Development and Validation of Vulnerable and Enabling Indices for HIV Viral Suppression among People with HIV Enrolled in the Ryan White Program.

Development and Validation of Vulnerable and Enabling Indices for HIV Viral Suppression among People with HIV Enrolled in the Ryan White Program.
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DOI:
10.3390/ijerph18137048
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发表时间:
2021-07-01
影响因子:
--
通讯作者:
Sheehan DM
Sheehan DM
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Gebrezgi MT;Trepka MJ;Gbadamosi SO;Fennie KP;Ramirez-Ortiz D;Li T;Fernandez SB;Brock P;Ladner RA;Sheehan DM

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背景:影响HIV护理的因素众多,在使用统计建模时通常需要考虑指数以防止共线性。利用弱势群体行为模型,我们为艾滋病毒感染者(PLWH)开发了弱势和赋权指数。方法:我们使用Ryan White Program (RWP)数据和主成分分析来开发一般和性别和种族/民族特定指数。我们评估了非病毒抑制的内部信度(Cronbach’s alpha)、收敛效度(相关系数)和预测效用(逻辑回归)。结果:心理健康、药物使用和社会经济地位三个一般因素占指标变异的79.2% (Cronbach ' s alpha 0.68)。在整个RWP人群中,指标表现出收敛效度和预测效用。使用性别或种族/民族特定指数并不能改善心理测量的表现。讨论:使用行政数据的一般心理健康、药物使用和社会经济指标显示,在总体PLWH人群以及按性别和种族/民族分层的人群中,非病毒抑制的可靠性、有效性和实用性是可以接受的。这些一般指数可以在性别和种族/民族不同的人群中具有相似的有效性和效用。
Background: Numerous factors impact HIV care, often requiring consideration of indices to prevent collinearity when using statistical modeling. Using the Behavioral Model for Vulnerable Populations, we developed vulnerable and enabling indices for people living with HIV (PLWH). Methods: We used Ryan White Program (RWP) data and principal component analysis to develop general and gender- and racial/ethnic-specific indices. We assessed internal reliability (Cronbach’s alpha), convergent validity (correlation coefficient), and predictive utility (logistic regression) with non-viral suppression. Results: Three general factors accounting for 79.2% of indicators’ variability surfaced: mental health, drug use, and socioeconomic status (Cronbach’s alpha 0.68). Among the overall RWP population, indices showed convergent validity and predictive utility. Using gender- or racial/ethnic-specific indices did not improve psychometric performance. Discussion: General mental health, drug use, and socioeconomic indices using administrative data showed acceptable reliability, validity, and utility for non-viral suppression in an overall PLWH population and in gender- and racial/ethnic-stratified populations. These general indices may be used with similar validity and utility across gender and racial/ethnic diverse populations.
纽约市艾滋病毒初级保健中脆弱人群参与的障碍和促进者。
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