Adaptation of a Depression Treatment Intervention for HIV Patients in Cameroon

喀麦隆艾滋病毒患者抑郁症治疗干预措施的调整

基本信息

  • 批准号:
    8099487
  • 负责人:
  • 金额:
    $ 22.84万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2009
  • 资助国家:
    美国
  • 起止时间:
    2009-07-21 至 2013-06-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Mental illness is a serious concern in the clinical management of HIV infection. In the United States, mood and anxiety disorders affect up to half of HIV+ patients. HIV+ individuals in resource-poor countries have similarly elevated rates of mental illnesses. Depression has been linked to a range of negative HIV-related behavioral and clinical health outcomes, including more sexual risk behaviors, worse antiretroviral therapy (ART) adherence, poor response to ART, faster immune system decline, and higher mortality. Approaches known as "Measurement-Based Care" (MBC) integrated into primary care settings have effectively addressed comorbid depression in non-HIV patient populations. Multisite randomized clinical trials have demonstrated the efficacy of MBC models, which employ clinical coordinators with depression expertise to help physicians implement guideline-concordant, algorithm-driven antidepressant treatment. The development of effective, culturally appropriate mental health interventions for HIV patients is particularly time-critical in sub-Saharan Africa (SSA), home to nearly two-thirds of the estimated 33 million people infected with HIV. Combination ART is just starting to become widely available in the region. Successful ART treatment and the prevention of drug resistance hinge on strict medication adherence. As depression is one of the most consistent predictors of poor adherence and has been declared by expert panels to be an important concern in the management of HIV around the world, tested interventions to address mental health issues in African HIV clinical settings are sorely needed. In the present R34 application, we propose to assess the feasibility and acceptability of implementing a randomized controlled trial (RCT) of an MBC depression management program that is primarily staffed by nurses and integrated into HIV clinical care sites. Project activities will take place in the English-speaking region of Cameroon due to the long-standing collaborative relationship between the University of North Carolina-Chapel Hill Center for AIDS Research and the Center for the Study and Control of Communicable Diseases of the University of Yaound¿ in Yaound¿, Cameroon. Our specific aims are to (1) Establish the validity, reliability, and cultural appropriateness of a case identification protocol to identify patients with major depressive disorder (MDD) at a semi-urban HIV clinical care site in English-speaking Cameroon; (2) Adapt an MBC treatment intervention for patients with MDD to the context of HIV treatment in Cameroon, and train HIV providers and nurses in implementing the intervention; and (3) Evaluate the feasibility of recruiting and retaining patients from our partnering clinic and collecting and processing laboratory specimens. Should our intervention prove feasible and demonstrate evidence of potential effectiveness, we will compete for R01 funding. This subsequent funding would permit us to implement an RCT of the effect of this depression identification and treatment protocol on ART adherence, HIV clinical indicators, and mental health outcomes.
描述(由申请人提供):精神疾病是HIV感染临床管理中的一个严重问题。在美国,情绪和焦虑障碍影响了多达一半的HIV+患者。在资源贫乏的国家,艾滋病毒阳性者的精神疾病发病率也同样升高。抑郁症与一系列与艾滋病毒相关的负面行为和临床健康结果有关,包括更多的性风险行为,更差的抗逆转录病毒治疗(ART)依从性,对ART的反应差,免疫系统下降更快,死亡率更高。被称为“基于测量的护理”(MBC)的方法被纳入初级保健环境,有效地解决了非艾滋病毒患者人群中的共病抑郁症。多中心随机临床试验已经证明了MBC模型的有效性,该模型雇用具有抑郁症专业知识的临床协调员来帮助医生实施与指南一致的算法驱动的抗抑郁治疗。为艾滋病毒患者制定有效的、文化上适当的心理健康干预措施在撒哈拉以南非洲(SSA)尤为紧迫,估计有3300万艾滋病毒感染者中有近三分之二在那里。联合抗逆转录病毒疗法刚刚开始在该地区广泛使用。成功的抗逆转录病毒治疗和耐药性的预防取决于严格的药物依从性。由于抑郁症是依从性差的最一致的预测因素之一,并且已被专家小组宣布为世界各地艾滋病毒管理的一个重要问题,因此迫切需要在非洲艾滋病毒临床环境中测试干预措施以解决心理健康问题。在目前的R34申请中,我们建议评估实施MBC抑郁症管理计划的随机对照试验(RCT)的可行性和可接受性,该计划主要由护士组成,并整合到HIV临床护理站点。由于北卡罗来纳大学教堂山艾滋病研究中心与喀麦隆雅温得雅温得大学传染病研究和控制中心之间的长期合作关系,项目活动将在喀麦隆的英语地区进行。我们的具体目标是:(1)建立病例识别协议的有效性、可靠性和文化适当性,以在讲英语的喀麦隆半城市艾滋病毒临床护理点识别重度抑郁症患者;(2)使针对重度抑郁症患者的MBC治疗干预适应喀麦隆艾滋病毒治疗的背景,并培训艾滋病毒提供者和护士实施干预;及(3)评估从合作诊所招募及挽留病人,以及收集及处理化验样本的可行性。如果我们的干预措施被证明是可行的,并证明了潜在的有效性,我们将竞争R 01资金。随后的资金将使我们能够实施一项RCT,研究这种抑郁症识别和治疗方案对ART依从性、HIV临床指标和心理健康结果的影响。

