From Intervention Development to Services

描述(由申请人提供)：我们建议在俄罗斯圣彼得堡研究针对精神病患者、艾滋病毒阳性或艾滋病毒风险孕妇的综合治疗模式的可行性，我们在那里有一个研究地点。2000年，大约有400万俄罗斯人正式登记患有精神障碍。官方数据已经比美国和大多数欧洲国家的患病率高出20%，医生估计，有精神问题的人中只有四分之一寻求专业帮助。到2009年，俄罗斯联邦估计将有500万人感染艾滋病毒-1。目前，俄罗斯高达90%的登记艾滋病毒感染是由于注射毒品造成的。物质使用是精神健康诊断的一种类型，通常与其他精神健康诊断同时发生。拟议的为期9个月的心理健康治疗计划将针对在市艾滋病中心接受服务的孕妇或在两家高危妇产医院分娩的孕妇。这两家医院每年约有2,000名妇女分娩。据估计，41%的人是已知或疑似静脉注射吸毒者，8%的人艾滋病毒阳性。这个总部位于美国的研究团队一直在为美国一些被剥夺最大公民权的个人进行多地点心理健康和艾滋病毒护理综合模式的研究。这个团队从医学研究所获得了最好的药物滥用护理模式，并花了4年时间对该模式进行了大量修改，使其在文化上适合美国一些最难接触到的人群：有精神健康、药物滥用和艾滋病毒诊断的人，其中大多数从未做过全职工作，不确定自己想要心理健康治疗(即仍处于沉思阶段)，不确定自己想要停止滥用药物，以及报告不信任政府或护理系统的人。我们建议从现在修订的综合模式开始，其重点是文化上的适宜性，评估患者的支持和结构需求并满足他们，以及在与艾滋病毒有关的物质流行正在站稳脚跟的俄罗斯。这个驻俄罗斯的团队在艾滋病毒、药物滥用和心理健康咨询方面拥有丰富的治疗和研究经验，并接受过美国的培训。 我们将研究建立综合治疗计划的可行性；对进入护理的妇女进行筛查；第一次预约的返回率；保留在该计划中的人；以及保留的人的趋势和干预效果。

DESCRIPTION (provided by applicant): We propose to examine the feasibility of an integrative treatment model for mentally ill, pregnant women who are HIV-positive or at risk for HIV in St. Petersburg, Russia where we have a research site. In 2000, around 4 million Russians were officially registered with mental disorders. The official figure is already 20% higher than the prevalence recorded in the U.S. and in most European countries and doctors estimate that only one quarter of those who have mental problems seek professional help. By 2009, an estimated 5 million individuals in the Russian federation will be infected with HIV-1. Up to 90% of registered HIV-infections in Russia are currently attributed to injection drug use. Substance use is one type of mental health diagnosis that often co-occurs with other mental health diagnoses. The proposed 9-month mental health treatment program will target pregnant women receiving services at the City AIDS Center or who present in labor at two high-risk Maternity Hospitals. Approximately 2,000 women per year give birth at the two hospitals. An estimated 41% are known or suspected intravenous drug users and 8% are HIV positive. The U.S. based research team has been engaged in a multisite integrated mental health and HIV care model for some of the most disenfranchised individuals in the United States. This team took the best substance abuse care model from the Institute of Medicine and spent 4 years making considerable alterations to the model to make it culturally appropriate to some of the hardest to reach populations in the United States: persons who have mental health, substance abuse and HIV diagnoses and most of whom have never worked at a full-time job, are not sure that they want mental health treatment (i.e. are still in the contemplative stage), were not sure that they wanted to stop abusing substances, and who report not trusting the government or cares systems. We propose to begin with the now revised integrative model, with its emphasis on being culturally appropriate and assessing the support and structural needs of patients and meeting them, to Russia where the substance related HIV epidemic is taking hold. The Russian-based team has extensive treatment and research experience with HIV, substance abuse and mental health counseling and have received U.S.-based training. We will examine the feasibility of establishing an integrated treatment program; screening women into care; return rates for the first appointment; retention in the program; and, for those retained, trends toward and intervention effect.