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: 8434928
• 负责人: Julia Cook Dombrowski
• 金额: $ 14.78万
• 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/8434928
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; 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; Clinical Research; 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; Lead; 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.

描述（由申请人提供）：该提案描述了一个为期5年的培训和研究计划，该计划将使首席研究员成为一名独立的以患者为导向的研究人员，在艾滋病健康服务方面具有专业知识，将研究与公共卫生实践相结合。该计划将以候选人之前在艾滋病毒/性病临床和流行病学研究方面的经验为基础，提高她在卫生服务研究和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）与公共卫生-西雅图和金县艾滋病毒/性病控制项目（PHSKC）之间密切合作的卓越指导团队和机构环境。研究计划-艾滋病毒护理的保留对于成功治疗艾滋病毒感染和预防艾滋病毒传播至关重要，但是艾滋病毒护理的保留没有标准定义，关于以人口为基础的监测和改善艾滋病毒护理的保留的研究也很少。该提案的具体目标是：目标1)确定与健康结果相关的艾滋病毒护理保留不足的定义，并确定预测护理保留不足的因素；目标2)确定促进HIV护理保留的医疗保健系统因素，并评估潜在的基于临床和基于人群的干预措施的可接受性，以提高护理保留；目标3)制定和开展一项干预措施的试点研究，以提高艾滋病毒护理的保留率。我们将对UW HIV临床信息系统和PHSKC监测系统的数据进行回顾性研究，并对新诊断的HIV患者进行前瞻性研究，以解决目标1。我们将通过对艾滋病毒护理提供者和艾滋病毒/艾滋病感染者进行定性个人访谈来解决目标2。我们将利用目标1和目标2的研究结果设计一项干预措施，旨在提高艾滋病毒护理的保留率，我们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，以评估干预措施提高艾滋病毒护理留用率的有效性。这项研究将为一个更大的关于艾滋病毒护理质量的研究项目奠定基础，该项目将包括对旨在改善护理提供并考虑成本效益的干预措施的严格评估。