项目成果

期刊论文数量(1)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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BRADLEY N GAYNES其他文献

BRADLEY N GAYNES的其他文献

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{{ truncateString('BRADLEY N GAYNES', 18)}}的其他基金

Adaptation of the Friendship Bench counseling intervention to improve mental health and HIV care engagement outcomes among people living with HIV who inject drugs in Vietnam
调整友谊长凳咨询干预措施,以改善越南注射吸毒艾滋病毒感染者的心理健康和艾滋病毒护理参与结果
  • 批准号:
    10219229
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Adaptation of the Friendship Bench counseling intervention to improve mental health and HIV care engagement outcomes among people living with HIV who inject drugs in Vietnam
调整友谊长凳咨询干预措施,以改善越南注射吸毒艾滋病毒感染者的心理健康和艾滋病毒护理参与结果
  • 批准号:
    10431911
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Malawian Program for Mental Health Research Training (WARMHEART)
马拉维心理健康研究培训计划 (WARMHEART)
  • 批准号:
    10430271
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Malawian Program for Mental Health Research Training (WARMHEART)
马拉维心理健康研究培训计划 (WARMHEART)
  • 批准号:
    10634644
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Malawian Program for Mental Health Research Training (WARMHEART)
马拉维心理健康研究培训计划 (WARMHEART)
  • 批准号:
    10055601
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Malawian Program for Mental Health Research Training (WARMHEART)
马拉维心理健康研究培训计划 (WARMHEART)
  • 批准号:
    10255520
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Adaptation of the Friendship Bench counseling intervention to improve mental health and HIV care engagement outcomes among people living with HIV who inject drugs in Vietnam
调整友谊长凳咨询干预措施,以改善越南注射吸毒艾滋病毒感染者的心理健康和艾滋病毒护理参与结果
  • 批准号:
    10012540
  • 财政年份:
    2020
  • 资助金额:
    $ 22.84万
  • 项目类别:
Adaptation of a Depression Treatment Intervention for HIV Patients in Cameroon
喀麦隆艾滋病毒患者抑郁症治疗干预措施的调整
  • 批准号:
    7754596
  • 财政年份:
    2009
  • 资助金额:
    $ 22.84万
  • 项目类别:
Adaptation of a Depression Treatment Intervention for HIV Patients in Cameroon
喀麦隆艾滋病毒患者抑郁症治疗干预措施的调整
  • 批准号:
    7897673
  • 财政年份:
    2009
  • 资助金额:
    $ 22.84万
  • 项目类别:
VENLAFAXINE XR AND ARIPIPRAZOLE IN PATIENTS WITH DEPRESSION
文拉法辛 XR 和阿立哌唑治疗抑郁症患者
  • 批准号:
    7625649
  • 财政年份:
    2006
  • 资助金额:
    $ 22.84万
  • 项目类别:

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