Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial
Abstract Introduction Cultural competency has been identified as a barrier to lesbian, gay, bisexual and transgender (LGBT) populations seeking care. Mystery shopping has been widely employed in the formal health care sector as a quality improvement (QI) tool to address specific client needs. The ap...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-06-01
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| Series: | Health Economics Review |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13561-023-00447-6 |
| _version_ | 1797769663502876672 |
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| author | Victoria L. Phillips Ashley Xue Marné Castillo Dalia Santiago Taylor Wimbly Lisa B. Hightow-Weidman Rob Stephenson José A. Bauermeister |
| author_facet | Victoria L. Phillips Ashley Xue Marné Castillo Dalia Santiago Taylor Wimbly Lisa B. Hightow-Weidman Rob Stephenson José A. Bauermeister |
| author_sort | Victoria L. Phillips |
| collection | DOAJ |
| description | Abstract Introduction Cultural competency has been identified as a barrier to lesbian, gay, bisexual and transgender (LGBT) populations seeking care. Mystery shopping has been widely employed in the formal health care sector as a quality improvement (QI) tool to address specific client needs. The approach has had limited use in community-based organizations due in part to lack of knowledge and resource requirement concerns. Several mystery shopping initiatives are now being implemented which focus on the LGBT population with the goal of reducing barriers to accessing care. One subset targets men who have sex with men (MSM) to increase uptake of human immunodeficiency virus (HIV) testing. No study investigates the costs of these initiatives. Get Connected was a randomized control trial with the objective of increasing uptake of HIV-prevention services among young men who have sex with men (YMSM) through use of a resource-locator application (App). The initial phase of the trial employed peer-led mystery shopping to identify culturally competent HIV testing sites for inclusion in the App. The second phase of the trial randomized YMSM to test the efficacy of the App. Our objective was to determine the resource inputs and costs of peer-led mystery shopping to identify clinics for inclusion in the App as costs would be critical in informing possible adoption by organizations and sustainability of this model. Methods Through consultation with study staff, we created a resource inventory for undertaking the community-based, peer-led mystery shopping program. We used activity-based costing to price each of the inputs. We classified inputs as start-up and those for on-going implementation. We calculated costs for each category, total costs and cost per mystery shopper visit for the four-month trial and annually to reflect standard budgeting periods for data collected from September of 2019 through September of 2020. Results Recruitment and training of peer mystery shoppers were the most expensive tasks. Average start-up costs were $10,001 (SD $39.8). Four-month average implementation costs per visit were $228 (SD $1.97). Average annual implementation costs per visit were 33% lower at $151 (SD $5.60). Conclusions Peer-led, mystery shopping of HIV-testing sites is feasible, and is likely affordable for medium to large public health departments. |
| first_indexed | 2024-03-12T21:12:15Z |
| format | Article |
| id | doaj.art-baf27c4f6b0447a6a097713a0ae86b94 |
| institution | Directory Open Access Journal |
| issn | 2191-1991 |
| language | English |
| last_indexed | 2024-03-12T21:12:15Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Health Economics Review |
| spelling | doaj.art-baf27c4f6b0447a6a097713a0ae86b942023-07-30T11:07:20ZengBMCHealth Economics Review2191-19912023-06-011311610.1186/s13561-023-00447-6Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trialVictoria L. Phillips0Ashley Xue1Marné Castillo2Dalia Santiago3Taylor Wimbly4Lisa B. Hightow-Weidman5Rob Stephenson6José A. Bauermeister7Rollins School of Public Health of Emory UniversityRollins School of Public Health of Emory UniversityDivision of Adolescent Medicine, The Children’s Hospital of PhiladelphiaDepartment of Pediatrics-Retrovirology, Baylor College of Medicine, Texas Children’s HospitalPrevention Research Center, Morehouse School of MedicineInstitute of Global Health and Infectious Diseases, University of North CarolinaSchool of Nursing and the Center for Sexuality and Health Disparities, University of MichiganSchool of Nursing, University of PennsylvaniaAbstract Introduction Cultural competency has been identified as a barrier to lesbian, gay, bisexual and transgender (LGBT) populations seeking care. Mystery shopping has been widely employed in the formal health care sector as a quality improvement (QI) tool to address specific client needs. The approach has had limited use in community-based organizations due in part to lack of knowledge and resource requirement concerns. Several mystery shopping initiatives are now being implemented which focus on the LGBT population with the goal of reducing barriers to accessing care. One subset targets men who have sex with men (MSM) to increase uptake of human immunodeficiency virus (HIV) testing. No study investigates the costs of these initiatives. Get Connected was a randomized control trial with the objective of increasing uptake of HIV-prevention services among young men who have sex with men (YMSM) through use of a resource-locator application (App). The initial phase of the trial employed peer-led mystery shopping to identify culturally competent HIV testing sites for inclusion in the App. The second phase of the trial randomized YMSM to test the efficacy of the App. Our objective was to determine the resource inputs and costs of peer-led mystery shopping to identify clinics for inclusion in the App as costs would be critical in informing possible adoption by organizations and sustainability of this model. Methods Through consultation with study staff, we created a resource inventory for undertaking the community-based, peer-led mystery shopping program. We used activity-based costing to price each of the inputs. We classified inputs as start-up and those for on-going implementation. We calculated costs for each category, total costs and cost per mystery shopper visit for the four-month trial and annually to reflect standard budgeting periods for data collected from September of 2019 through September of 2020. Results Recruitment and training of peer mystery shoppers were the most expensive tasks. Average start-up costs were $10,001 (SD $39.8). Four-month average implementation costs per visit were $228 (SD $1.97). Average annual implementation costs per visit were 33% lower at $151 (SD $5.60). Conclusions Peer-led, mystery shopping of HIV-testing sites is feasible, and is likely affordable for medium to large public health departments.https://doi.org/10.1186/s13561-023-00447-6CostsActivity-based costingCultural competencyQuality improvementYoung men who have sex with menHIV-testing |
| spellingShingle | Victoria L. Phillips Ashley Xue Marné Castillo Dalia Santiago Taylor Wimbly Lisa B. Hightow-Weidman Rob Stephenson José A. Bauermeister Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial Health Economics Review Costs Activity-based costing Cultural competency Quality improvement Young men who have sex with men HIV-testing |
| title | Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial |
| title_full | Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial |
| title_fullStr | Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial |
| title_full_unstemmed | Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial |
| title_short | Cost of peer mystery shopping to increase cultural competency in community clinics offering HIV/STI testing to young men who have sex with men: results from the get connected trial |
| title_sort | cost of peer mystery shopping to increase cultural competency in community clinics offering hiv sti testing to young men who have sex with men results from the get connected trial |
| topic | Costs Activity-based costing Cultural competency Quality improvement Young men who have sex with men HIV-testing |
| url | https://doi.org/10.1186/s13561-023-00447-6 |
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