Background At the McGill University Health Centre (MUHC), 10% of patients living with HIV do not return for care annually. Currently, no formal system exists to re-engage out-of-care (OOC) patients. Lost & Found, developed using an implementation science approach, is an intervention to re-engage OOC patients. It is based on existing evidence-based interventions and will be adapted for use by nurses at the MUHC. The aims of this study are to simultaneously assess both implementation and effectiveness of Lost & Found in order to determine the viability of a future multisite stepped-wedge cluster randomised trial. Methods Lost & Found consists of two core elements: identifying and contacting OOC patients. Based on formative work involving MUHC nurses, and the use of a combined implementation framework (enhanced Replicating Effective Programs, Tailored Implementation for Chronic Diseases, and Proctor et al.'s implementation outcomes), we will adapt the intervention to our clinic. Adaptations include the creation of an OOC risk prediction tool, an automated real-time OOC list, and prioritization of high-risk OOC patients for re-engagement. Delivery and ongoing adaptation of the intervention will follow a three-pronged implementation strategy consisting of (1) promoting adaptability; (2) planning, engaging, executing, evaluating, and reflecting cycles; and (3) internal facilitation. This 15-month quasi-experimental pilot study adopts a type II implementation-effectiveness hybrid design. To evaluate implementation, a convergent parallel mixed-methods approach will guide the mixing of qualitative and quantitative data at time points throughout the study. In addition, descriptive and pre-post analyses, for each of the implementation and sustainability phases, will inform evaluations of the cumulative effectiveness and sustainability of the Lost & Found intervention. Discussion This study will provide preliminary evidence for (1) the utility of our chosen implementation strategies and (2) the effectiveness of the intervention. Ultimately, this information may be used to inform future re-engagement efforts using implementation science in other HIV care centres. In addition, the procedures and measurement tools developed for this study will be foundational to the development of a multi-site, randomised stepped wedge study that would provide more robust evidence in support of the Lost & Found intervention.

中文翻译：

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一项 II 型实施-有效性混合准实验性试验研究，对临床干预以重新让 HIV 感染者参与护理，“失物招领”：实施科学协议。

背景 在麦吉尔大学健康中心 (MUHC)，每年有 10% 的 HIV 感染者不再接受治疗。目前，没有正式的系统来重新参与失医 (OOC) 患者。Lost & Found 是使用实施科学方法开发的，是一种重新吸引 OOC 患者的干预措施。它基于现有的循证干预措施，并将适用于 MUHC 的护士使用。本研究的目的是同时评估失物招领的实施和有效性，以确定未来多站点阶梯楔形整群随机试验的可行性。方法失物招领包括两个核心要素：识别和联系 OOC 患者。基于涉及 MUHC 护士的形成性工作，以及使用组合实施框架（增强复制有效计划、针对慢性病的定制实施以及 Proctor 等人的实施结果），我们将调整干预以适应我们的诊所。调整包括创建 OOC 风险预测工具、自动实时 OOC 列表，以及高风险 OOC 患者重新参与的优先级。干预措施的实施和持续调整将遵循三管齐下的实施策略，包括：（1）促进适应性；(2) 计划、参与、执行、评估和反映周期；(3) 内部促进。这项为期 15 个月的准实验性试点研究采用 II 型实施-有效性混合设计。为了评估实施，收敛的并行混合方法方法将指导在整个研究的时间点混合定性和定量数据。此外，每个实施和可持续性阶段的描述性和事后分析将为失物招领干预的累积有效性和可持续性评估提供信息。讨论 本研究将为 (1) 我们选择的实施策略的效用和 (2) 干预的有效性提供初步证据。最终，这些信息可用于为未来在其他 HIV 护理中心使用实施科学的重新参与工作提供信息。此外，为本研究开发的程序和测量工具将成为多站点开发的基础，