Service Delivery Models Research Articles

Development and evaluation of an online professional development course to support delivery of tiered school-based rehabilitation services

Purpose The Facilitating Integration of Rehabilitation Services Through Training (FIRST) Course provides online professional development on tiered service delivery models for rehabilitation professionals working in education settings. Created by content and e-learning experts, this study describes our use of the Analysis, Design, Development, Implementation, Evaluation (ADDIE) instructional design model and the Successive Approximation Model (SAM) to develop, implement, and evaluate the FIRST Course, and reports the findings of an initial program evaluation. Method Rehabilitation professionals who completed the FIRST Course were invited to complete a cross-sectional survey to evaluate its utility. Results Between May 1, 2020, and August 11, 2023, 314 occupational therapists, 54 physiotherapists, and 170 speech-language pathologists completed the online course and survey. Respondents perceived the FIRST Course content to be relevant to their practice and to meet their learning needs regarding tiered services in education settings. Most respondents viewed the course positively and would recommend it to colleagues. More experienced respondents suggested a need for training on tiered service delivery models beyond an introductory level. Conclusions The ADDIE and SAM instructional design models were successfully applied to develop, implement, and evaluate online professional development for school-based rehabilitation professionals who wish to learn about tiered service delivery models.

Using Collective Impact to Examine Direct Service Worker Training and Credentialing in North Carolina: Recommendations for Change.

Older adults and people living with disabilities receive home- and community-based services (HCBS) from approximately 113,000 often under-resourced and inadequately supported direct service workers (e.g., personal care aides, direct support professionals, nurse aides) in North Carolina. The demand in NC is projected to be ∼ 23,000 new direct service jobs from 2020 to 2030. We conducted a Medicaid-funded landscape analysis of direct service training/credentialing requirements and practices across service delivery models using the Collective Impact (CI) framework. With input from HCBS, licensing entities, advocates, and those with lived experience, we characterized NC's HCBS training/credentialing landscape and generated a first-of-its-kind comprehensive crosswalk resource. This project revealed the complexity and limitations of the multiple and varied training and credentialing requirements for direct service workers in NC. Robust community engagement efforts drove the development of preliminary findings and recommendations for improving the training and credentialing requirements for direct service workers in NC.

Affective Experiences of Older Adults Enrolled in a Multi-Component Health Promotion Program: A Focu-Group Study

The purpose of this qualitative study using focus groups was to explore the affective experiences of older adults enrolled in Bingocize®, a health promotion program that combines bingo and exercise after program facili-tators received a supplemental training developed by a recreational therapist titled, FUNctional Movement. The training emphasized participant enjoyment and autono-my support utilizing The Self-Determination Enjoyment Enhancement Service Delivery Model. Focus groups, comprised of 17 participants across three sessions, re-vealed that while the supplemental training may have improved engagement, many were unaware of the fall prevention components of Bingocize®. Focus group themes included autonomy sup-port, enjoyment, future desired activities, and barriers to physical activity. This may highlight a need to explicitly incorporate fall prevention and functional movement into Bingocize® training for facilitators. Additionally, integrating health education topics like sexual health and incontinence into Bingocize® could address participant needs and enhance program offerings. These findings may provide insights for refining Bin-gocize® training, aligning it more closely with participant expectations through a rec-reational therapy approach to physical activity in long-term care settings. The authors provide practice recommendations.

Leveraging Blockchain Technology for Public Health

This study delves into the metamorphic potential pertaining to blockchain technology public health, concentrating on its aptness towards addressing the critical challenges related to data security, privacy, and it enroute for improving health service outcomes. By incorporating decentralized structures and smart contracts, blockchain intensify data integrity, ensuring consistency and protective access control, which is principally effective for sensitive medical information. The study enlightens on the advantages of blockchain in entrusting patients as well as healthcare providers with control over public health related information, ensuring privacy and reinforcing regulatory compliance. It delves into the process of how blockchain can streamline healthcare processes, upgrading interoperability among healthcare systems, and create more systematic and affordable models for healthcare service delivery. Based on the case studies from different healthcare stakeholders, the paper provides factual and feasible insights for real-world implementations of blockchain in healthcare, exhibiting its potential to transfigure supply chain management, different insurance claims processing and managing electronic health records. Moreover, the study also recognizes the challenges, including technical constraints, ethical reviews, and the complication of integrating blockchain with existing healthcare framework. The study widens it discussion towards the legal and regulatory aspect, emphasizing the need for a comprehensive approach to adoption. Looking forward, the paper covers the emerging trends and offers guidance for healthcare stakeholders considering blockchain implementation, summarizing that blockchain could be a catalyst for remarkable improvements in public healthcare data administration and patient care.

