An interview with Kristefer Stojanovski, MPH, PhD(c), Public Health Researcher and Evaluation Specialist, Capacity Building Assistance Program, San Francisco Department of Public Health by Anna Morgan, RN, BSN, MPH, NaRCAD Program Manager Tags: Data, Evaluation, HIV/AIDS, PrEP, Sexual Health NaRCAD: Hi, Kristefer! Thanks for taking the time to chat with us today. Can you tell us a bit about your background and the work you’re currently doing as it relates to academic detailing? Kristefer: Thanks for having me. I’m a public health researcher and an evaluation specialist with the Capacity Building Assistance Program at San Francisco Department of Public Health. I serve as a specialist and a technical assistance provider for the West region of the United States. My work is focused on data and evaluation of academic detailing programs that are working on topics like sexual health, HIV, and PrEP. My main goal is to help folks measure, or think about, what “success” may look like for an academic detailing program. NaRCAD: What data do you think is most important for academic detailers to track during their visits when measuring or thinking about success? Kristefer: I see evaluation data and detailing efforts as one complete package. Detailers should think about their data at a high level and focus on the information they’re collecting and how that information serves the overall goal of detailing, which is to improve knowledge, attitudes, intentions, and behaviors of providers and clinics. At the same time, detailers should think about how they can show that they’re achieving that goal. For example, it’s useful to track how many providers they’ve seen, how much time was spent with providers, what they talked about during the visit, the resources that were provided, how the providers plan to use those resources, if a follow-up visit was scheduled, and the purpose of that follow-up visit. It’s important to track a mix of quantitative and qualitative data, but the critical components that should be tracked are the outcomes and the process of detailing. NaRCAD: What about academic detailing programs? What data should they collect? Kristefer: In a typical detailing program, detailers have a longitudinal, continuous outreach to providers. There’s an interesting conversation to be had about how we can use that temporal matrix as a tool and strategy for evaluation. I’m interested in how we can use the work academic detailers are doing – the actual visits themselves - as pieces of data over time. For example, if detailers are collecting some of the rich conversation that they’re having with providers or clinics, it’s fascinating to track those conversations over time and see how the detailing program is changing the knowledge, attitudes, intentions, and behaviors of those providers and clinics. There’s a lot of work that detailers are already doing that can be easily turned into data sources for both the detailing effort and the evaluation effort. I like to think about how we can make things as simple as possible. NaRCAD: Is there a specific platform that makes things simple and is best for collecting data for academic detailers and programs? Kristefer: That certainly becomes a little bit more individualistic when thinking about the needs, challenges, and abilities of each jurisdiction. Detailing is a conversational effort that is attempting to make concrete behavior change, so it becomes more convoluted when you think about how to track a conversation. Some jurisdictions might have a place to track conversations in their electronic health record, where others may not. At the most basic level, detailers can chart their conversations on one-page Word documents. The detailers I worked with charted their conversations with providers over time and eventually put it in one large PDF that could be easily uploaded into a qualitative data analysis software. You have to be creative when it comes to tracking this information. NaRCAD: How would you recommend that programs with limited resources go about data collection and evaluation? Kristefer: A lot of times we say we want to have high-tech solutions when we don’t actually need them. For a resource constrained department, having that one-page Word document that allows detailers to chart their interactions is more than enough data. Charting for just five minutes after a detailing visit about everything that took place becomes a wealth of information. You can also use an Excel document to input data from provider surveys. There are many low-tech ways to track information and it’s important to be aware of the low hanging