Caregiver Mental Health and Child Physical Health in HIV-Affected Families

受艾滋病毒影响的家庭中看护者的心理健康和儿童的身体健康

• 批准号: 8548123
• 负责人: Sarah Sutherlin-McIvor Murray
• 金额: $ 4.22万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-18 至 2015-09-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8548123
• 关键词: AIDS/HIV problem; Address; Adult; Affect; Africa; Age; Anxiety; Area; Bass; Biological; Caregivers; Child; Child Development; Child Mental Health; Child health care; Clinic; Community Health; Comorbidity; Complex; Country; Data Analyses; Depressed mood; Development; Disease; Eastern Africa; Educational Status; Effectiveness; Enrollment; Environment; Epidemic; Epidemiology; Exhibits; Family; Family member; Female; Fostering; Funding; Future; Gender; Goals; Growth; HIV; HIV Seropositivity; Health; High Prevalence; Income; Institutes; Intervention; Lead; Life; Link; Literature; Longitudinal Studies; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mentorship; Meta-Analysis; Modeling; Morbidity - disease rate; Mothers; National Institute of Mental Health; Orphan; Outcome; Parenting behavior; Policies; Population; Population Study; Psychometrics; Psychopathology; Randomized Controlled Trials; Recommendation; Recruitment Activity; Research; Research Personnel; Resources; Risk; Rural; Sampling; Services; Severity of illness; Social support; Symptoms; Techniques; Time; Training; Uganda; Underweight; Woman; Work; aged; antiretroviral therapy; arm; career; early childhood; follow-up; high risk; improved; innovation; intergenerational; knowledge base; maternal depression; meetings; nutrition; physical conditioning; pre-doctoral; skills; standard care; standard of care

DESCRIPTION (provided by applicant): Ms. Murray proposes to investigate caregiver mental health and child physical health among HIV-affected families in Uganda. The goal of this research is to prepare Ms. Murray for a career as an independent researcher of global mental health in low-resource settings. Ms. Murray will perform the proposed research while completing intensive predoctoral training that combines coursework, seminars, and mentorship geared towards the following objectives: (1) to develop a multifaceted knowledge-base on the interaction of HIV, mental health, and child development by drawing upon biological, developmental, and sociocultural perspectives; (2) to develop the competencies in longitudinal data analysis, mixed models, causal inference, and psychometrics necessary for addressing epidemiologic questions in a complex, HIV-endemic environment; and, (3) to disseminate key study findings in order to promote health in HIV-affected families and participate in professional development. Meeting these objectives will lead to the methodological skills and subject-matter expertise necessary to become an independent investigator in her proposed project and future career. Poorer physical health outcomes have been demonstrated among children of depressed mothers in low-resource settings, placing them at greater risk for low educational achievement and disease. Only five longitudinal studies have been conducted on this relationship to date. No study has assessed this relationship specifically in HIV-affected families, though HIV-infected caregivers are at higher risk of depression, and, HIV-infected and affected children are at higher risk of poor child growth and nutrition. With growing evidence that community health workers can effectively treat depression in low-resource settings, results of the proposed research could have major implications for the standard of care offered to HIV-affected families. The proposed research will address this gap in the literature through two aims: (1) to assess the degree to which caregiver mental health affects physical health outcomes of HIV-infected and affected young children (ages 2-5 years) over a two year follow-up; and, (2) to explore the potential reciprocal impact of improvements in child physical health on caregiver mental health over time. Further, mechanisms of this relationship will be explored in a secondary aim to examine potential mediators and moderators of the relationship between caregiver mental health and child physical health in HIV-infected and affected young children. For this research, the applicant will conduct a secondary analysis of data collected from caregiver-child dyads in the control arm of a randomized controlled trial of a parenting skills intervention for HIV-affecte families in rural Uganda. The proposed research fits well with the National Institute of Mental Health's emphasis on exploring the impact of co-morbidities linked to HIV on the healthy development of children, examining this question from a unique intergenerational perspective.

描述(由申请人提供)：Murray女士建议调查乌干达受艾滋病毒影响的家庭中的照顾者心理健康和儿童身体健康。这项研究的目标是为默里女士的职业生涯做好准备，成为一名在低资源环境下研究全球心理健康的独立研究员。Murray女士将进行拟议的研究，同时完成密集的博士前培训，结合课程、研讨会和指导，以实现以下目标：(1)通过利用生物学、发展和社会文化视角，开发关于艾滋病毒、心理健康和儿童发展相互作用的多方面知识库；(2)发展在复杂的艾滋病毒流行环境中解决流行病学问题所需的纵向数据分析、混合模型、因果推理和心理计量学方面的能力；以及(3)传播关键研究成果，以促进受艾滋病毒影响的家庭的健康并参与专业发展。实现这些目标将带来必要的方法技能和专题专门知识，使其成为拟议项目和未来职业生涯中的独立调查员。 在资源匮乏的情况下，抑郁母亲的孩子的身体健康状况较差，这使他们面临更大的教育成就低和疾病风险。到目前为止，只有五项纵向研究对这种关系进行了研究。没有研究特别评估这种关系在受艾滋病毒影响的家庭中，尽管感染艾滋病毒的照顾者患抑郁症的风险更高，感染艾滋病毒和受影响的儿童患上儿童生长不良和营养不良的风险更高。随着越来越多的证据表明，社区卫生工作者可以在资源不足的情况下有效地治疗抑郁症，拟议的研究结果可能会对向受艾滋病毒影响的家庭提供的护理标准产生重大影响。 这项拟议的研究将通过两个目的来解决文献中的这一差距：(1)评估照顾者心理健康在两年内对艾滋病毒感染和受影响幼儿(2-5岁)的身体健康结果的影响程度；(2)探索随着时间的推移，儿童身体健康改善对照顾者心理健康的潜在互惠影响。此外，将探讨这种关系的机制，作为第二个目标，以检查艾滋病毒感染和受影响幼儿中照顾者心理健康和儿童身体健康之间关系的潜在中介和调节因素。在这项研究中，申请者将对从乌干达农村受艾滋病毒影响的家庭的育儿技能干预的随机对照试验的对照组中收集的照顾者-儿童二人组收集的数据进行二级分析。这项拟议的研究与国家精神卫生研究所的重点是探索与艾滋病毒有关的共病对儿童健康发展的影响很好地契合，从独特的代际角度审查了这一问题。