Medical stakeholder perspectives on implementing a computerized battery to identify neurocognitive impairments among youth in Botswana

Amelia E. Van Pelt*, Elizabeth D. Lowenthal, Onkemetse Phoi, Ontibile Tshume, Mogomotsi Matshaba, Rinad S. Beidas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


HIV infection and in utero exposure, common in Sub-Saharan Africa, are associated with pediatric neurocognitive impairment. Cognitive screening can identify impairments, but it is rarely used in this setting. The Penn Computerized Neurocognitive Battery (PennCNB), an evidence-based cognitive screening tool, was adapted for use in Botswana. To facilitate future implementation, 20 semi-structured interviews were conducted to elicit key stakeholders’ perspectives on factors likely to be related to successful uptake of the PennCNB in clinical settings. An integrated analytic approach combining constructs from the Consolidated Framework for Implementation Research and modified grounded theory was used. Results underscore the need for cognitive screening in Botswana and the acceptability of the PennCNB. Implementation barriers include limited time and resources, whereas facilitators include standard procedures for introducing new tools into medical settings and for training implementers. Recommended implementation strategies include integrating screening into the existing workflow, implementing the tool in the medical and educational sectors, and targeting selection of children for assessment. This research addresses the research-to-practice gap by engaging in pre-implementation inquiry and designing for implementation. Results will inform the development of strategies to maximize the likelihood of successful implementation of the PennCNB to identify neurocognitive impairment in children in this high-need setting.

Original languageEnglish (US)
Pages (from-to)1513-1521
Number of pages9
JournalAIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV
Issue number12
StatePublished - 2022


  • Neurocognitive assessment
  • Sub-Saharan Africa
  • implementation science
  • youth

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Social Psychology


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