Development of an Antiretroviral Therapy Adherence Measure for Pediatrics

描述（由申请人提供）：持续坚持抗逆转录病毒治疗（ART）是艾滋病毒管理的核心。对于资源有限环境中的儿童，没有经过充分验证的遵守措施。一个可靠、有效的衡量工具将为这一脆弱群体提供更有效、更有效的艾滋病毒护理。我的长期目标是成为一名临床科学家，在资源有限的情况下开发改善儿科艾滋病护理系统的工具。在短期内，我想把重点放在一个可靠的，有效的，具有成本效益的方法来衡量儿童的抗逆转录病毒疗法的坚持，因为这是提供长期艾滋病毒管理的挑战的核心。该应用程序的目的是开发和测试一种可靠、有效的工具，以衡量肯尼亚西部0至14岁儿童的儿科ART依从性。开发经验证的依从性指标的基本原理是获得准确测量依从性的能力，测试干预措施以提高依从性，并评估治疗是否优化临床结局。这项工作将在长期的美国-肯尼亚合作伙伴关系中完成，即提供医疗保健的学术模式（AMPATH）。AMPATH为肯尼亚西部超过80，000名成人和儿童HIV感染者提供护理，其中包括超过2，800名接受ART治疗的儿童。我计划通过追求以下三个具体目标来实现本申请的研究目标：目标1：开发可靠，有效的综合儿科ART依从性测量问卷（CAMP -儿科综合ART测量）;目标2：开发可靠、有效、简短版本的儿科ART依从性测量工具（SF-CAMP），用作忙碌临床护理环境中的依从性筛选测量;目标S：评估肯尼亚西部AMPATH HIV临床护理系统中CAMP和SF-CAMP的现场准备情况、实施可行性和临床效用。我还提出了一个培训，学习和指导课程，在国际环境中设计和测试健康行为测量工具，使用心理测量分析来开发和验证临床工具，并评估儿科艾滋病护理。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科学家谁可以改善儿科艾滋病毒护理提供。

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.