Connecting People, Places, and Barriers: The Effect of These Connections on Adhe

连接人、地方和障碍：这些连接对 Adhe 的影响

• 批准号: 8730821
• 负责人: Debarchana Ghosh
• 金额: $ 17.27万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8730821
• 关键词: AIDS/HIV problem; Address; Adherence; Affect; Area; Behavior; Behavior Therapy; Behavioral; Biometry; Buprenorphine; Career Choice; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Communities; Consult; Data; Data Collection; Dependency; Development; Dimensions; District of Columbia; Drug abuse; Drug usage; Drug user; Ego; Epidemic; Epidemiology; Evaluation; Geographic Information Systems; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Health; Health Communication; Imagery; Individual; Information Sciences; Intervention; Knowledge; Link; Literature; Location; Maps; Measures; Mentors; Mentorship; Methadone; Metric; Modeling; Neighborhoods; Opiate Addiction; Pathway Analysis; Pattern; Persons; Pharmaceutical Preparations; Phase; Population; Process; Protocols documentation; Psychosocial Factor; Public Health; Randomized Controlled Trials; Research; Research Methodology; Research Project Grants; Risk Factors; Science; Services; Shapes; Social Network; Structure; Substance Use Disorder; Substance abuse problem; System; Techniques; Testing; Time; Training; Treatment outcome; Value of Life; Viral; Visit; Vulnerable Populations; Work; Writing; arm; base; career; career development; design; effective intervention; experience; falls; health disparity; health training; high risk; improved; indexing; interest; intervention effect; mHealth; member; men; novel; peer; population health; public health relevance; sex; social; success; theories; therapy design; therapy development; transmission process

DESCRIPTION (provided by applicant): As a trained health geographer with expertise in the areas of social-ecological models, neighborhood effects, and Geographic Information System, I am further interested in expanding my research foci in the interface of substance abuse and HIV/AIDS, both from methodological and intervention perspectives. To that end, in the upcoming five years of training, I will devote my time to focused research on multidimensional correlates to adherence, retention, and HIV treatment outcomes among infected drug users using system science techniques. The ultimate goal is to design interventions to improve HIV treatment outcomes among this vulnerable population. To achieve this goal, I will work with an internationally recognized group of mentors to obtain training in the epidemiology of substance use disorders, HIV transmission and treatment, social network analysis, and design of interventions. My specific objectives to achieve this career goal are: 1. Enhance my background and understanding of existing literature on behavioral and clinical interventions to seek, test, treat, and retain in care among drug users with HIV infection. 2. A. Advance expertise in theory, visualization, and application of social network analysis, including egocentric network, whole network, and longitudinal networks. Incorporate spatial dependency to innovatively advance social network metrics to spatial-social network metrics. B. Develop expertise in research methods necessary to design, perform, and evaluate randomized controlled trials. 3. Gain experience in intervention development, testing, implementation, and dissemination that will address multidimensional barriers to adherence and retention in care among HIV positive drug users. 4. Development of an independent career path in behavioral intervention-oriented research focused on the intersection between substance abuse and HIV by successfully writing and receipt of a R01 grant. Given the vital importance of mentoring in the process of training and career development, I have assembled a strong interdisciplinary panel of mentors and consultants who will provide guidance throughout my five years of advanced training. Dr. Frederick Altice will serve as my primary mentor (substance abuse, HIV, intervention), with Drs. Michael Copenhaver (HIV, intervention) and Carl Latkin (social network analysis, neighborhood effects, intervention) as co-mentors. I will further consult Drs. Ofer Harel for biostatistics, Lesie Snyder for health communication, and Michael Emch for geographical theories of health research. The training will provide opportunities to conduct two research projects for vulnerable drug users with HIV infection. Study 1: To inform the development of an intervention by examining multidimensional (individual- social-ecological) correlates of adherence to ART, retention in care, and HIV treatment outcomes among drug using HIV positive population. [Year 1, 2, 3 (Part)] This is a secondary analysis using data from a randomized controlled trial (Project STRIDE, Altice, R01 DA030768) and its 'Social Network and Neighborhood' Supplement. To this I add the following aims: Specific Aim 1: Extend social network metrics (i.e., derived from network structure) to spatial-social metrics (based on both network structure and spatial proximity between subjects and their network members). Specific Aim 2: Visualize and map the 'activity space' patterns of subjects in a Geographic Information Science interface, including visits to routine locations of positive and negative influence. This is significantly different tha the just the residential location of the subjects. Specific Aim 3: Examine the combined effect of individual, social relationships, activity space, and neighborhood correlates of adherence to ART, retention, and HIV treatment outcomes modeled on a robust multidimensional social-ecological framework. Study 2: To develop and pilot a spatial-network driven intervention with short message services (SMS) that will optimize adherence to ART, retention in care, and HIV treatment outcomes for HIV positive drug users. [Year 3(Part), 4, 5] Phase 1: Select social network members (or alters) who will have stronger effect on the subjects (or egos) adherence to ART, retention, and HIV treatment outcomes. Formative evaluations of ego's activity space and composition and features of their social networks from Study 1 will determine the selection protocol. Phase 2: Conduct a pilot to test the feasibility, acceptability, and preliminary efficacyof a novel spatial- network driven intervention with SMS. The intervention has three arms: 1) Ego in HIV care with two alters assigned highest Interaction Index value, living inside ego's activity space receiving SMS, 2) Egos in HIV care with two alters assigned highest Interaction Index values, living outside the activity space receiving SMS, and 3) Egos in HIV care with no intervention (observational arm).

