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The structural and health policy environment for delivering integrated HIV and substance use disorder treatments in Puerto Rico

Overview of attention for article published in BMC Health Services Research, March 2017
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Title
The structural and health policy environment for delivering integrated HIV and substance use disorder treatments in Puerto Rico
Published in
BMC Health Services Research, March 2017
DOI 10.1186/s12913-017-2174-7
Pubmed ID
Authors

Jared A. Leff, Diana Hernández, Paul A. Teixeira, Pedro C. Castellón, Daniel J. Feaster, Allan E. Rodriguez, Jorge L. Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R. Metsch, Bruce R. Schackman

Abstract

HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments. We conducted semi-structured qualitative interviews (n = 8) with government and program administrators in English and Spanish. Data were analyzed to identify dominant and recurrent themes. Participants discussed how lack of integration among medical and mental health service providers, lack of public transportation, and turnover in appointed government officials were barriers to integrated HIV and SUD treatment. Federal funding for support services for HIV patients was a facilitator. The Affordable Care Act has limited impact in Puerto Rico because provisions related to health insurance reform do not apply to U.S. territories. Implications for intervention design include the need to provide care coordination for services from multiple providers, who are often physically separated and working in different reimbursement systems, and the potential for mobile and patient transportation services to bridge these gaps. Continuous interaction with political leaders is needed to maintain current facilitators. These findings are relevant as the current economic crisis in Puerto Rico affects funding, and may be relevant for other settings with substance use-driven epidemics.

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The data shown below were collected from the profiles of 4 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 127 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 127 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 25 20%
Researcher 14 11%
Student > Ph. D. Student 14 11%
Student > Bachelor 10 8%
Student > Doctoral Student 8 6%
Other 22 17%
Unknown 34 27%
Readers by discipline Count As %
Medicine and Dentistry 22 17%
Psychology 15 12%
Nursing and Health Professions 14 11%
Social Sciences 14 11%
Computer Science 4 3%
Other 18 14%
Unknown 40 31%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 October 2017.
All research outputs
#14,364,802
of 23,002,898 outputs
Outputs from BMC Health Services Research
#5,132
of 7,703 outputs
Outputs of similar age
#173,795
of 309,260 outputs
Outputs of similar age from BMC Health Services Research
#93
of 145 outputs
Altmetric has tracked 23,002,898 research outputs across all sources so far. This one is in the 35th percentile – i.e., 35% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,703 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.8. This one is in the 30th percentile – i.e., 30% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 309,260 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 40th percentile – i.e., 40% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 145 others from the same source and published within six weeks on either side of this one. This one is in the 32nd percentile – i.e., 32% of its contemporaries scored the same or lower than it.