fruit in terms of data collection. You want to be able to easily collect data that serves the detailing efforts, the program, and the evaluation and improvement process. NaRCAD: That’s a great way to look at it. What are some best practices for using data for leadership buy-in? Kristefer: I can’t stress enough how important data is in getting leadership buy-in. Data is not only quantitative and qualitative, but also using the information gathered to tell a story. It would be a strong statement if someone was able to go to leadership with a story about how providers have changed their practices based on the detailing effort. Using concrete results and showing leadership that detailing is making a change is extremely helpful for buy-in. Being able to show crazy big outcomes with your data won’t happen, but sharing stories from providers and clinics about how detailing has helped them is quite moving. I’ve heard some amazing stories during my evaluation. For example, detailers helped providers at some clinics to provide patients with directly observed therapy for PrEP at the same time that they were providing them with medication-assisted treatment for opioid use disorder. It’s impressive that detailing at those sites was able to make the clinics think creatively and be able to provide PrEP to these patients. NaRCAD: That certainly is impressive! What has surprised you the most about the academic detailing data you’ve evaluated? Kristefer: I can’t help but to think that pharmaceutical companies spend millions of dollars and resources on this model and they certainly wouldn’t have been doing this for decades if it didn’t work. We’re almost a little late to the game as public health practitioners, but through my experience evaluating some of this work and reading other evaluations, I’ve been shocked by how much providers truly value detailers. It’s fascinating to see how these health systems and departments are viewed as trusted partners by providers and clinics and how detailing has served as a role to improve that partnership and collaboration. Providers have often said how crucial this information has been in getting access to Department of Public Health resources they didn’t even know existed, which is pretty sad. Seeing public health and the medical system working side by side in this kind of way has been breathtaking. Biography. Kristefer Stojanovski is a PhD Candidate in the Department of Health Behavior & Health Education, School of Public Health at the University of Michigan. Kristefer has been doing community-based mixed methods research since 2010. His research explores the social and structural determinants to sexual health and HIV outcomes among key populations in the U.S. and in Southeastern Europe. Kristefer’s work interrogates how stigma drives HIV risk and infection using complex systems theory, structural equation, agent-based and multilevel modeling. Kristefer also translates his research into policy and decision-making. He is an evaluation specialist with the Capacity Building Assistance program with the San Francisco Department of Public Health.
21 Comments
Lucia Pedana
9/13/2023 10:51:25 am
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Abigail
10/28/2023 04:44:21 am
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Loren Masha
11/22/2023 01:39:47 pm
Cured from Hsv-2, via… R.buckler11@gmail.com.......
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10/30/2023 09:27:39 pm
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Lucia Pedana
11/1/2023 08:14:54 pm
I was having Herpes Simplex Virus then I came across a review of people testifying how they got cured and got rid of Herpes completely from their body by using Dr Osato herbal medicine. So I contacted him through his email and explained my problem to him. He told me all the things I needed to do and he sent the herbal medicine to me through UPS and he also gave me instructions on how to take the herbal medicine, which I rightly followed. After I finished taking the cure, I went for a checkup and my result was Negative and all the symptoms of herpes were completely gone from my body. If you are down with any of the following diseases/viruses like HERPES-1&2, HIV, HPV, LOW SPERM, DIABETES, CANCER, PENIS ENLARGEMENT or any other disease or ailment I recommend you to contact this great herbalist called Dr Osato he uses natural herbs to cure diseases/viruses. Be rest assured you will surely testify like the way I am doing right now by writing this amazing testimony. You can contact Dr Osato via email: osatoherbalcure@gmail.com or through WhatsApp +2347051705853.
