Comparative Efficacy of HIV-Prevention among Youth with Mental Health Needs

有心理健康需求的青少年艾滋病毒预防的比较效果

• 批准号: 8848142
• 负责人: DAVID Heaton BARKER
• 金额: $ 16.95万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8848142
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adolescence; Adolescent; Adolescent Risk Behavior; Adolescent and Young Adult; Adolescent sexual risk; Affect; Age; Alcohol or Other Drugs use; Ambulatory Care; Area; Attention; Behavior; Behavior assessment; Behavior monitoring; Behavioral; Characteristics; Child; Child Rearing; Clinical; Clinical Trials; Collaborations; Complex; Data; Data Set; Databases; Development; Dimensions; Educational workshop; Emotional; Family Process; Foundations; Funding; Future; Goals; Grant; HIV; HIV prevention trial; HIV risk; Head; Health; Hospitals; Individual; Intervention; K-Series Research Career Programs; Learning; Link; Manuscripts; Measurement; Measures; Mental Health; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Modeling; Outcome; Parents; Policy Maker; Population; Positioning Attribute; Preparation; Prevention; Prevention approach; Prevention program; Prevention strategy; Prevention trial; Process; Psychopathology; Reading; Relative (related person); Research; Research Design; Resources; Rhode Island; Risk; Risk Behaviors; Risk Factors; Same-sex; Sample Size; Sampling; Schools; Scientist; Sex Behavior; Sexual Partners; Signal Transduction; Statistical Models; Structure; Subgroup; Target Populations; Techniques; Testing; Therapeutic; Training; United States; United States National Institutes of Health; Universities; Vulnerable Populations; Work; Youth; adolescent HIV prevention; adolescent substance use; base; career; communication behavior; comparative efficacy; cost effective; design; efficacy research; emotion regulation; experience; family management; follow-up; improved; meetings; multidisciplinary; permissiveness; programs; prospective; sex; sex risk; sexual debut; sexual minority; skills; skills training; social; young adult

DESCRIPTION (provided by applicant): This Mentored Research Scientist Career Development Award will provide Dr. David Barker with focused training to enable him to leverage modern statistical modeling methods in identifying promising areas of intervention, and to collaborate with multidisciplinary teams to implement effective HIV-prevention programs for adolescents and young adults. One challenge to the effective dissemination of existing prevention programs is the limited understanding of who responds or does not respond to a given program. Providing such information to policy makers and program directors will help match existing prevention programs to the needs of target populations. Identifying which prevention program works best for which subgroups of youth requires sophisticated statistical modeling and large samples to identify and describe the subgroups. Combining across studies is a cost-effective way to increase the sample size of individual trials. However, combining data introduces complexity due to differences in how studies are designed and in how key outcomes are collected, analyzed and interpreted. The proposed research combines data from five NIH-funded trials of HIV-prevention programs for youth with mental health concerns to compare the efficacy of the programs and identify which youth respond or do not respond to current programs. The proposed research assists Dr. Barker in achieving his career and training goals to: (1) learn modern modeling approaches to address complex data structures that arise when combining multiple datasets, (2) learn methods for drawing causal inferences when integrating data across multiple clinical trials, (3) learn methods to compare the efficacy of prevention programs not tested in a "head-to-head" trial, (4) extend his training in HIV-risk prevention to key vulnerable populations identified in the National HIV/AIDS Strategy for the United States, namely substance using populations and sexual minority populations, (5) develop a program of research that utilizes existing data to identify promising areas for improving prevention efforts, and (6) develop collaborations with prominent scientist involved in HIV-prevention to develop high-quality research manuscripts and grants. The specific aims of the proposed research are to (1) build a database that links data from 5 NIH-funded prospective HIV-prevention trials, (2) Apply consistent analyses across the 5 trials by jointly modeling the multiple dimensions of adolescent sexual risk behavior, (3) compare the efficacy of current prevention programs for youth with mental health concerns, and (4) Identify and describe subgroups of adolescents with mental health concerns who responded or did not respond to each prevention approach. These aims will be achieved by using the skills learned through this K23 mechanism to address the analytic complexities of combining data across multiple prevention trials. Training will include a combination of didactic coursework, workshops, and mentoring by a team of experts in modern analytic approaches and HIV-prevention. The mentoring will include tailored reading assignments, regular face-to-face meetings, mentored research, and collaborative projects and manuscripts. The training received through this K23 application will place Dr. Barker in a position to collaborate with prominent HIV-prevention scientists in funded research focused on leveraging modern analytic modeling techniques to improve HIV-prevention efforts.

该指导研究科学家职业发展奖将为大卫巴克博士提供重点培训，使他能够利用现代统计建模方法来确定有希望的干预领域，并与多学科团队合作，为青少年和年轻人实施有效的艾滋病毒预防计划。有效传播现有预防方案的一个挑战是，对谁对某一方案作出反应或不作出反应的了解有限。向决策者和方案主任提供这类信息将有助于使现有的预防方案与目标人群的需要相匹配。确定哪种预防方案最适合哪些青年亚群，需要复杂的统计建模和大样本来确定和描述亚群。跨研究合并是增加个体试验样本量的一种具有成本效益的方法。然而，由于研究设计方式以及关键结果收集、分析和解释方式的差异，合并数据会带来复杂性。这项拟议的研究结合了五项由NIH资助的针对青少年心理健康问题的艾滋病毒预防计划试验的数据，以比较这些计划的有效性，并确定哪些青少年对当前的计划有反应或没有反应。拟议的研究有助于巴克博士实现他的职业和培训目标：（1）学习现代建模方法，以解决组合多个数据集时出现的复杂数据结构，（2）学习在多个临床试验中整合数据时进行因果推断的方法，（3）学习比较未在“头对头”试验中测试的预防计划的有效性的方法，（4）将他在艾滋病毒风险预防方面的培训扩展到美国国家艾滋病毒/艾滋病战略中确定的关键脆弱人群，即药物使用人群和性少数人群，（5）制定一项研究计划，利用现有数据确定有希望改善预防工作的领域，和（6）与参与艾滋病预防的著名科学家合作，以开发高质量的研究手稿和赠款。拟议研究的具体目标是（1）建立一个数据库，将来自5个NIH资助的前瞻性艾滋病预防试验的数据联系起来，（2）通过联合建模青少年性风险行为的多个维度，在5个试验中应用一致的分析，（3）比较当前预防计划对青少年心理健康问题的有效性，（4）识别和描述对每种预防方法有反应或无反应的有心理健康问题的青少年亚组。这些目标将通过使用通过这种K23机制学到的技能来实现，以解决多项预防试验中合并数据的分析复杂性。培训将包括教学课程、讲习班和现代分析方法和艾滋病毒预防专家小组的指导。指导将包括量身定制的阅读任务，定期面对面的会议，指导研究，合作项目和手稿。通过K23应用程序接受的培训将使Barker博士能够与着名的艾滋病毒预防科学家合作，开展资助的研究，重点是利用现代分析建模技术来改善艾滋病毒预防工作。