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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

基本信息

批准号：
8609071
负责人：
Julia Cook Dombrowski
金额：
$ 11.02万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
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/8609071
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 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 L Cells 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

项目摘要

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. PUBLIC HEALTH RELEVANCE: Ongoing HIV care is necessary for the health of persons living with (HIV/AIDS) and for preventing the transmission of HIV. This project will evaluate measures of retention in HIV care, identify factors that facilitate retention in HIV care, and develop an intervention to increase the retention of patients in HIV care.

描述（由申请人提供）：本提案描述了一个为期5年的培训和研究计划，该计划将使主要研究者能够实现她的目标，即成为一名独立的以患者为导向的研究者，拥有艾滋病毒卫生服务方面的专业知识，将研究和公共卫生实践相结合。拟议的方案将建立在候选人的艾滋病毒/性传播疾病的临床和流行病学研究的经验，通过提高她的技能，在卫生服务研究和临床试验的行为干预的行为进行。该培训计划将利用一个特殊的指导团队和机构环境，涉及华盛顿大学（UW）和公共卫生艾滋病毒/性病控制计划-西雅图和金郡（PHSKC）之间的密切合作。研究计划-艾滋病毒护理中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，但艾滋病毒护理中的保留没有标准定义，关于监测和改善艾滋病毒护理中保留的基于人口的方法的研究很少。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）确定促进艾滋病毒护理保留的医疗保健系统因素，并评估潜在的基于诊所和基于人口的干预措施的可接受性，以改善护理保留;和目标3）制定和开展一项干预措施的试点研究，以改善艾滋病毒护理的保留情况。我们将通过对来自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感染者进行前瞻性研究来解决目标1。我们将通过与艾滋病毒护理提供者和艾滋病毒/艾滋病感染者的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，设计一项旨在提高艾滋病毒护理保留率的干预措施，并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，以评估干预措施对提高艾滋病毒护理保留率的有效性。这项研究将为一个更大的高质量艾滋病毒护理研究计划奠定基础，该计划将包括对旨在改善护理提供的干预措施进行严格评估，并考虑到成本效益。公共卫生相关性：持续的艾滋病毒护理对于艾滋病毒/艾滋病感染者的健康和预防艾滋病毒的传播是必要的。该项目将评估艾滋病毒护理中的保留措施，确定促进艾滋病毒护理保留的因素，并制定干预措施，以增加艾滋病毒护理中患者的保留。