Clinic and Population-Based Approaches to Retention in HIV Care

基于临床和人群的艾滋病毒护理保留方法

• 批准号: 7930126
• 负责人: Julia Cook Dombrowski
• 金额: $ 12.72万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-09 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7930126
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Age; Alcohol or Other Drugs use; Appointment; Area; Attitude; Behavior Therapy; Biological; CD4 Lymphocyte Count; Caring; Cells; Cellular Phone; Cessation of life; Clinic; Clinic Visits; Clinical; Collaborations; Conduct Clinical Trials; County; Data; Data Analyses; Databases; Development Plans; Diagnosis; Disease; Effectiveness of Interventions; Enrollment; Environment; Epidemiologic Studies; Evaluation; Failure; Frequencies; Funding; Future; Goals; HIV; HIV Infections; HIV diagnosis; HIV/STD; Health; Health Services; Health Services Research; Healthcare Systems; Individual; Infection prevention; Information Systems; Intervention; Intervention Trial; Interview; Life; Maintenance; Measures; Medical; Mental Health Services; Mentors; Metric; Modification; Monitor; Newly Diagnosed; Outcome; Patients; Perception; Persons; Pilot Projects; Play; Prevention; Principal Investigator; Prospective Studies; Protocols documentation; Provider; Public Health; Public Health Practice; Qualitative Methods; RNA; Relative (related person); Reminder Systems; Research; Research Infrastructure; Research Personnel; Research Training; Retrospective Studies; Risk; Role; Schedule; Services; Staging; Structure; Substance abuse problem; Surveillance Program; System; Time; Training; Universities; Viral Load result; Visit; Washington; Work; base; care delivery; career development; contingency management; cost effectiveness; design; experience; improved; patient oriented; pilot trial; population based; prevent; programs; public health relevance; severe mental illness; skills; therapy design; transmission process; voucher

DESCRIPTION (provided by applicant): This proposal describes a 5-year training and research program that will allow the Principal Investigator to achieve her goal of becoming an independent patient-oriented investigator with expertise in HIV health services, integrating research and public health practice. The proposed program will build on the candidate's prior experience in HIV/STD clinical and epidemiologic research by enhancing her skills in health services research and in the conduct of clinical trials involving behavioral interventions. The training plan will take advantage of an exceptional mentoring team and institutional environment that involves close collaboration between the University of Washington (UW) and the HIV/STD Control Program of Public Health-Seattle & King County (PHSKC). Research Plan - Retention in HIV care is crucial for the successful treatment of HIV infection and the prevention of HIV transmission, but there is no standard definition of retention in HIV care and little research on population-based approaches to monitoring and improving retention in HIV care. The specific aims of this proposal are: Aim 1) To establish a definition of inadequate retention in HIV care that is correlated with health outcomes and to identify factors that predict poor retention in care; Aim 2) To identify healthcare system factors that facilitate retention in HIV care and evaluate the acceptability of potential clinic-based and population-based interventions to improve retention in care; and Aim 3) To develop and conduct a pilot study of an intervention to improve retention in HIV care. We will address Aim 1 with retrospective studies of data from the UW HIV Clinical Information System and the PHSKC surveillance system and with a prospective study of persons with newly diagnosed HIV entering HIV medical care. We will address Aim 2 using qualitative individual interviews with HIV care providers and persons living with HIV/AIDS. We will design an intervention aimed at improving retention in HIV care using the results of the studies from Aims 1 and 2, and we will conduct a pilot study to assess feasibility and acceptability of the intervention (Aim 3). We will then incorporate the results of all of these studies into the design of a future trial to evaluate the effectiveness of the intervention to improve retention in HIV care. This research will lay the groundwork for a larger research program on quality HIV care that will include rigorous evaluation of interventions aimed at improving the delivery of care with consideration for cost-effectiveness. PUBLIC HEALTH RELEVANCE: Ongoing HIV care is necessary for the health of persons living with (HIV/AIDS) and for preventing the transmission of HIV. This project will evaluate measures of retention in HIV care, identify factors that facilitate retention in HIV care, and develop an intervention to increase the retention of patients in HIV care.

描述(由申请人提供)：本提案描述了一项为期5年的培训和研究计划，该计划将使首席调查员实现她的目标，即成为一名独立的、以患者为导向的调查员，具有艾滋病毒健康服务方面的专业知识，将研究与公共卫生实践相结合。拟议的计划将建立在候选人在艾滋病毒/性传播疾病临床和流行病学研究方面的先前经验的基础上，通过提高她在卫生服务研究和进行涉及行为干预的临床试验方面的技能。该培训计划将利用华盛顿大学(UW)与西雅图和金县(PHSKC)公共卫生艾滋病毒/性传播疾病控制计划(PHSKC)之间密切合作的卓越指导团队和机构环境。研究计划--保留艾滋病毒护理对成功治疗艾滋病毒感染和预防艾滋病毒传播至关重要，但没有关于保留艾滋病毒护理的标准定义，也没有关于监测和改善艾滋病毒护理保留情况的以人口为基础的办法的研究。这项建议的具体目的是：目的1)确定与健康结果相关的艾滋病毒护理保留不足的定义，并确定预测艾滋病毒护理保留不足的因素；目的2)确定促进艾滋病毒护理保留的医疗保健系统因素，并评估潜在的以诊所和人口为基础的干预措施的可接受性，以改善艾滋病毒护理的保留；以及目的3)开发和进行一项干预措施的试点研究，以改善艾滋病毒护理的保留。我们将针对目标1对华盛顿大学艾滋病毒临床信息系统和PHSKC监测系统的数据进行回顾研究，并对进入艾滋病毒医疗护理的新诊断艾滋病毒感染者进行前瞻性研究。我们将通过对艾滋病毒护理提供者和艾滋病毒/艾滋病患者的定性个别访谈来解决目标2。我们将利用目标1和目标2的研究结果设计一项旨在改善艾滋病毒护理留存的干预措施，并将进行一项试点研究，以评估干预措施的可行性和可接受性(目标3)。然后，我们将把所有这些研究的结果纳入未来试验的设计中，以评估干预措施的有效性，以改善艾滋病毒护理的保留。这项研究将为一个更大的关于高质量艾滋病毒护理的研究计划奠定基础，该研究计划将包括对旨在改善护理提供并考虑成本效益的干预措施进行严格评估。 公共卫生相关性：持续的艾滋病毒护理对于艾滋病毒/艾滋病感染者的健康和预防艾滋病毒的传播是必要的。该项目将评估艾滋病毒护理中保留的措施，确定促进艾滋病毒护理中保留的因素，并制定干预措施，以增加患者在艾滋病毒护理中的保留。