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A Computerized Neurocognitive Battery for Use in Youth Affected by HIV in Resource-limited Settings

一种计算机化神经认知电池，用于资源有限环境中受艾滋病毒影响的青少年

基本信息

批准号：
10163887
负责人：
Elizabeth Dawn Lowenthal
金额：
$ 39.06万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10163887
关键词：
5 year old Accounting Adolescent Adult Affect Africa African Assessment tool Attention Back Botswana Caring Child Childhood Clinic Clinical Cognition Disorders Cognitive Cognitive deficits Collaborations Collection Consumption Developmental Delay Disorders Exhibits Exposure to Face Foundations HIV HIV Encephalopathy HIV Infections HIV therapy Health Professional High Prevalence Hour Impaired cognition Incidence International Interview Language Measures Neurocognitive Neurocognitive Deficit Neurodevelopmental Disorder Neurodevelopmental Problem Neuropsychology Parents Performance Perinatal Exposure Population Prevalence Procedures Psychosocial Assessment and Care Questionnaires Reporting Research Research Personnel Resources School-Age Population Schools Screening procedure Sensitivity and Specificity Series Severities Short-Term Memory South Africa Speed Structure Symptoms Testing Time Training Translating Translations Validation Work Youth antiretroviral therapy base brief screening caregiver education child battery cognitive function cognitive rehabilitation cognitive testing computerized design executive function experience high risk implementation science improved instrument member multidisciplinary neurobehavioral neurocognitive disorder neurocognitive test neuroimaging novel pediatric human immunodeficiency virus pediatrician peer prenatal therapy processing speed programs psychosocial screening socioeconomics teacher theories tool

项目摘要

Abstract The introduction of combined antiretroviral therapies has reduced the incidence and severity of HIV-related encephalopathy in youth living with HIV. However, neurodevelopmental delays and cognitive impairment are nonetheless still common in this population. Unfortunately, in resource-limited settings (RLS), where HIV infection impacts millions of children, cognitive and neurodevelopmental disorders commonly go undetected because of a lack of appropriate assessment instruments and local expertise. In this project, we build on the synergistic work of two research groups to: (1) culturally adapt and validate the Penn Computerized Neurocognitive Battery (CNB) and examine its validity for detecting both advanced and subtle neurodevelopmental problems among school-aged HIV-infected and HIV-exposed children in RLS; and (2) simultaneously fine-tune a brief screening instrument (The Pediatric Symptom Checklist, PSC) to prioritize children most likely to benefit from further cognitive assessments. The CNB is a well-validated battery of neurocognitive tests that assesses all major domains of cognitive functioning in adults and children as young as 5 years of age. It has shown sensitivity to mild cognitive deficits, and has been applied in large-scale studies and in multiple cultural contexts. We aim to validate the CNB in youth in Botswana, a RLS with high rates of perinatal exposure to HIV and limited neurocognitive assessment tools and expertise, by culturally adapting and then administering the adapted version of the CNB to 200 HIV-infected, 200 HIV-exposed uninfected, and 240 HIV-unexposed uninfected children. A series of analyses will be conducted to examine the reliability and construct validity of the CNB in these populations. Since a one hour comprehensive cognitive assessment may not be feasible to implement among all children in many busy clinics in resource-limited settings, we will also adapt a rapid psychosocial screening tool, the Pediatric Symptom Checklist to make it suitable for identifying children who are most likely to benefit from further neurocognitive assessment. To accomplish these aims, we have assembled a unique, multi-disciplinary expert team with long-term experience developing and validating novel and highly adaptable neurocognitive assessments, and conducting Africa-based collaborative HIV research. This project will apply procedures for effective translation and cultural adaptation that have been developed through extensive collaborations of our group with international researchers from both Western and non-Western cultures (e.g., in South Africa in an adult Xhosa-speaking population). If successful, the proposed tools would provide practical screening and streamlined, comprehensive assessments that could be widely used in RLS to identify children with cognitive deficits within programs focused on the care and treatment of children living with or affected by HIV. The utility of such assessments could extend well beyond children affected by HIV and increase general access to pediatric cognitive assessments in RLS.

摘要联合抗逆转录病毒疗法的引入降低了艾滋病毒相关疾病的发生率和严重程度青年艾滋病毒携带者的脑病。然而，神经发育迟缓和认知障碍尽管如此，在这个人群中仍然很常见。不幸的是，在资源有限的情况下，艾滋病毒感染影响数百万儿童，认知和神经发育障碍通常未被发现因为缺乏适当的评估工具和当地的专门知识。在这个项目中，我们建立在两个研究小组的协同工作：(1)从文化上适应和验证宾夕法尼亚州立大学计算机化神经认知电池(CNB)及其对高级和细微检测的有效性 RLS中学龄儿童的神经发育问题；和(2) 同时微调简短的筛查工具(儿科症状检查表，PSC)以确定优先顺序儿童最有可能从进一步的认知评估中受益。CNB是一个经过充分验证的电池神经认知测试，评估成人和儿童在幼年时认知功能的所有主要领域作为5岁。它已显示出对轻度认知缺陷的敏感性，并已应用于大规模研究以及在多元文化背景下。我们的目标是在博茨瓦纳的年轻人中验证CNB，这是一种具有高发病率的RLS 通过文化适应，围产期暴露于艾滋病毒和有限的神经认知评估工具和专业知识然后给200名感染艾滋病毒的人和200名暴露于艾滋病毒的未感染的人接种经调整的CNB，以及 240名未接触艾滋病毒的未感染儿童。将进行一系列分析，以检查可靠性和构建CNB在这些人群中的效度。因为一小时的综合认知评估可能在资源有限的许多繁忙诊所的所有儿童中实施是不可行的，我们还将采用一种快速的心理社会筛查工具，儿科症状检查表，使其适合于识别最有可能从进一步的神经认知评估中受益的儿童。为了实现这些目标，我们我组建了一支独特的、多学科的专家团队，具有长期的开发和验证经验新颖和高度适应性的神经认知评估，并在非洲开展协作艾滋病毒研究。该项目将采用有效翻译和文化适应的程序由我们的团队与来自西方和非西方文化(例如，在南非讲科萨语的成年人口中)。如果成功，建议的工具将提供实用的筛选和简化的全面评估，这些评估可以广泛应用在RLS中用于在专注于护理和治疗的项目中识别有认知缺陷的儿童感染艾滋病毒或受艾滋病毒影响的儿童。这种评估的效用可能远远超出儿童的范畴。受艾滋病毒影响，并增加在RLS中进行儿童认知评估的普遍机会。