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Moma garage
11/4/2023 05:58:54 pm
God bless Dr Akhigbe for saving my life. I was infected with HERPES for than 2 years, I tried different doctors over a period of time but no one work, but when i came on the Internet i saw great testimony about DR AKHIGBE how he was able to cure someone from HERPES virus with the help of herbal medicine I contacted him and he promised to cure my herpes virus.well i decided to give him a try, DR AKHIGBE put his best in it and gave me good and effective result just as he has promised. Well after taking all the treatment sent to me by Dr AKHIGBE I went back to the Hospital for check up, and now I have been confirmed HERPES Negative. You can contact him if you have any kind of sickness like, HERPES, HIV, CANCER, PILE, HEPATITIS, DIABETES, and alot more you can contact him ON Whatsapp +2349021374574 or Email Drakhigbeherbalhome5@gmail.com
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Rachelle Hollie
11/15/2023 12:48:26 pm
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Lewis
11/29/2023 06:01:02 pm
I want to thank Dr Osato for the help he has rendered to me by getting Rid of my Herpes with his herbal medicine. I got Diagnosed of the herpes virus and after the Usage of Dr Osato Herbal Medicine, I was cured from Herpes and the virus was completely gone from my body. The Symptoms of Herpes Virus are completely gone.. So anyone who is having the virus should contact Dr OSATO to give you the herbal medicine to cure yourself. Dr Osato also has the cure for different types of diseases like HERPES 1$2, HIV, DIABETES, CANCER, HPV etc.. You can contact Dr Osato on email: osatoherbalcure@gmail.com or call and whatsapp him on +2347051705853. His website is https://osatoherbalcure.wordpress.com
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Cherlyn Solie
12/5/2023 06:00:48 pm
All thanks belong to Dr Osato, the great herbal man that cured me from HERPES. I got diagnosed 7 months ago and I was desperately looking for a possible way to get this virus out of my body because I believe there is a cure somewhere. I keep searching until i saw people's testimony about Dr Osato recommendations online, how he has being curing HERPES with his herbal medicine and i emailed him and tell him my problem and he prepare my cure and send it to me through UPS and gave me instructions on how to use the herbal medicine and behold after usage i went to the hospital for checkup my result was Negative and the symptoms of herpes was completely gone from my body. You can contact Dr Osato to get your herbs too and cure yourself from this horrible virus. His email is osatoherbalcure@gmail.com or through WhatsApp +2347051705853. His website is https://osatoherbalcure.wordpress.com. Dr Osato cures so many different types of diseases/viruses with his herbs such as HERPES, HIV/AIDS, CANCER of all kinds, HSV 1&2, DIABETES, HPV and so many more. I want to thank God for using Dr Osato to cure me from genital herpes.
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Moma garage
1/10/2024 12:47:07 pm
God bless Dr Akhigbe for his marvelous work in my life, I was diagnosed of Herpes Virus since over a month now and I was taking my medications, I wasn't satisfied i needed to get the Herpes virus out of my system, I searched about some possible cure for Herpes i saw a comment about Dr Akhigbe, how he cured Herpes with his herbal medicine, I contacted him and he guided me. I asked for solutions, he started the remedy for my health, he sent me the medicine through UPS SPEED POST. I took the medicine as prescribed by him and 7 days later i was cured from Herpes ,thank you for anyone that may need the medication you can contact him for your urgent cure Drakhigbeherbalhome5@gmail.com or Whats App +2349021374574.
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Jessica Lucas
1/11/2024 11:18:28 pm
It's so amazing when one finally finds joy in achieving something that’s so important to humans, which is sound good health, bcs there’s nothing more beautiful than having good health and being free from disease and infections. I don’t even know what else to say or rather how to express my joy, but it must! Be voiced out for thy Lord God Almighty is worthy to be praised 🙏🙌. I never knew or believed I would be cured from my hsv2. It is a miracle and a thing of joy, just 14 days of me following some real and fast effective protocols I was able to eradicate my long term genital herpes. I can boldly say that I’m now herpes negative, I’m cured from my HSV2 and i’m so excited that the medicine I took was made by Dr AKHIGBE email him at drakhigbeherbalhome5@gmail.com. or contact his whatsapp +2349021374574.
