title: A comprehensive theoretical framework for the implementation and evaluation of opt-out HIV testing.
abstract: Opt-out HIV testing (in which patients are offered HIV testing as a default) is a potentially powerful strategy for increasing the number of people who know their HIV status and thus limiting viral transmission. Like any change in clinical practice, implementation of opt-out HIV testing in a health service requires a change management strategy, which should have theoretical support. This paper considers the application of three theories to the implementation and evaluation of an opt-out HIV testing programme: Behavioural Economics, the Health Belief Model and Normalisation Process Theory. An awareness, understanding and integration of these theories may motivate health care providers to order HIV tests that they may not routinely order, influence their beliefs about who should be tested for HIV and inform the operational aspects of opt-out HIV testing. Ongoing process evaluation of opt-out HIV testing programmes (based on these theories) will help to achieve individual health care provider self-efficacy and group collective action, thereby improving testing rates and health outcomes.
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.
authors.forename: Stacy
authors.initials: S
authors.lastname: Leidel
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.
authors.forename: Gavin
authors.initials: G
authors.lastname: Leslie
authors.affiliation: School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia.
authors.forename: Duncan
authors.initials: D
authors.lastname: Boldy
authors.affiliation: School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
authors.forename: Sonya
authors.initials: S
authors.lastname: Girdler
mesh_terms: D001364:Awareness; D002755:Choice Behavior; D060909:Economics, Behavioral; D015658:HIV Infections / Q000175:diagnosis*; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D008960:Models, Psychological; D036301:Qualitative Research; D012931:Social Environment
keywords: epistemology; healthcare; public health