Table 2 The inner setting and intervention characteristics that impacted HTC and the use of SAIA, assessed through interviews guided by CFIR constructs
CFIR domain | Constructs and sub-constructs | Impact | Description |
|---|---|---|---|
Inner setting impact on HTC | Structural characteristics | None noted | Participants had mixed availability of resources to promote privacy during HTC, but none identified this as a barrier to HTC |
Networks and communication | Facilitator | Most clinics had regular meetings and other informal communication channels, allowing for strong communication | |
Implementation climate | |||
Tension for change | Mixed | Facilitator: Clinics largely identified a need for HTC and reported that they embrace change Barrier: Some clinics did not believe HTC needed to be improved, and felt that the time need to make change was a barrier | |
Relative priority | Mixed | Facilitator: Some clinics reported that HTC was a high priority Barrier: At some clinics, HTC was not identified as one of their top priorities | |
Goals and feedback | Facilitator | Clinics reported clear goal setting, both internally and from the DOHS. Clinics reported clear methods of tracking progress | |
Learning climate | Mixed | Facilitator: Some clinics noted group-consensus problem-solving, which empowered staff to be involved in solution generation Barrier: Other clinics described top-down approaches, which may take more time to effect change | |
Readiness for implementation | |||
Leadership engagement | Mixed | Facilitator: DOHS support and resources were an important facilitator for all clinics Barrier: Clinics had mixed leadership engagement internally. Low engagement impacted ability to obtain necessary resources and enact change in some facilities | |
Available resources | Mixed | Facilitator: Free provision of HIV testing kits by DOHS allowed most clinics to have all necessary resources Barrier: Clinics that were not able to obtain test kits noted this as crucial barrier to successful HTC | |
SAIA intervention characteristics | Adaptability | None noted | No clinics reported adapting SAIA |
Complexity | Facilitator | All responding clinics reported SAIA to be easy to learn and implement | |
Design quality and packaging | Facilitator | All clinics approved of the SAIA design, and the training and training materials were cited as particularly useful | |