From Intervention Development to Services

从干预开发到服务

• 批准号: 7126020
• 负责人: KATHRYN WHETTEN
• 金额: $ 26.75万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-26 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7126020
• 关键词: Commonwealth of Independent States; HIV infections; behavioral /social science research tag; clinical research; counseling; culture; emerging infectious disease; female; high risk behavior /lifestyle; human subject; interdisciplinary collaboration; interview; maternal behavior; mental disorder diagnosis; mental disorders; mental health epidemiology; model design /development; patient oriented research; pregnancy; psychotherapy; substance abuse epidemiology; substance abuse related disorder; therapy design /development

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.

描述（由申请人提供）：我们建议在俄罗斯彼得堡研究针对精神病患者、艾滋病毒呈阳性或有艾滋病毒风险的孕妇的综合治疗模式的可行性，我们在那里有一个研究中心。2000年，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%，医生估计只有四分之一的精神问题患者寻求专业帮助。到2009年，估计俄罗斯联邦将有500万人感染艾滋病毒-1。在俄罗斯，高达90%的登记艾滋病毒感染目前归因于注射吸毒。物质使用是一种精神健康诊断，通常与其他精神健康诊断同时发生。拟议的9个月心理健康治疗方案将针对在市艾滋病中心接受服务的孕妇或在两家高风险妇产医院分娩的孕妇。每年约有2 000名妇女在这两家医院分娩。据估计，41%的人是已知或怀疑的静脉注射毒品使用者，8%的人是艾滋病毒阳性。总部设在美国的研究小组一直在为美国一些最被剥夺权利的人提供多地点综合心理健康和艾滋病毒护理模式。该团队采用了医学研究所最好的药物滥用护理模型，并花了4年时间对该模型进行了相当大的修改，使其在文化上适合美国一些最难接触的人群：有精神健康、滥用药物和艾滋病毒诊断的人，其中大多数人从未从事过全职工作，不确定他们是否想要心理健康治疗（即仍处于康复阶段），不确定他们是否想要停止滥用药物，并且报告不信任政府或护理系统。我们建议开始采用现已修订的综合模式，其重点是在文化上适当，评估患者的支助和结构需求并满足这些需求，以俄罗斯为例，因为与药物有关的艾滋病毒流行病正在形成。这个俄罗斯团队在艾滋病毒、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，并接受了美国-基础训练。 我们将研究建立一个综合治疗计划的可行性;筛选妇女进入护理;第一次预约的回报率;保留在该计划中;以及，对于那些保留，趋势和干预效果。