HIV Engagement and Adolescent Depression Support (HEADS-UP)

艾滋病毒参与和青少年抑郁症支持 (HEADS-UP)

• 批准号: 10481504
• 负责人: Nivedita L Bhushan
• 金额: $ 21.29万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-15 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10481504
• 关键词: Address; Adherence; Adolescent; Adolescent Development; Adult; Affect; Africa South of the Sahara; Age; Botswana; Caregivers; Caring; Child; Chronic Disease; Clinic; Clinical Trials; Counseling; Country; Data; Depression screen; Development; Diagnosis; Effectiveness; Focus Groups; Friendships; General Population; Goals; HIV; HIV-infected adolescents; Health; Home; Individual; Infrastructure; Intervention; Interview; Literature; Malawi; Measures; Mental Depression; Mental Health; Methods; Modeling; National Institute of Mental Health; Outcome; Participant; Persons; Pilot Projects; Population; Protocols documentation; Provider; Psychosocial Factor; Randomized; Randomized Controlled Trials; Research; Research Priority; Resource-limited setting; Resources; Role; Source; Stigmatization; Supervision; Testing; Text Messaging; Training; Viral; Work; Youth; Zimbabwe; adolescent health; antiretroviral therapy; arm; base; care outcomes; child depression; depressive symptoms; design; evidence base; experience; follow-up; improved; innovation; peer support; preference; problem solving therapy; scale up; standard care; theories; young adult

ABSTRACT Sub-Saharan Africa is home to the largest population of adolescents living with HIV (ALWH). Engaging ALWH in HIV care is challenging and reflected in lower rates of viral suppression and higher rates of loss to follow-up as compared to adults in the region. Depression has been identified as a significant barrier to initiating and remaining in HIV care. Indeed, this is the case for ALWH in Malawi where estimates of viral suppression range from 40%-78% and estimates of depression range from 18-26%. Resource-appropriate interventions that improve depression and address engagement in HIV care for ALWH are urgently needed. The Friendship Bench (FB) is an evidence-based depression counseling intervention delivered by trained, supervised lay health workers. It is proven to reduce depression in the general population in low-resource settings but has not been adapted to be youth-friendly or enhanced with peer support to facilitate engagement in HIV care among ALWH. FB is based on problem-solving therapy, which offers an ideal framework for youth-friendly adaption and integration of retention peer support into a proven depression treatment model. Our long-term goal is to adapt, test, and scale up resource-appropriate interventions to reduce depression and improve engagement in HIV care amongst ALWH. Our specific aims are: 1) to conduct formative research for youth-friendly adaptation and peer support enhancement of FB; 2) to adapt the evidence-based FB protocol to meet the developmental and contextual needs of ALWH and enhance this adapted FB protocol with peer support to facilitate HIV care engagement among ALWH; and 3) to determine the feasibility, fidelity, and acceptability of the Adapted and Enhanced FB protocols to improve depression and engagement in HIV care among ALWH. For the latter, we will conduct a 3-arm individually randomized pilot study to compare the adapted FB and the enhanced FB to standard care. The proposed aims pave the way for a R01 application to test the adapted and enhanced Friendship Bench interventions in a cluster randomized controlled trial and represent an important step forward towards improving depression among ALWH.

摘要 撒哈拉以南非洲是青少年艾滋病毒感染者最多的地区 （ALWH）。让ALWH参与艾滋病毒护理具有挑战性，这反映在病毒感染率较低 与该地区的成年人相比，抑制和失访率更高。抑郁 已被确定为启动和继续接受艾滋病毒护理的一个重大障碍。这确是 在马拉维的ALWH病例中，估计病毒抑制率为40%-78%， 据估计，抑郁症的发病率为18- 26%。资源适当的干预措施， 抑郁症和解决艾滋病毒护理的ALWH的参与是迫切需要的。 友谊长凳（FB）是一个循证抑郁咨询干预 由受过训练的、受监督的非专业卫生工作者提供。它被证明可以减少抑郁症的 在资源匮乏的环境中，为广大民众提供服务，但尚未进行调整，使之对青年人友好， 通过同伴支持，促进艾滋病毒/艾滋病患者参与艾滋病毒护理。FB基于 解决问题的疗法，它为青年友好的适应提供了一个理想的框架， 将同伴支持与抑郁症治疗模式相结合。 我们的长期目标是调整、测试和扩大资源适当的干预措施， 减少抑郁症，并提高艾滋病毒护理的参与度。我们的具体目标是： 1)进行形成性研究，以促进对青年友好的适应和同伴支持， 2）调整循证FB协议，以满足发展和背景需求 并在同伴支持下加强这一适应性FB协议，以促进艾滋病毒护理 （3）确定ALWH的可行性、忠实性和可接受性; 调整和加强FB协议，以改善抑郁症和参与艾滋病毒护理， 好的。对于后者，我们将进行一项3组单独随机化初步研究，以比较 适应FB和增强FB标准护理。拟议的目标为R 01铺平了道路 应用程序，以测试集群中经过调整和增强的友谊长凳干预措施 随机对照试验，代表着朝着改善迈出的重要一步 ALWH中的抑郁症