Coding Audiotapes of Clinic Visits for Adherence Content

对诊所就诊的录音带进行编码以确保遵守内容

• 批准号: 7006201
• 负责人: IRA B WILSON
• 金额: $ 24.37万
• 依托单位: TUFTS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-06 至 2007-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7006201
• 关键词: Coding; Audiotapes; Clinic; Visits; Adherence

DESCRIPTION (provided by applicant): Antiretroviral (ARV) adherence is a pressing problem for persons with HIV. While many believe that better physician-patient (MD-PT) relationships can lead to better ARV adherence, virtually nothing is known about the specific features of MD-PT communication that produce better adherence with ARVs. Such knowledge is essential to the rational design of interventions. The broad, long term objective of this R21 is to improve patients' ARV adherence by better understanding adherence-related MD-PT dialog. We have developed a new method to describe MD-PT dialogue called the Generalized Medical Interaction Analysis System (GMIAS). Several systems to code and analyze MD-PT communication already exist, but these existing systems are principally intended to characterize interpersonal processes and affective features of the interaction. They do not capture medication adherence content. The GMIAS was developed using the principles of Speech Act Theory, and is designed to capture both adherence content and interaction processes. We propose to apply this new coding system to 300 audiotaped MD-PT visits (150 intervention, 150 control) that are being collected as part of a randomized, controlled, cross over study of a physician-focused intervention to improve adherence with HIV ARVs. Our Specific Aims are to: 1) Develop software to facilitate more rapid analysis of transcribed audiotapes of MD-PT visits, 2) Compare the amount of adherence-related dialogue in intervention and control visits using the GMIAS (discriminant validity), 3) Determine the extent to which adherence-related dialogue is related to subsequent adherence as assessed by MEMS, and to viral loads (predictive validity), 4) Using the approach described in SA 1 and 2, compare the validity of the GMIAS with an existing coding system (correlational validity) and, 5) Identify specific categories of adherence-related content, and the interaction processes in which it occurs, which relate most strongly to adherence outcomes. This project is innovative because it implements and tests the validity of a new methodology to understand MD-PT dialogue. As such, it advances basic social science research related to medication adherence. While this work focuses on adherence with ARVs for HIV disease, the GMIAS has been designed to be easily generalizable to other conditions and research problems in MD-PT communication.

描述（由申请人提供）：坚持抗逆转录病毒（ARV）治疗是艾滋病毒感染者面临的一个紧迫问题。虽然许多人认为，更好的医患（MD-PT）关系可以导致更好的抗逆转录病毒药物的依从性，几乎没有什么是已知的MD-PT沟通，产生更好的抗逆转录病毒药物的依从性的具体功能。 这种知识对于合理设计干预措施至关重要。 该R21的广泛、长期目标是通过更好地理解依从性相关MD-PT对话来提高患者的ARV依从性。 我们已经开发了一种新的方法来描述MD-PT对话称为广义医疗互动分析系统（GMIAS）。已经存在几个编码和分析MD-PT通信的系统，但是这些现有的系统主要用于表征交互的人际过程和情感特征。 它们不捕获药物依从性内容。 GMIAS是使用言语行为理论的原则开发的，旨在捕获遵守内容和交互过程。 我们建议将这一新的编码系统应用于300次MD-PT访视（150次干预，150次对照）的录音，这些访视是作为一项以医生为中心的干预措施的随机、对照、交叉研究的一部分收集的，以提高对HIV ARV的依从性。 我们的具体目标是：1）开发软件以便于更快速地分析MD-PT访视的转录录音带，2）使用GMIAS比较干预和对照访视中依从性相关对话的数量3）确定依从性相关对话与MEMS评估的后续依从性和病毒载量相关的程度（预测有效性），4）使用SA 1和2中描述的方法，比较GMIAS与现有编码系统的有效性（相关有效性）和，5）识别与依从性相关的内容的特定类别，以及它发生的交互过程，这与依从性结果密切相关。这个项目是创新的，因为它实施和测试一种新的方法来理解MD-PT对话的有效性。 因此，它推进了与药物依从性相关的基础社会科学研究。 虽然这项工作的重点是坚持与抗逆转录病毒药物治疗艾滋病毒疾病，GMIAS已被设计为很容易推广到其他条件和研究问题的MD-PT沟通。