The Road Home: Building the evidence base for a service delivery model that integrates housing, mental health, medical and legal services.

The evaluation of the Road Home (RH) program has revealed many learnings of interest to practitioners, researchers and evaluators. The focus of this analysis is twofold - on an innovative approach to building an evidence base using a developmental evaluation and action learning design and how research knowledge and skills can be applied in practitioner contexts and be robust, rigorous and above all useful. It particularly features the role of reflective practice, an affordable, underutilised and easy to access evaluation and program improvement method for practitioners working with evaluators and researchers. Appreciating what is involved in approaching evaluation and other forms of organisational research in this way is important if industry collaborations and innovations that bring theory to practice and practice to theory are to be successful.

Scope of nursing work and models of service delivery in Australian primary and secondary schools: a scoping review protocol.

The objective of this review is to generate a national picture of the scope of nursing work and models of service delivery in Australian primary and secondary schools. Schools are an important setting for providing health services to school-aged children and youth. Early intervention with identified health needs has the potential to improve health and educational outcomes across the life course. Additionally, many children and young people present with health issues requiring sophisticated management at school. Nurses have worked in Australian schools for more than a century, but there is a lack of clarity about the scope of nursing work and models of service delivery in Australian schools. The review will include papers describing the work of registered or enrolled nurses in primary and secondary Australian schools providing education to children aged 3-18 years, in urban, regional, and remote areas of all states and territories. Peer-reviewed, non-peer-reviewed, and gray literature, not limited by publication date or language, will be included. The review will be conducted in accordance with the JBI methodology for scoping reviews. Databases to be searched will include CINAHL, MEDLINE, PsycINFO (all via EBSCOhost), together with ERIC, Informit, and Google. Two authors will independently screen titles and abstracts, and extract data from included papers. Data will be analyzed by state/territory and by education sector (government/non-government) to generate a national picture. The findings will be reported in a narrative synthesis aligned with the review questions. Open Science Framework https://osf.io/6yqrm.

Adopting sustainable innovations for remote access to TB and HIV care in South Africa.

For the last decade, South Africa has made substantial progress to control the dual HIV and TB epidemics. However, disruptions in TB and HIV treatment during the COVID-19 pandemic threatened to reverse this. This study aimed to identify adaptations in HIV and TB service delivery models in response to COVID-19 and government restrictions. This information informed the development of an online survey, which was utilized as part of a consultation exercise to further capture adaptations made to HIV/TB service delivery within the South African context. The literature review involved screening 380 titles and abstracts, identifying 30 HIV and TB studies across 19 countries, and categorizing 90 individual interventions into ten thematic areas. Common themes included interventions addressing screening, testing, diagnosis, medication collection and delivery support, and virtual models. Digital health interventions and adaptations to medication collection/delivery were reported in 38% of studies. Analysis of survey responses from 33 stakeholders in South Africa revealed that 47% of interventions targeted HIV, 11% TB, and 23% HIV/TB integrated service delivery. Most interventions (81%) were integrated into the national HIV or TB program, with implementation occurring at various levels: 39% at facility level, 35% at sub-district or district level, and 18% at provincial level. Programmatic data was available for 86% of interventions, with 50% being funded. This study demonstrated that services can be delivered in locations other than in health facilities (e.g., community-based or home-based) and that integrated services can also free up additional resources. Although studies varied, COVID-19 accelerated the adoption of differentiated service delivery (DSD) models for TB care, including multi-month dispensing (MMD) for TB preventative therapy (TPT) and TB treatment, home-based or mobile outreach screening and testing, and community pickup points (PuP) for TB medications. These initiatives had previously lagged behind HIV-focused DSD models, and it is crucial to sustain these services beyond the pandemic. To achieve universal health coverage, it will also be important to capitalize on these experiences and learn from HIV-focused DSD models so programs can deliver integrated person-centered chronic care services for TB, HIV, and non-communicable diseases.

