Catherine O’nEal

A growing number of researchers and practitioners are embracing a “participatory turn” in machine learning (ML) to improve model development, prevent harm, and provide communities more influence over systems that impact them. In this paper, we explore the intersection of participatory practices in healthcare and the emerging focus on responsible AI with a focus on human immunodeficiency virus (HIV) care. We review the historical context of participation in HIV treatment and prevention, emphasizing how patient activism has shaped practices in this field. We then review participatory ML in HIV prevention and present a brief case study of a project designed to identify candidates for pre-exposure prophylaxis (PrEP) in Louisiana. The review highlights the essential steps in conducting participatory ML. Finally, we draw lessons for future participatory ML projects, underscoring the importance of long-term collaboration, responsiveness to partner feedback, and the crucial role of capacity-building for individuals and organizations. Effective participation requires substantial resources and investment, which supports overall project goals beyond mere improvements in model performance. We also draw lessons for advancing the participatory ML field, including (1) the impact of funding mandates on fostering effective engagement; (2) the need to scale participatory processes rather than just technologies; and (3) the need for genuine participation to allow flexibility in project plans, timelines, and shifts in institutional power dynamics.

The Society for Healthcare Epidemiology of America, the Association of Professionals in Infection Control and Epidemiology, the Infectious Diseases Society of America, and the Pediatric Infectious Diseases Society represent the core expertise regarding healthcare infection prevention and infectious diseases and have written multisociety statement for healthcare facility leaders, regulatory agencies, payors, and patients to strengthen requirements and expectations around facility infection prevention and control (IPC) programs. Based on a systematic literature search and formal consensus process, the authors advocate raising the expectations for facility IPC programs, moving to effective programs that are: • Foundational and influential parts of the facility’s operational structure • Resourced with the correct expertise and leadership • Prioritized to address all potential infectious harms This document discusses the IPC program’s leadership—a dyad model that includes both physician and infection preventionist leaders—its reporting structure, expertise, and competencies of its members, and the roles and accountability of partnering groups within the healthcare facility. The document outlines a process for identifying minimum IPC program medical director support. It applies to all types of healthcare settings except post-acute long-term care and focuses on resources for the IPC program. Long-term acute care hospital (LTACH) staffing and antimicrobial stewardship programs will be discussed in subsequent documents.