing PrEP in their clinicb

1. PrEP would be more effective than interventions we are currently promoting to prevent HIV among patients at our clinic

Cost: Perceived costs associated with implementing PrEP at their clinica

1. PrEP is too expensive

Characteristics of individuals

Concerned attitudes: Participant’s concerns about prescribing PrEP to patients in their clinica

1. It is more suitable to provide PrEP in STD clinics than in family planning clinics

2. It is more suitable to provide PrEP in clinics that specialize in HIV care than in family planning clinics

3. Use of PrEP will increase HIV drug resistance

4. I am concerned that PrEP is not effective

5. Use of PrEP will result in less federal funding for HIV treatment

6. Non-biomedical (behavioral) HIV prevention interventions should be attempted before prescribing PrEP

7. Use of PrEP will cause patients to engage in riskier behaviors

8. If an HIV negative patient is in a relationship with an HIV positive partner, we should attempt treating partner instead of prescribing PrEP

9. If an HIV negative patient is in a relationship with an HIV positive partner, we should attempt treating partner before prescribing PrEP

10. I am concerned about potential side effects of PrEP

Inner setting

Implementation climate: The extent to which PrEP implementation will be rewarded, supported, and expected within their clinicb

1. Individuals in my clinic will approve of providers prescribing PrEP to at-risk HIV-negative individuals

2. My clinic hires individuals who have previously used new types of HIV prevention practices

3. Individuals working in my clinic value new types of HIV prevention practices

4. Individuals working at my clinic are flexible enough to integrate new types of HIV prevention practices

5. Individuals working at my clinic are open to new types of HIV prevention practices

Compatibility: How PrEP aligns with the needs of the patient population served by the clinicb

1. PrEP seems like a good match for patients at my clinic

2. PrEP seems suitable for patients at my clinic.

3. Patients at my clinic who are at risk for HIV would really benefit from PrEP

Leadership engagement: How committed leadership is to improving clinic practicesb

1. Senior leadership/clinical management in my clinic reward clinical innovation and creativity to improve patient care

2. Senior leadership/clinical management in my clinic solicit opinions of clinical staff regarding decisions about patient care

3. Senior leadership/clinical management in my clinic seek ways to improve patient education and increase patient participation in treatment

Available resources: The level of resources that could be dedicated to PrEP implementation at their clinicb

1. My clinic has necessary support in terms of budget or financial resources

2. My clinic has necessary support in terms of training

3. My clinic has necessary support in terms of facilities

4. My clinic has necessary support in terms of staffing

Outer setting

Cosmopolitanism: The degree to which the clinic is networked with other external HIV or PrEP-providing organizationsb

1. Individuals in my clinic are connected with other community organizations that provide HIV prevention services to patients

Outcome

Readiness for PrEP implementation: Perceived clinic ability to conduct the various steps of the PrEP cascadeb

1. Others in my clinic can screen a patient for symptoms of acute HIV

2. Others in my clinic can assess a patient’s HIV risk using the CDC PrEP guidelines

3. Others in my clinic can test a patient for HIV

4. My clinic has the capacity to provide HIV test results within one week of testing

5. Others in my clinic can assess a patients readiness for PrEP

6. Others in my clinic can assess a patients kidney function

7. My clinic has the capacity to conduct lab work to assess a patients kidney function and provide results within one week of testing

8. Others in my clinic can test a patient for active HBV infection and interpret results

9. My clinic has the capacity to provide HBV test results within one week of testing

10. Others in my clinic can ensure a patient is not taking any concomitant medications that may affect their ability to take PrEP

11. Others in my clinic can counsel a patient on the potential side effects of PrEP

12. Others in my clinic can counsel a patient on PrEP adherence

13. Others in my clinic can assess a patients pregnancy intentions and conduct preconception and contraceptive counseling

14. Others in my clinic can prescribe PrEP to a patient

15. Others in my clinic can help patients navigate insurance payments regarding PrEP treatment

16. Others in my clinic can refer patients to experts in PrEP and HIV when necessary

17. My clinic knows where to access resources for PrEP and HIV education

18. Others can conduct 3-month follow up visits for medication adherence counseling and side-effect assessmentd

19. Others can conduct 3-month follow up visits for laboratory testingd

20. Others can conduct 3-month follow up visits for pregnancy intentions and preconception or contraceptive counselingd

21. My clinic has an onsite pharmacy or affiliated pharmacy that will carry PrEP

22. There are community-based organizations or other partners in my community that will help facilitate PrEP access for patients at my clinic

  1. aHigher values indicate more unfavorable scores (i.e., barriers)
  2. bHigher values indicate more favorable scores (i.e., facilitators)
  3. cItem was reverse-coded
  4. dAdministrators did not answer these questions