Navigating the Complexities of School Leadership for Students With Disabilities

This case study delves into the complexities faced by Principal Williams, a newly appointed leader at Hudford Elementary School, as she navigates the challenges of providing high-quality education for students with disabilities in an elementary school. Under the Individuals with Disabilities Education Act (IDEA), each student with a disability is required to have access to the general education curriculum and specially designed instruction (SDI) that is tailored to the student’s unique needs. As Principal Williams steps into her role as leader of Hudford Elementary School, she has questions about the current service delivery model for students, the distribution of responsibilities across general and special education, and the extent of inclusion. She is considering her next steps, including how she will address some problematic working conditions experienced by special educators at the school. Through this case, readers gain insights into the complexity of supporting students with disabilities in a time of teacher shortages and learn about identifying the resources teachers need to fulfill their responsibilities.

Development of a pharmacy-based HIV PrEP service delivery intervention for Washington, District of Columbia (DC): A study protocol.

Pharmacy-based PrEP service delivery models can help address many of the barriers that inhibit the uptake of PrEP. In an increasing number of states, legislation has been passed, or is under consideration, to allow pharmacists to initiate PrEP without a prescription from a physician or other prescriber. However, there is not yet legislation in Washington, DC to allow pharmacy-based PrEP despite its potential to curb new cases of HIV, which disproportionately affect the Black community in the area. The DC Ends HIV Plan has a goal of less than 130 new cases of HIV per year by 2030, which would require that over 13,000 high-risk residents use PrEP. However, in 2021 only 6,724 Washingtonians were taking PrEP. This study seeks to address the absence of critical formative research into the factors that would influence the implementation of pharmacy-based PrEP in Washington DC using the Implementation Mapping (IM) framework. A needs assessment will be conducted through in-depth interviews (IDIs) with pharmacists (n = 6), PrEP providers (n = 6), current PrEP users (n = 6), DC Department of Health officials (n = 2), DC Board of Pharmacy officials (n = 4) and pharmacy-based PrEP experts (n = 4) to provide input on the operational aspects of pharmacy-based PrEP model as a strategy to increase PrEP uptake. Information gathered through this needs assessment will be used to develop standard operating procedures for the introduction of pilot pharmacy-based PrEP into community-based retail pharmacies.

Feasibility of an environmental scan-based approach to collecting information about factors impacting cancer genetics services in Latin American countries.

Clinical cancer genetics services are expanding globally, but national policy and health care systems influence availability and implementation. Understanding the environmental factors within a country is required to appropriately implement, adapt, and evaluate cancer genetics service delivery models. An environmental scan (ES) is an approach used in business, public health, health care and other sectors to collect information about an environment or system for strategic decision making and program planning. An ES has been previously used to assess cancer genetics clinic-level factors to inform quality improvement efforts in the United States. We assessed the feasibility of using an ES to collect information about factors that may influence cancer genetics service delivery in the outer-most socio-ecological model environmental levels (policy, national agencies, healthcare systems, cultural considerations) in three Latin American countries. Oncology and Genetics care team members at three participating sites used publicly available sources and personal experiences to complete a data collection form (DCF) that included questions about subtopics: laws and policies, relevant agencies and regulations, health care systems and insurance, and cultural considerations. Time to complete the DCF and DCF completeness were used to measure ES feasibility. Participating sites completed the DCF in 3 months, and most questions (average, 87.0%) were answered. Questions in the cultural considerations subtopic had the fewest answers (average, 77.8%). Overall, the ES was feasible and identified a lack of published literature related to cultural considerations impacting health care and genetics services uptake in Latin America. Environmental factors impact cancer genetics services, and identification of these factors will facilitate future collaborative research and genetics service delivery dissemination efforts.

Evaluation of the feasibility, acceptability, and impact of Group Antenatal Care at the health post level on continuation in antenatal care and facility based delivery in Ethiopia using a cluster randomized stepped-wedge design: Study protocol