描述（由申请人提供）：作为一名训练有素的健康地理学家，在社会生态模型，邻里效应和地理信息系统领域具有专业知识，我进一步有兴趣扩大我的研究重点在药物滥用和艾滋病毒/艾滋病的接口，无论是从方法和干预的角度。为此，在未来五年的培训中，我将利用系统科学技术，专注于研究受感染吸毒者的依从性、保留率和艾滋病毒治疗结果的多维度相关性。最终目标是设计干预措施，改善这一弱势群体的艾滋病毒治疗结果。为了实现这一目标，我将与一个国际公认的导师小组合作，获得药物使用障碍流行病学、艾滋病毒传播和治疗、社会网络分析和干预措施设计方面的培训。我实现这一职业目标的具体目标是：1。提高我的背景和现有文献的行为和临床干预措施的理解，以寻求，测试，治疗，并保持在与艾滋病毒感染的吸毒者之间的照顾。2. A.在社交网络分析（包括自我中心网络、整体网络和纵向网络）的理论、可视化和应用方面拥有先进的专业知识。结合空间依赖性，创新性地将社交网络指标提升为空间社交网络指标。 B。培养设计、执行和评估随机对照试验所需的研究方法方面的专业知识。3.在干预措施的制定、检测、实施和传播方面获得经验，这些干预措施将解决艾滋病毒阳性吸毒者坚持和继续接受护理的多方面障碍。4.在以行为干预为导向的研究中发展独立的职业道路，重点关注药物滥用和艾滋病毒之间的交叉点，成功地撰写并获得R 01赠款。 鉴于辅导在培训和职业发展过程中的至关重要性，我组建了一个强大的跨学科导师和顾问小组，他们将在我五年的高级培训期间提供指导。Frederick Altice博士将担任我的主要导师（药物滥用，艾滋病毒，干预），Michael Copenhaver博士（艾滋病毒，干预）和Carl Latkin博士（社会网络分析，邻里效应，干预）作为共同导师。我将进一步咨询Ofer Harel博士的生物统计学，Lesie Snyder的健康传播，以及Michael Emch的健康研究地理理论。培训将提供机会，为感染艾滋病毒的易受伤害吸毒者开展两个研究项目。研究1：通过检查使用药物的艾滋病毒阳性人群中坚持抗逆转录病毒疗法、继续护理和艾滋病毒治疗结果的多维度（个人-社会-生态）相关性，为制定干预措施提供信息。[Year 1、2、3（部分）]这是一项次要分析，使用的数据来自一项随机对照试验（项目 STRIDE，Altice，R 01 DA 030768）及其“社交网络和邻里”补充。为此，我添加了以下目标：具体目标1：扩展社交网络指标（即，从网络结构导出）到空间-社会度量（基于网络结构和主体与其网络成员之间的空间接近度）。 具体目标二：在地理信息科学界面中可视化和绘制受试者的“活动空间”模式，包括访问具有积极和消极影响的常规位置。这与受试者的居住地点有很大不同。 具体目标3：检查个人，社会关系，活动空间和邻里相关的坚持ART，保留和艾滋病毒治疗结果的综合影响，以一个强大的多维社会生态框架为模型。研究2：开发和试点一个空间网络驱动的短信息服务（SMS）的干预措施，将优化艾滋病毒阳性吸毒者的抗逆转录病毒治疗依从性，保持护理和艾滋病毒治疗结果。[Year 3（部分），4，5]第1阶段：选择对受试者（或自我）对ART的依从性、保留率和HIV治疗结果有更强影响的社交网络成员（或改变者）。研究1中自我的活动空间和社交网络的构成和特征的形成性评价将决定选择协议。第二阶段：进行一个试点，以测试一种新的空间网络驱动的SMS干预的可行性，可接受性和初步疗效.干预有三个臂：1）HIV护理中的自我，其中两个分身被分配最高交互指数值，生活在自我的活动空间内接收SMS，2）HIV护理中的自我，其中两个分身被分配最高交互指数值，生活在活动空间外接收SMS，以及3）HIV护理中的自我，没有干预（观察臂）。