HIV Care for Substance Users with Psychiatric Disorders

描述（由申请人提供）： 该提案概述了NIDA K23指导研究科学家发展奖的综合培训和研究计划。Himelhoch博士的长期目标是成为一名学术卫生服务研究人员，研究艾滋病毒相关医疗保健的获取、提供和结果，为同时患有精神疾病和物质障碍的艾滋病毒+患者提供医疗保健。一个关键的挑战是找到有效的方法，帮助患有精神和物质障碍的人成功地获得和协调与艾滋病毒有关的保健。为了应对这一挑战，巴尔的摩市的主要艾滋病毒利益攸关方提议制定一项病例管理干预措施，以帮助这些人更好地获得和协调与艾滋病毒相关的医疗保健。我的直接职业目标是与这些利益相关者合作，使用基于社区的参与式框架来帮助开发，然后研究使用这种案例管理干预的可行性。培训计划包括高级生物统计学教学课程，临床试验设计，定性方法，以及基于社区的参与性研究，可行性和有效性试验以及病例管理干预的教程。该培训计划将与三个指导研究项目相结合。首先，将利用艾滋病毒研究网络数据库的数据进行纵向研究，以研究艾滋病毒相关的卫生保健利用模式，以帮助确定可能在社区为基础的干预措施中针对的潜在因素。第二，定性研究将调查病人的观点，因为它涉及到接受艾滋病毒相关的医疗保健的障碍。本研究将有助于确保设计过程中不排除以患者为中心的相关信息。第三，将研究采用最终案件管理办法的试点可行性研究。如果这些研究的结果表明，个案管理干预是可行的，它将告知后续发展的校外赠款建议，旨在研究这种干预的有效性。

DESCRIPTION (provided by applicant): This proposal outlines an integrated training and research program for a NIDA K23 Mentored Research Scientist Development Award. Dr, Himelhoch's long-term goal is to become an academic health services researcher studying access, provision and outcomes of HIV related medical care for HIV+ individuals with co-occurring psychiatric and substance disorders. A crucial challenge is to find effective ways to help individuals with co-occurring psychiatric and substance disorders successfully access and coordinate HIV related health care. To address this challenge, key HIV stakeholders in the City of Baltimore have proposed the development of a case-management intervention that may help these individuals better access and coordinate their HIV related health care. My immediate career goal then is to partner with these stakeholders using a community based participatory framework to help develop and then study the feasibility of using this case-management intervention. The training plan includes didactic coursework in advanced biostatistics, design of clinical trials, qualitative methods, and tutorials in community based participatory research, feasibility and effectiveness trials and case management interventions. This training plan will be integrated with three mentored research projects. First, a longitudinal study using data from the HIV Research Network Database will be used to study patterns of HIV related health care utilization to help identify potential factors that may be targeted in the community-based intervention. Second, a qualitative study will be employed to investigate the patient's perspective as it relates to obstacles to receiving HIV related medical care. This study will help ensure that relevant patient centered information is not excluded from the design process. Third, a pilot feasibility study using the final case management approach will be studied. If the results of these studies suggest the case management intervention is feasible it will inform the subsequent development of an extramural grant proposal aimed at studying the effectiveness of this intervention.