Background Adequate antenatal care (ANC) and facility-based delivery are linked to improved maternal and neonatal outcomes. Adequate antenatal care attendance and facility birth rates are increasing in Ethiopia but remain well below national goals and global recommendations. Group ANC (G-ANC), when implemented at higher level facilities, is associated with improved quality and experience of ANC, and increased ANC retention and facility-based delivery. The objectives of the study are to assess the feasibility, acceptability, and impact of G-ANC implemented at lower-level facilities (health posts) on ANC continuation and facility-based delivery. Methods G-ANC will first be piloted in five purposively selected health posts. The study will then use a stepped-wedge design in 36 health posts under six health centers, with randomization of the order of the start of the intervention done at the health center level (clusters). The design will include three time periods: first is a six-month control period with no G-ANC implementation, followed by another six months period where G-ANC will be introduced in half (n=18) of the study health posts, then final six months where G-ANC will be implemented in the remaining 18 health posts. Quantitative and qualitative data collection approaches will be used. The study has “pause and reflect” points designed to iterate on the intervention before rolling out to the next set of sites. Qualitative research will be conducted using in-depth interviews with pregnant women, health care workers, facility managers, and regional health managers. 770 women will be enrolled across all phases. Conclusions The study will inform decision makers locally and globally on whether G-ANC is a feasible service delivery model at the health post level. Effectiveness of G-ANC at increasing ANC retention and facility-based delivery will be reported, as well as its acceptability to pregnant women and Health Extension Workers. Registration NCT05054491, ClinicalTrials.gov (September 23rd 2021).

First Contact Physiotherapy: A 4-Year Service Evaluation of UK Primary Care Data.

The First Contact Physiotherapist (FCP) role offers patients direct access to musculoskeletal (MSK) specialists in primary care settings and is designed to reduce GP workload while providing high-quality care. Despite positive early evaluations of FCP services, there remains a need for up-to-date assessments of their impact. To evaluate the FCP model of care implemented in an NHS Primary Care Network (PCN) against pre-defined service objectives. A service evaluation was conducted using data from April 2020 to March 2024. Key performance indicators were based on national FCP evaluation criteria. Data included appointment utilisation, wait times, referral patterns, patient and staff satisfaction surveys, and audit results from clinical data. Over 4years, 12,185 patients were seen. Of these, 69% of patients were seen as true first contacts. The majority of patients (86.4%) were managed within primary care, with a referral rate of 8.5% to outpatient physiotherapy and 5.1% to orthopaedics. Patient satisfaction was high, with 82% rating their FCP experience as excellent or outstanding. The FCP service successfully met its objectives by reducing GP workload and providing effective care. However, there was an increase in outpatient physiotherapy referrals over the 4-year period. Staff satisfaction was generally positive, though some highlighted concerns about appointment duration and workload. This evaluation demonstrates that FCP services provide a viable solution for managing MSK conditions in primary care. Future research should explore the most effective MSK service delivery models and incorporate digital solutions for comprehensive outcome and experience measures.

Private provider practices and incentives for hypertension management in rural and peri-urban Telangana, India– a qualitative study

Hypertension poses a critical threat to health in India, being the predominant risk factor for mortality and disability. With over 70% of outpatient care being provided by the private sector, our study investigated the practices and incentives of private health providers in screening, diagnosing, treating, monitoring, and counseling hypertension patients in rural and peri-urban India. Conducted from April 2020 to February 2021, the qualitative study involved 46 participants, including various healthcare professionals and patients in three Telangana state districts. Analysis revealed a lack of recognition of hypertension’s gravity among private providers in these areas, leading to inconsistent screening practices and varied diagnostic thresholds, particularly among rural medical practitioners. Both formal and informal providers lacked standardized protocols and follow-up mechanisms, with limited technical knowledge about hypertension observed, especially among rural practitioners who were often the first point of contact. Drug effectiveness, and incentives from pharmaceutical sales representatives influenced prescribing practices. Diagnostic labs also offered financial incentives for patient referrals. Thus, aligning providers’ objectives with patient preferences and public health goals is crucial. To encourage evidence-based hypertension care, the government and NGOs could implement strategies such as tailored incentives, financial rewards, tax benefits, accreditation, and recognition for private healthcare providers. Professional bodies in the private sector should establish programs emphasizing quality assurance and certifications. Future research should focus on designing and testing new models for private sector hypertension service delivery, coupled with targeted interventions to enhance care in rural and peri-urban settings.

Service Engagement Among People Experiencing Homelessness and Mental Disorders: A Call for Person-centred Innovations.

In recent years, there has been increased support for the use of coercive policies to address the seemingly intractable problem of homelessness among people with mental disorders in North America. Although these policy approaches respond to a critical issue, rising rates of unsheltered homelessness, low service engagement and concerns about disruptive behaviors in public settings, they are unlikely on their own to be successful. To avoid coercive practices, there is an urgent need to consider alternative, person-centred approaches to promote service engagement among people experiencing homelessness and mental disorders, with input from those with lived experience and frontline homeless service providers. Three person-centred approaches are proposed for consideration: (1) cross-sectoral service delivery models, (2) peer-led services, and (3) financial incentives. These approaches merit further study to support voluntary treatment engagement and exits from homelessness among people with mental and substance use disorders and safeguard the human rights of this population.

