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P047 Developing an HIV care pathway to support local implementation of the HIV action plan
IntroductionTo meet the UNAIDS targets of zero new HIV infections, AIDS diagnoses, and HIV related deaths by 2030, the HIV Action Plan (HIVAP) for England sets out key objectives and actions to achieve necessary progress by 2025. To support local implementation of the HIVAP, the UK Health Security Agency (UKHSA) developed an HIV care pathway (CP) with the aim of driving data informed service improvements through facilitated discussions.MethodsA UKHSA working group including epidemiological, clinical, and quality improvement subject-experts prepared logic models comprising five themes to help achieve meeting the HIV AP targets. Indicators were mapped to the logic models and a population level CP was developed consisting of a combination of existing and new indicators across components of the HIV care pathway (figure 1).ResultsThe outcome was an HIV CP comprising thirteen associated indicators (Figure 2). The data is presented in an interactive dashboard which allows for comparative analysis and disaggregation by demographic factors, including age, gender, sexual orientation, ethnicity, and probable route of HIV exposure. The CP has been piloted in a facilitated workshop in southeast England, attended by service providers and commissioners who provided positive feedback which will be incorporated into the next iteration prior to national roll-out.Abstract P047 Figure 1HIV Care PathwayAbstract P047 Figure 2HIV care pathway: list of indicatorsDiscussionThe CP indicators cover the pathway, which is accessed through testing and then splits into two interlinked arms depending on the test result, one focusing on prevention and the other on treatment and retention. The CP will be used in local facilitated workshops and presented as an interactive dashboard available to key stakeholders in due course. Feedback will be used to continuously improve the care pathway and its application. An evaluation plan will be implemented to assess the impact of the HIV CP.
Journal Article
P104 Who prefers to pay for online STI testing services instead of accessing free NHS services?
IntroductionFree online STI testing aligned with NHS services has become available in most areas of England in recent years. Many private online services offer similar tests, but for a price.MethodsWe analysed data collected from a pan-UK online test provider for >70 NHS services (SH) as well as their paid (TM) service to compare their respective users.ResultsData were collected from the year 2022, with a total of 968,517 users requesting a test kit from the free services and 15,185 users ordering from the paid TM service.The average age of TM users was 31 vs. 29 for SH users. More users aged 25 and over used the TM service (73.6%) than those using the SH services (62.0%). Male users (50.0%) were more likely to use TM services than those that used SH services (39.2%), while female users (58.2%) were more likely to opt for the free services than the paid TM service (49.8%). Users in the least deprived areas (51.6%) used the paid TM service more than those who used free SH services (37.1%). No difference in the average health, education, employment or income score of paid and free users was observed. Additionally, a higher percentage of users who use paid services ordered tests between Monday and Friday (80.0%) and between 7AM and 1PM (42.5%) compared to those that utilized the free SH services (77.1% and 38.1%, respectively).DiscussionThis study suggests that users who opt for the paid TM service are more likely to be older, male, and from less deprived areas. Possible explanations for these findings include the convenience of the paid service, perceived higher quality of the service, and the perception that the paid service may provide quicker results. Health commissioners in the UK should consider these findings when designing future testing programs.
Journal Article
P012 Improving timely access to intrauterine contraception (IUC) insertion through piloting a booking online after self-triage model (BOAST) integrating with the electronic patient record (EPR)
IntroductionLondon faces a high unmet demand for IUC fitting. To facilitate timely access to obtaining IUC in a London sexual health clinic, a model allowing direct online booking of IUC-fitting appointments following electronic triage (BOAST) was piloted. Patients’ triage responses populated contraceptive proformae within their EPR. BOAST was piloted alongside the pre-existing two-appointment process: telephonic pre-fit counselling followed by a later fitting appointment. Both systems provided SMS links for pre-fit information videos and prompting remote STI testing.MethodsAppointment scheduling, demographic data, clinical outcomes were collected retrospectively from IUC-insertion bookings between 19/01/2023–10/02/2023.37 pre-fit telephone appointments (booked via call centre & online) were converted to BOAST appointments.Results37/37 BOAST appointments were booked, with completion of self-triage forms, within four days of go live. Patients were: mean age 29 (range 21–50 years), 54% ≤35yrs, 100% cis-female. 35% (n=13) White British, 27% other white (n=10) and 54% (n=20) born outside the UK.8% (3/37) BOAST appointments were not attended. In those that attended: 65% (22/34) received IUC-fitting; three referred to complex clinic; nine rebooked due to pregnancy risk.Abstract P012 Table 1Comparison of traditional model vs BOAST 19/01/2023–10/02/2023. BOAST model (x1 face-to face appointment) Traditional model (x2 appointments, 1st phone) Attended first appointment 34/37, 92% 79/92, 85% IUC-fitted successfully first fit appointment 22/34, 65% 47/79, 59% Mean time from booking to IUC-fitting (range 0–24 days ) 11 32 DiscussionThe one-stop-shop BOAST approach reduced waiting times and enabled proportionally more successful fittings. Conversion of phone appointments to IUC-fit appointments increased service capacity for IUC fits, attracting higher ISHT income. IUC-fit appointment lengths could be reduced because triage forms pre-populated EPR proformae.BOAST model was successfully piloted and is now being scaled further. We recommend that triage adaptations and earlier intervention pathways, when triage highlights complex issues, could further help manage demand and drive more efficient use of resources.
Journal Article
Disney movie posters : from Steamboat Willie to Inside Out
\"Anyone who has ever seen a Disney movie knows that the iconic images are beautifully conveyed via the magnificent posters. The tone of the movie and the full range of emotions we experience in seeing the film are often captured in a single poster. After having seen and experienced a wonderful Disney motion picture, the mere sight of the poster can bring back the feelings of having taken the journey by watching the film. Disney Movie Posters is a tribute to those posters, which tell the story both before and after we see the movie. Disney Movie Posters have been an important part of the motion picture process since Disney began making motion pictures. Not only are they eye-catching pieces of artwork, they are also designed to entice the movie-going audience. From Steamboat Willie, to Frozen and countless movies in between, Disney Movie Posters have been an important part of the films themselves. Disney shorts, animated movies, live action movies and Pixar movies can be remembered and honored by the posters that so efficiently capture the magic of the film.\"--provided by publisher.
Book
Posters : a global history
In 'Posters: A global history' Elizabeth Guffey tells the story of this ephemeral art form, from its birth in the nineteenth century to its place in contemporary culture. She argues that even among today's burgeoning digital media, few forms of graphic design can rival posters for their tangibility and sheer spatial presence. From London to Ramallah, Los Angeles to Lagos, posters provide new opportunities to communicate across public spaces that are themselves increasingly transformed by digital media. This book re-examines the roots of the poster, charting its rise from the revolutionary lithographs that papered nineteenth-century London and Paris to twentieth-century works of propaganda, advertising, pop culture and protest. It considers the lives of posters: where and why posters were made, and why and how they endured. It examines posters from today's world, including posters of Palestinian martyrs and West African examples describing voodoo activities, and offers a rich variety of both familiar and lesser-known examples from the Soviet Union, China, Eastern and Western Europe, the U.S. and elsewhere. Beautifully illustrated, Posters provides a fresh history of the nineteenth- and twentieth-century poster as well as revealing insights into the designs and creative practices of our twenty-first-century world.
Book