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The Adolescent to Adult Patient-centered HIV Transition Study (ADAPT)

以患者为中心的青少年到成人艾滋病毒过渡研究 (ADAPT)

基本信息

批准号：
9767839
负责人：
Manhattan E Charurat
金额：
$ 26.65万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-08-19 至 2022-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9767839
关键词：
19 year old Address Adolescence Adolescent Adult Advocate Affect Africa South of the Sahara African Appointment Area Behavioral Caring Characteristics Child Childhood Clinic Clinical Cluster randomized trial Continuity of Patient Care Data Development Education Educational Intervention Ego Enrollment Ensure Epidemiology Equation Evaluation Faculty Focus Groups Funding Government HIV HIV Infections HIV-infected adolescents Health Health Personnel Health care facility Healthcare Systems Human Individual Infection Institutes Institution Intervention Lead Letters Life Maryland Measures Medical Modeling Nigeria Nigerian Outcome Outcome Measure Ownership Parents Participant Pathway interactions Patient-Focused Outcomes Patients Perinatal Predictive Factor Process Provider Psychosocial Factor Randomized Randomized Clinical Trials Research Resources Role Services Site Social Network Social Sciences Social support Standard Model Structure Support Groups Support System System Time Universities Viral Load result Work Youth adolescent patient aged arm base design effective intervention emerging adult expectation experience follow-up improved innovation insight low and middle-income countries medical schools medical specialties patient oriented pediatric human immunodeficiency virus peer primary outcome programs psychosocial public health relevance randomized trial response satisfaction secondary outcome tool treatment services virology

项目摘要

One of the distinct challenges faced by emerging adults with HIV is the transition of their care from their long- term pediatric HIV provider to treatment within an adult HIV program. While conceptually the transition from pediatric to adult care may seem straightforward, the reality is that the transition often is a very difficult process. The consequences of an unsuccessful transition can range from difficult to catastrophic. The Adolescent to Adult Patient-centered HIV Transition (ADAPT) Study is a randomized trial of innovative interventions targeting gaps in care that are major drivers of loss in the ART continuum of care cascade among adolescents and increasing missed opportunities to engage adolescents into care. The specific aims of ADAPT are: (a) to inform strategies for transition services in resource-limited settings; (b) to examine the developmental, clinical, and other factors that predict a successful transition; and (c) to gain fundamental insight on implementation barriers among African adolescents through the application of the ego-network defined social support that will inform targets for structured intervention. Our multi-PI team includes strong complementary expertise in pediatric and adolescent HIV care, epidemiology, and social science. ADAPT will be conducted in central, southern, and northern Nigeria at selected PEPFAR sites supported by the Institute of Human Virology, Nigeria. To address Aim 1 we will conduct six focus groups including: Adolescent patients, parents and health care providers. To address aim 2, we will conduct a cluster randomized clinical trial. The two interventions are based on prior evidence-informed engagement strategies: 1) educational interventions and 2) interventions that use a peer transition advocate who prepares the adolescent and their parents for transition. We will enroll 300 patients (150 patients in each arm). The sites will be randomized to an intervention. The primary outcome will be successful transition, keeping two follow-up appointments within a nine months period following transition. Secondary outcomes, as recommended by focus group participants will also be measured. To examine the potential role of social network components and characteristics of both egos and alters on primary outcomes, a Generalized Estimating Equation (GEE) approach will be used to explore the associations between primary outcomes and factors at the ego, alter, and network levels. The finding from this study will guide institution of best practices for transitioning adolescents in Nigeria and other countries lower and middle income countries with similar challenges and potential for high impact.

新成年艾滋病毒感染者面临的一个独特挑战是他们的护理从长期的过渡