Development of an Antiretroviral Therapy Adherence Measure for Pediatrics

儿科抗逆转录病毒治疗依从性测量的开发

• 批准号: 8257176
• 负责人: Rachel Christine Vreeman
• 金额: $ 17.23万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2014-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8257176
• 关键词: Address; Adherence; Adult; Africa; Age; Biometry; Caregivers; Caring; Child; Childhood; Chronic; Clinic; Clinical; Clinical Management; Data; Development; Development Plans; Dose; Environment; Epidemiologic Methods; Evaluation; Goals; HIV; Health; Health Services Accessibility; Health Services Research; Health behavior; Home environment; International; Intervention; Kenya; Knowledge; Measurement; Measures; Mentors; Mentorship; Modeling; Outcome; Patients; Pediatrics; Pharmaceutical Preparations; Plasma; Principal Investigator; Property; Psychometrics; Questionnaires; Readiness; Research; Research Personnel; Resources; Review Literature; Scientist; Screening procedure; Site; Social Sciences; Testing; Training; USAID; Vulnerable Populations; Work; antiretroviral therapy; base; behavior measurement; care systems; career development; clinical care; cost effective; design; effective intervention; experience; improved; instrument; multidisciplinary; pediatric human immunodeficiency virus; prevent; skills; therapy adherence; tool; viral resistance

DESCRIPTION (provided by applicant): Sustaining adherence to antiretroviral therapy (ART) is central to HIV management. For children in resource- limited settings, no well-validated measures of adherence exist. A reliable, valid measurement tool would provide more efficient, effective HIV care for this vulnerable population. My long-term goal is to work as a clinician-scientist who develops instruments to improve pediatric HIV care systems In resource-limited settings. In the near term, I want to focus on a reliable, valid, cost-effective way to measure children's ART adherence because this is central to the challenge of providing long-term HIV management. The objective of this application is to develop and test a reliable, valid instrument to measure pediatric ART adherence for children ages 0 to 14 years in western Kenya. The rationale for developing a validated adherence measure is to gain the ability to measure adherence accurately, test interventions to improve adherence, and assess if therapies optimize clinical outcomes. This work will be done within a long-standing US-Kenya partnership, the Academic Model for Providing Access to Healthcare (AMPATH). AMPATH cares for over 80,000 adult and pediatric HIV-infected patients in western Kenya, including over 2,800 children on ART. I plan to accomplish the research objective of this application by pursuing the following three specific aims: Aim 1: Develop a reliable, valid comprehensive pediatric ART adherence measurement questionnaire (CAMP - Comprehensive ART Measure for Pediatrics); Aim 2: Develop a reliable, valid, short-form version of the pediatric ART adherence measurement tool (SF-CAMP) for use as an adherence screening measure in busy clinical care environments; Aim S: Evaluate the field-readiness, implementation feasibility, and clinical utility of CAMP and SF-CAMP within the AMPATH HIV clinical care system in western Kenya. I also propose a course of training, study, and mentorship in the design and testing of health behavior measurement tools for International settings, the use of psychometric analyses to develop and validate clinical tools, and evaluation of pediatric HIV care. The combination of research work and my career development plan will enable me to become an independent clinician-scientist who can improve pediatric HIV care provision. PUBLIC HEALTH RELEVANCE: The contribution of this study is expected to be a reliable, valid instrument to measure pediatric ART adherence within a resource-limited setting. The proposed research is significant because we must measure adherence accurately to provide long-term clinical management for HIV-infected children and to find effective interventions to prevent viral resistance and poor outcomes.

描述（由申请人提供）：维持对抗逆转录病毒疗法（ART）的依从性是艾滋病毒管理的核心。对于资源有限的环境中的儿童，不存在固定的验证措施。可靠的有效测量工具将为这一脆弱人群提供更高效，有效的艾滋病毒护理。我的长期目标是担任临床医生科学家，他开发了在资源有限的环境中改善小儿艾滋病毒护理系统的工具。在短期内，我想专注于一种可靠，有效，具有成本效益的方法来衡量儿童的艺术依从性，因为这对于提供长期艾滋病毒管理的挑战至关重要。该应用的目的是开发和测试一种可靠的，有效的工具，以测量肯尼亚西部0至14岁儿童的小儿艺术依从性。制定经过验证的依从性度量的基本原理是获得准确测量依从性，测试干预措施以提高依从性的能力，并评估疗法是否优化了临床结果。这项工作将在长期以来的US-Kenya合作伙伴关系中完成，这是提供医疗保健（AMPATH）的学术模型。在肯尼亚西部，有80,000多名成人和小儿HIV感染的患者的ampath关心，其中包括2800多名艺术儿童。我计划通过追求以下三个特定目标来实现此应用的研究目标：目标1：开发可靠，有效的综合儿科艺术依从性测量问卷（CAMP-儿科的全面艺术措施）； AIM 2：开发可靠的，有效的，短形式的版本的儿科艺术依从性测量工具（SF-camp）作为在繁忙的临床护理环境中用作依从性筛查； AIM S：评估肯尼亚西部Ampath HIV临床护理系统中营地和SF-CAMP的现场准备，实施可行性和临床实用性。我还提出了针对国际环境的健康行为测量工具的设计和测试的培训，学习和指导，使用心理测量分析来开发和验证临床工具以及对儿科HIV护理的评估。研究工作和我的职业发展计划的结合将使我成为一个独立的临床医生，可以改善小儿艾滋病毒护理的提供。公共卫生相关性：预计这项研究的贡献将是一种可靠的，有效的工具，可以在资源有限的环境中衡量儿科艺术的依从性。拟议的研究很重要，因为我们必须准确地衡量依从性，以为感染HIV的儿童提供长期临床管理，并找到有效的干预措施，以防止病毒抗性和不良结局。