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Ruth Cholay
1/16/2024 05:04:54 am
I'm here to let everyone know that there is a cure for HERPES1&2. The doctors have succeeded in letting people living with Herpes know that there is no cure for Herpes and they have been enslaved to the antiviral and other supplementary Orthodox medicine just to help suppress the virus and not a cure. I got diagnose of herpes1&2 and i did not believe in my doctor that no cure for herpes rather i went into research online and I was introduce to Dr Osato a herbal healer by a blogger who also narrated Her story online on how she was cured of Herpes after using Dr Osato Herbal Medicine. I got the herbal medicine from Dr Osato and made use of it as I was instructed. I went to the clinic for a checkup after two weeks of using the herbal product. My result came out Negative and I was booked for another appointment after 30days to confirm my result and the test still showed Negative and I was given the green light that I am fully free from herpes. All thanks to God for using this Great herbalist to heal me. You can contact Dr Osato by email: osatoherbalcure@gmail.com or WhatsApp +2347051705853. His website is https://osatoherbalcure.wordpress.com. I have promised to keep sharing my testimony, so people will know that there is a cure for herpes.
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Susan
2/5/2024 05:03:21 am
Natural herbs have cured so many illness that drugs and injection cant cure. I've seen the great importance of natural herbs and the wonderful work they have done in people's lives. i read people's testimonies online on how they were cured of herpes, fibroids cyst, colon cleanse, hiv, diabetics etc by Dr UMA herbal medicine, so i decided to contact the doctor because i know nature has the power to heal anything. I was diagnosed with herpes for the past 7 years but Dr. UMA cured me with his herbs after taking his herbs for just 2weeks and i referred my aunt and her husband to him immediately because they were both suffering from herpes virus and they were cured too .I know is hard to believe but am a living testimony. There is no harm trying herbs. Contact dr.umaherbalcenter@gmail.com or WhatsApp +2347035619585.
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Cresia Sutherland
2/6/2024 08:59:26 am
I want to share this great testimony to the world on how Dr Osato cured me from Herpes with his herbs, I was nervous when I first contacted him about the cure for HSV but I decided to give him a try because I was desperate to get cured and be free from HSV. Dr Osato prepared the cure and sent it to me through UPS,which I used just the way Dr Osato instructed me and thank God today I am a beneficiary of this cure. I went back to the hospital after 14days of taking the herbs and I tested Herpes Negative. So I will tell you all who are looking for a cure to his/her HSV1&2 that Dr Osato took research before he could finally get the solution to it and a lot of people are benefiting from him right now. He also cured my friend from HPV. Dr Osato heals with natural herbs. Please i urge you to contact him now through his email address: osatoherbalcure@gmail.com or call and WhatsApp him on +2347051705853. His website is osatoherbalcure.wordpress.com and he is capable of curing HIV/AIDS, HERPES, HPV, HSV1&2, CANCER of all kinds,DIABETES and so many other infections.
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Lisa
2/14/2024 10:42:15 pm
I have tried every other herbal medicine before but no result until a friend of mine told me about Dr Zack Balo herbal medicine which I ordered. Anyone reading my testimony should please help me to thank Dr Zack Balo the greatest herbalist doctor of our time for curing me of Herpes 1&2. it was my friend that told me about Dr Zack Balo on how he have helped her in curing Herpes before. He also have the herbs to cure any diseases such as the following diseases; HERPES, DIABETES, HIV&AIDS, URINARY TRACT INFECTION, HEPATITIS B, IMPOTENCE, BARENESS/INFERTILITY DIARRHEA ASTHMA…ETC kindly reach Dr Zack Balo now through his Email/Website to order for your herbs : wiseindividualspell@gmail.com and https://wiseindividualspell.webnode.com or WhatsApp him via: +44 7521 379357
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Maria Helena
2/16/2024 04:30:53 pm
Reply
Susan
3/5/2024 12:15:31 pm
Natural herbs have cured so many illness that drugs and injection cant cure. I've seen the great importance of natural herbs and the wonderful work they have done in people's lives. i read people's testimonies online on how they were cured of herpes, fibroids cyst, colon cleanse, hiv, diabetics etc by Dr UMA herbal medicine, so i decided to contact the doctor because i know nature has the power to heal anything. I was diagnosed with herpes for the past 7 years but Dr. UMA cured me with his herbs after taking his herbs for just 2weeks and i referred my aunt and her husband to him immediately because they were both suffering from herpes virus and they were cured too .I know is hard to believe but am a living testimony. There is no harm trying herbs. Contact dr.umaherbalcenter@gmail.com or WhatsApp +2347035619585.
