Table 5 Intervention-Context-Actor-Mechanism-Outcome configurations: Case Z
Intervention modalities | Context | Actor | Mechanism | Outcome |
|---|---|---|---|---|
Club rules and regulation | - Integration of HIV treatment with other chronic diseases of lifestyle - Unconducive environment - Lack of resources - Presence of non-HIV positive patients | - Patient | - Perceived stigma - Poor knowledge of club rules and regulations - Perceived absence of punitive measures | - Inadvertent disclosure of HIV status - Poor attendance at club appointments |
Group dynamics | - Unconducive environment - Lack of resources - Experimenting various execution models | - Patient - Group | - Perceived lack of social support - Feeling of frustration related to loss of group dynamics | - Reduced adherence related to constant changes and disruptions in group dynamics |
Health talks/education | - Lack of resources - Presence of non-HIV positive patients - Unconducive environment | - Patient | - Perceived inadequacy | - Reduced self-efficacy leading to poor retention in care and medication adherence - Inadvertent disclosure of HIV status |
Quick medication access | - Unconducive environment - Lack of resources - Experimenting various execution models | - Patient | - Perceived benefit - Perceived stigma | - Adherence to medication related to medication availability - Poor adherence resulting from poor club attendance |
Prompt continuity of care | - Poor adherence club programme coordination and execution | - Clinicians - Patient | - Role confusion - Dissatisfaction | - Reduced rate of retention in care |
Club facilitator-patient relationship | - Unconducive environment - Lack of health talks and counselling sessions | - Facilitator - Patient | - Trust - Perceived lack of support | - Poor adherence to medication - Poor retention in care |
Overall intervention | - Unconducive environment - Lack of resources - Experimenting various execution models - Presence of non-HIV positive patients - Experimenting various execution models - Poor adherence club programme coordination | - Patients - Club teams | - Demotivation - Frustration - Confusion | - Reduced attendance at club sessions - Poor retention in care - Reduced medication adherence rates |