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员，研究为同时患有精神和物质障碍的HIV+患者提供与艾滋病毒相关的医疗服务的途径、提供和结果。一个关键的挑战是找到有效的方法，帮助患有精神疾病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开发一种病例管理干预措施，以帮助这些人更好地获得和协调与艾滋病毒有关的卫生保健。因此，我的直接职业目标是与这些利益攸关方合作，使用基于社区的参与性框架来帮助开发，然后研究使用这种病例管理干预措施的可行性。培训计划包括高级生物统计学、临床试验设计、定性方法的教学课程，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。这项培训计划将与三个指导性研究项目相结合。首先，将使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卫生保健利用的模式，以帮助确定社区干预中可能针对的潜在因素。第二，将采用定性研究来调查患者的视角，因为它与接受艾滋病毒相关医疗护理的障碍有关。这项研究将有助于确保相关的以患者为中心的信息不被排除在设计过程之外。第三，将研究采用最终病例管理方法的试点可行性研究。如果这些研究的结果表明病例管理干预措施是可行的，它将为随后制定一项旨在研究这一干预措施的有效性的外部赠款提案提供信息。

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.