Reply
Martha Jecorick
3/12/2024 08:15:13 pm
DR. OSATO`S CURE FOR HERPES1&2 - A NATURAL WAY TO GET HERPES1&2 CURED. If you have been looking for ways to naturally get rid of the herpes simplex virus from your body totally, then you are welcome to read further. Let's face reality here, you have tried so many counter drugs and you are confused, weak and angry because nothing seems to work. Good News For you my friend.... Yes, I came with good news that will liberate you from the pains and stress of herpes outbreak, you will get total cure from this virus using Dr. Osato Herbal Methodology. Who is Dr. Osato? You may ask. Dr. Osato is a herbalist and a naturalist. He researched and identified some herbs and established a unique methodology to healing the human body using Herbal medicine that was confidently entrenched in his over 30 years of experience. According to him, he has the cure for so many diseases/virus like GENITAL HERPES, HIV, DIABETES, CANCER, HPV, HSV1&2, GENITAL WART, SHINGLES, VAGINAL INFECTION and so many more. You can reach Dr Osato on his email: osatoherbalcure@gmail.com or WhatsApp +2347051705853. You can also contact him through his website: https://osatoherbalcure.wordpress.com I am using this medium to inform everyone how to get treated of herpes using Dr Osato recommended Herbal methodology.
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magriet dennis
3/23/2024 11:27:02 pm
Get rid of all kinds of Herpes and virus infections, Diabetes, Hepatitis A B C, Menopause and HIV with Natural Roots and Herbs, i was once infected with HERPES and after using Dr UMA Herbal Medicine for couple of weeks i couldn't trace it anymore, i even went for checkup and my test came out Negative. Get your cure today from this wonderful herbalist, Dr. UMA.
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Lisa
3/24/2024 07:43:13 pm
I have tried every other herbal medicine before but no result until a friend of mine told me about Dr Zack Balo herbal medicine which I ordered. Anyone reading my testimony should please help me to thank Dr Zack Balo the greatest herbalist doctor of our time for curing me of Herpes 1&2. it was my friend that told me about Dr Zack Balo on how he have helped her in curing Herpes before. He also have the herbs to cure any diseases such as the following diseases; HERPES, DIABETES, HIV&AIDS, URINARY TRACT INFECTION, HEPATITIS B, IMPOTENCE, BARENESS/INFERTILITY DIARRHEA ASTHMA…ETC kindly reach Dr Zack Balo now through his Email/Website to order for your herbs : wiseindividualspell@gmail.com and https://wiseindividualspell.webnode.com
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frances tony
3/27/2024 11:01:40 pm
I thought the physicians says there is no cure for HSV 2!!! I am telling you today that DR.UMA cure HSV 2 with his herbal medicine and once you get cured you are cured forever it is never reversible, I have been suffering for this deadly disease called h HSV 2 for more than a 2years and lost all hope because my doctor says there is no cure for HSV 2. Brethren I saw a testimony on the internet on how DR.UMA cure HSV, Hapatitis etc with his herbal medication and an email and watsapp to contact him was also displayed, I thought this was joke but I decided to contact him and he replied telling me not to worry that my problem is over . DR.UMA sent me a herbal medication to drink for one month but only 2weeks I feel strange and I went to my doctor and he confirmed me negative. He can help you too. Contact him via email...dr.umaherbalcenter@gmail.com WhatsApp +2347035619585. He is capable of curing AUTISM, HERPES, HPV, HSV1&2, HEPATITIS A B C, and DIABETES.
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