Health & Psychosocial Need: Children with Developmental Disorder in a Time of HIV

健康

• 批准号: 8200372
• 负责人: Leslie L. Davidson
• 金额: $ 12.14万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8200372
• 关键词: 6 year old; Acquired Immunodeficiency Syndrome; Address; Admission activity; Adolescence; Affect; Africa; African; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anemia; Area; Behavioral; Benzene; Caregivers; Caring; Characteristics; Child; Child Care; Child Development; Child Mental Health; Child health care; Childhood; Cognitive; Collaborations; Communities; Community Health; Crutches; Data; Databases; Day Care; Dental caries; Developing Countries; Development; Developmental Delay Disorders; Developmental Disabilities; Disabled Persons; Economic Factors; Education; Educational process of instructing; England; Epidemiologic Studies; Ethnography; Failure; Family; Family Caregiver; Fees; Funding; Future; Glass; Goals; Government; Grant; Growth; HIV; HIV Infections; Health; Health Services Accessibility; Health Status; High Prevalence; Household; Housing; Human immunodeficiency virus test; Immunization; Improve Access; Infection; Interdisciplinary Study; International; Intervention; Intervention Studies; Lead; Life; Life Cycle Stages; Link; Marijuana; Measurement; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental Health Services; Methods; Modeling; Monitor; Neurodevelopmental Disability; Neurodevelopmental Disorder; Nutritional; Outcome; Parent-Child Relations; Parents; Perinatal Infection; Personal Satisfaction; Population; Population Study; Poverty; Prevalence; Preventive; Primary Prevention; Primary Schools; Provider; Psychosocial Assessment and Care; Psychosocial Factor; Public Health Students; Rehabilitation therapy; Relative (related person); Research; Research Methodology; Research Personnel; Resources; Risk; Risk Behaviors; Risk Factors; Risk-Taking; Rural; School-Age Population; Schools; Screening procedure; Seizures; Services; Social Functioning; Social Welfare; Social support; Socioeconomic Status; South Africa; Stress; Students; Substance abuse problem; Supplementation; Technology Transfer; Testing; Therapeutic Intervention; Time; Tobacco; Training; Translating; Trauma; Trust; United States; Universities; Violence; Work; Youth; addiction; aged; base; cognitive function; cohort; contextual factors; design; developmental disease; developmentally disabled; disability; early childhood; experience; follow-up; improved; improved functioning; intervention program; longitudinal design; loss of function; medical schools; multidisciplinary; neurodevelopment; nutrition; pediatric department; population based; profession allied to medicine; programs; psychosocial; resilience; social; social organization; socioeconomics; technology development; therapy design; transmission process; waiver

DESCRIPTION (provided by applicant): With the long term goal of intervening to promote better physical and psychosocial functioning of children in South Africa, this study will determine how the ability of children with neurodevelopmental disorders to function cognitively and socially is influenced by both health-related (HIV, anemia, other infection), contextual (socio-economic and environmental, access to care and therapeutic intervention) and psychosocial factors (caregiver characteristics including mental health and substance use, family functioning). Approximately 2000 5 and 6 year old children from a HIV prevalent area will be screened for disability and then assessed before school entry. They will be reassessed 24 months later after school entry. The study will offer HIV testing to children and caregivers and referral for treatment for all conditions identified. Many of these children live with parents who are ill or have parents who have died from AIDS. Additional challenges such as poverty, inadequate access to health care and to education are common; many other risks to child health and well-being, including inadequate nutrition, infection and trauma as well as caregiver depression and substance use affect many children. As a result, many children do not function at optimal levels, and are at risk for developmental disabilities. The study will investigate first cross sectionally and then longitudinally the relationships among neurodevelopmental disorders and the above mentioned risk factors including as outcomes, child cognitive and psychosocial functioning and in the longitudinal aim, school functioning .The study will address both cross sectional and longitudinal relationships, assessing the impact of referral, treatment and access to programs over time. Community ethnographic studies will be linked to the findings of the epidemiologic study to identify culturally appropriate interventions. We will identify factors open to intervention which are known to affect child risk and resilience and work with community leaders in a participatory approach to develop an effective community based intervention. In addition, training in research methods and enhancing research capacity will be one of the key aims of this research. This will involve training public health students, ethnography students, pediatric registrars, allied health professionals and community health workers in both field and classroom teaching and training. This will be managed in collaboration with the UKZN Fogarty Program, the Valley Trust, the Rehabilitation Unit and the Medical School at UKZN with assistance from the Columbia investigators

描述（由申请人提供）：本研究的长期目标是通过干预促进南非儿童更好的身体和社会心理功能，本研究将确定患有神经发育障碍的儿童的认知和社交功能如何受到健康相关（艾滋病毒、贫血、其他感染）、背景（社会经济和环境、获得护理和治疗干预）和社会心理因素的影响 （看护者特征包括心理健康和药物使用、家庭功能）。来自艾滋病毒流行地区的大约 2000 名 5 岁和 6 岁儿童将接受残疾筛查，然后在入学前进行评估。他们将在入学24个月后接受重新评估。该研究将为儿童和护理人员提供艾滋病毒检测，并转诊治疗所有已发现的病症。这些儿童中的许多人与生病的父母或死于艾滋病的父母住在一起。贫困、获得医疗保健和教育机会不足等其他挑战也很常见；儿童健康和福祉面临的许多其他风险，包括营养不足、感染和创伤以及看护者抑郁和药物滥用，影响着许多儿童。因此，许多儿童的机能无法达到最佳水平，并且面临发育障碍的风险。该研究将首先横向调查，然后纵向调查神经发育障碍与上述风险因素之间的关系，包括结果、儿童认知和心理社会功能，纵向目标是学校功能。该研究将解决横向和纵向关系，评估转诊、治疗和参与项目的影响。社区民族志研究将与流行病学研究的结果联系起来，以确定文化上适当的干预措施。我们将确定已知可影响儿童风险和复原力的干预因素，并以参与式方法与社区领导合作，制定有效的社区干预措施。此外，研究方法的培训和研究能力的提升将是本研究的重点目标之一。这将涉及对公共卫生学生、民族志学生、儿科登记员、专职卫生专业人员和社区卫生工作者进行现场和课堂教学和培训。该项目将在哥伦比亚研究人员的协助下与 UKZN Fogarty 计划、Valley Trust、康复中心和 UKZN 医学院合作管理