Delivering Enhanced Milieu Teaching to Toddlers With Down Syndrome via Hybrid Telepractice: A Single-Case Experimental Design.

This pilot study investigated delivering enhanced milieu teaching tailored for children with Down Syndrome (EMT-DS) through hybrid telepractice. In this multiple-baseline design across behaviors study, a speech-language pathologist (SLP) taught EMT-DS to three caregivers and their children with DS (22-40 months) using a hybrid service delivery model. Sessions were conducted in person and via telepractice. The SLP taught caregivers EMT-DS, emphasizing the use of (a) four target EMT strategies: matched turns, expansions, time delays, and milieu teaching episodes; (b) augmentative and alternative communication (AAC; manual signs, speech-generating device); and (c) aided AAC modeling. The SLP provided caregiver instruction following the teach-model-coach-review approach. Caregiver outcomes were the accuracy (primary) and frequency (secondary) of EMT strategy use. Child outcomes were exploratory and included the rate of symbolic communication acts, weighted number of communication acts, and number of different words (NDW). There was a functional relation between the intervention and the accuracy and frequency of EMT strategy use for all three caregivers. All caregivers showed an increase in the accuracy for all four target strategies. Caregivers also increased the frequency of the three EMT strategies: expansions, time delays, and milieu teaching episodes. There were no changes in the frequency of matched turns. Caregiver use of EMT strategies maintained for 6 weeks post-intervention. After caregivers learned EMT strategies, gradual increases in the rate of symbolic communication acts and NDW occurred for all three children. Results demonstrate the preliminary efficacy of using a hybrid service delivery model to teach caregivers EMT-DS. https://doi.org/10.23641/asha.27115252.

Randomized control trial comparing genetic counseling service delivery models in an underserved population.

This randomized controlled trial compares outcomes of telephone versus in-person genetic counseling service models in underserved, bilingual patient populations referred for cancer genetic counseling. Between 2022 and 2023, a two-arm (telephone vs. in-person genetic counseling) prospective, randomized controlled study with 201 participants was conducted at two county hospital cancer genetics clinics. Primary outcomes included comparison of pre- and post-genetic counseling genetics knowledge (Multi-dimensional Model of Informed Choice, MMIC), genetic counseling visit satisfaction (Genetic Counseling Satisfaction Scale, GCSS), and genetic counseling visit completion rates. Secondary outcomes included comparison of genetic testing attitudes and informed choice (MMIC), genetic counseling-specific empowerment (Genomic Outcomes Scale, GOS), and genetic testing completion and cancellation/failure rates, using linear regression models (significance ≤0.05). There were no statistically significant differences between arms in pre/post-genetic counseling MMIC knowledge and attitude, GOS or GCSS scores or genetic counseling completion. While more participants in the telephone versus in-person arm made an informed choice about testing (52.5% v. 39.0%, p = 0.0552), test completion was lower (74% v. 100%, p < 0.05) for this group. Genetic counseling completion rates and MMICknowledge and attitude, GOS, and GCSS scores suggest telephone genetic counseling is comparable to in-person genetic counseling for underserved populations. Higher informed choice scores and significantly lower testing completion rates for telephone visits require further study.

Vaccines and vaccination in prison settings: availability and model of service delivery in 20 European countries.

Prisons, due to various risk factors, are environments that are conducive to infectious disease transmission, with significantly higher prevalence of infectious diseases within prisons compared to the general population. This underscores the importance of preventive measures, particularly vaccination. As part of the international project "Reaching the hard-to-reach: Increasing access and vaccine uptake among the prison population in Europe" (RISE-Vac), this study aimed to map the availability and delivery framework of vaccination services in prisons across Europe and beyond. A questionnaire designed to collect data on the availability and delivery model of vaccination services in prisons was validated and uploaded in SurveyMonkey in July 2023. Then, it was submitted to potential participants, with at least one representative from each European country. Potential participants emailed an invitation letter by the RISE-Vac partners and by the European Organization of Prison and Correctional Services (EUROPRIS). Twenty European countries responded. Vaccines are available in European countries, although their availability differs by country and type of vaccine. The first dose is offered to people living in prisons (PLP), mostly within one month, COVID-19 is the most widely offered vaccine. In all countries, vaccines are actively offered by healthcare workers; in most countries, there is no evaluation of vaccination status among people who work in prison. The survey shows variance in vaccine availability for PLP and staff across countries and vaccine types. Quality healthcare in prisons is not only a matter of the right to health but also a critical public health investment: enhancing vaccine uptake consistently among PLP and staff should be prioritized.

