Unveiling Key Determinants for Scaling-up Systems Navigation and Psychosocial Counselling (SNaP) for People Who Inject Drugs with HIV in Vietnam Using the Consolidated Framework for Implementation Research

Objective: Systems Navigation and Psychosocial counseling (SNaP) is an evidence-based intervention that was clinically proven to improve HIV-related health outcomes among people who inject drugs living with HIV in a study in Indonesia, Ukraine, and one province in Vietnam. However, whether or not the SNaP intervention is effective when it is scaled up to different regions in Vietnam. This study was conducted in 2 provinces (Hanoi and Thai Nguyen) to explore key determinants for scaling up the SNaP intervention in Vietnam.

Methods: Data were collected via 4 focus group discussions (FGDs) with leaders of provincial and site health departments. FGDs were transcribed, translated into English, and coded using Dedoose software to categorize determinants based on five domains of the Consolidated Framework for Implementation Research (CFIR).

Results:  The SNaP intervention's alignment with the country’s current health regulations (outer setting) was most highlighted as the key facilitator for scaling up, followed by the willingness of healthcare leaders and providers to incorporate SNaP into their clinical practices, which was due to the intervention’s strong evidence base and quality (intervention characteristics). The most prevalent barrier was clinics’ limited resources, specifically, time, personnel, and financial support (inner setting).

Conclusions: The reported determinants provided practical implications to inform the development of relevant implementation strategies to scale up the SNaP intervention across Vietnam.

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