QM-ARC: QoS-aware Multi-tier Adaptive Cache Replacement Strategy

Distributed data-centric systems, such as Named Data Networking, utilize in-network caching to reduce application latency by buffering relevant data in high-speed memory. However, the significant increase in data traffic makes expanding memory capacity prohibitively expensive. To address this challenge, integrating technologies like non-volatile memory and high-speed solid-state drives with dynamic random-access memory can form a cost-effective multi-tier cache system. Additionally, most existing caching policies focus on categorizing data based on recency and frequency, overlooking the varying Quality-of-Service (QoS) requirements of applications and customers—a concept supported by Service Level Agreements in various service delivery models, particularly in Cloud computing. One of the most prominent algorithms in caching policy literature is the Adaptive Replacement Cache (ARC), that uses recency and frequency lists but does not account for QoS. In this paper, we propose a QoS-aware Multi-tier Adaptive Replacement Cache (QM-ARC) policy. QM-ARC extends ARC by incorporating QoS-based priorities between data applications and customers using a penalty concept borrowed from service-level management practices. QM-ARC is generic, applicable to any number of cache tiers, and can accommodate various penalty functions. Furthermore, we introduce a complementary feature for QM-ARC that employs Q-learning to dynamically adjust the sizes of the two ARC lists. Our solution, evaluated using both synthetic and real-world traces, demonstrates significant improvements in QoS compared to state-of-the-art methods by better considering priority levels. Results show that QM-ARC reduces penalties by up to 45% and increases the hit rate for high priority data by up to 84%, without negatively impacting the overall hit rate, which also increases by up to 61%.

Searching for effective strategies to reach boys and young men; a mixed-methods study protocol for youth clinics in Sweden

BackgroundEfforts to engage boys and young men in sexual and reproductive health (SRH) services in Sweden remain limited, with only a small proportion accessing youth clinics, the primary providers of such services. Existing initiatives are often ad-hoc and lack institutionalization within public policy and practice. This study aims to identify feasible and effective interventions to improve boys’ and young men’s access to youth clinics in Sweden.MethodsEmploying a mixed-methods approach, this study investigates interventions, strategies, and factors influencing access to SRH services for boys and young men in Sweden. Firstly, a systematic literature review will be conducted to identify evaluated interventions globally. Secondly, strategies to attracts boys and young men in youth clinics in Sweden will be mapped. Thirdly, case studies in two regions in Sweden – chosen for their demographic and geographic diversity – will be conducted interviewing healthcare providers, managers, policymakers, and boys and young men. Lastly, Q-methodology will be used to rank all identified strategies. Healthcare providers and managers will rank these strategies based on their perceived effectiveness and feasibility while boys and young men will rank the interventions based on perceived effectiveness.DiscussionThe added value of this project is generating robust evidence regarding boys and young men’s involvement in SRH services, especially their access to youth clinics. This is crucial for (1) developing gender-sensitive services and service delivery models that effectively promote young men’s SRH; (2) informing future young men’s health policies ensuring that their unique SRH concerns are addressed; and (3) improving young men’s participation in SRH provision. This will ultimately foster a culture of shared responsibilities and advance gender equality.

Differentiated Service Delivery Models for Maintaining HIV Treatment and Prevention Services During Crisis and Disease Outbreaks: Lessons from the COVID-19 Pandemic.

This review summarizes differentiated service delivery (DSD) models for HIV treatment and prevention that have been adapted for maintaining continuity of services during the COVID-19 pandemic and proposes strategies for sustaining their benefits now and during future disruptions. The COVID-19 pandemic resulted in an overburdened and disrupted health system, forcing countries to adopt and/or scale up DSD models for HIV services. While initially implemented as emergency measures, these models evolved and were refined over time to fit recipient needs ensuring continued HIV treatment and prevention services with minimal health system impact. Successful models employed task shifting, community-based delivery models, multimonth scripting and dispensing, and telehealth for remote consultation. DSD models enabled HIV services globally to be maintained during the COVID-19 pandemic. Though these models and adaptations were critical in addressing health gaps and disruptions caused by the pandemic, they were beneficial in improving efficiency and access to client-centered services and should be sustained.