Development and Validation of a Multidimensional Index of Engagement in HIV Care

艾滋病毒护理多维参与指数的制定和验证

• 批准号: 8721488
• 负责人: Katerina A Christopoulos
• 金额: $ 66.8万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-14 至 2018-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8721488
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Affect; Ambulatory Care; Analgesics; Appointment; Beryllium; Caring; Cities; Clinic; Clinical; Clinical Research; Cognitive; Commit; Consensus; Data; Data Collection; Databases; Development; Dimensions; Elements; Factor Analysis; Feeling; Focus Groups; Foundations; Future; Goals; Government Agencies; HIV; Healthcare; Individual; Intervention; Interview; Life; Link; Measures; Medical; Mental Depression; Methods; Metric; Misinformation; Modeling; Morbidity - disease rate; Outcome; Patient Outcomes Assessments; Patients; Pattern; Persons; Population; Prevention; Primary Health Care; Procedures; Process; Provider; Public Health; Research; Research Personnel; Risk; Sampling; Schedule; Site; Structure; Surveys; System; Testing; Translating; Treatment outcome; Trust; Uncertainty; United States; Validation; Viral Load result; Visit; Work; antiretroviral therapy; base; care delivery; clinical care; cohort; effective intervention; empowerment; experience; health care model; improved; indexing; intravenous drug use; member; men; mortality; patient oriented; planetary Atmosphere; prospective; public health relevance; sex; shared decision making; social stigma; therapy design; tool; transmission process

DESCRIPTION (provided by applicant): Less than half of individuals living with HIV in the United States are receiving ongoing care, and only one- quarter have an undetectable viral load. The National HIV/AIDS Strategy prioritizes care and treatment of HIV- infected individuals, yet improvement in care retention rates is clearly needed. Research on HIV care has used attendance at primary care appointments to assess whether patients are in care. While medical visits are necessary, they are not sufficient and do not necessarily reflect a patient's level of engagement. Engagement in care is about the patient experience and interactions with providers and the care site. We propose to create a patient-centered Index of Engagement in HIV Care that will be framed within a model of Health Care Empowerment, which refers to participation in care in a way that is engaged, informed, collaborative, committed, and tolerant of uncertainty. We will create the index through a collaborative process of consensus- building with patients, providers, and research experts using iterative online Delphi surveys and in-person focus groups. We will then translate these narrative findings into scale items and develop them further through cognitive interviewing with patients. We will validate the index by administering i to a sample of patients undergoing the Patient Reported Outcomes within the CFAR Network of Integrated Clinical Systems (CNICS) and examining retrospective, cross-sectional, and prospective appointment and viral load data. The resulting Index of Engagement in HIV Care will have implications for both clinical care and research, identifying patients who are at risk fo poor clinical outcomes and providing a metric by which to develop and evaluate interventions aiming to improve engagement in care.

描述（由申请人提供）：在美国，不到一半的艾滋病毒感染者正在接受持续的护理，只有四分之一的病毒载量检测不到。《国家艾滋病毒/艾滋病战略》将艾滋病毒感染者的护理和治疗列为优先事项，但显然需要提高护理保留率。关于艾滋病毒护理的研究利用初级保健预约的出席率来评估患者是否得到护理。虽然医疗访问是必要的，但这还不够，也不一定反映病人的参与程度。参与护理是关于患者的体验以及与提供者和护理站点的互动。我们建议创建一个以患者为中心的艾滋病护理参与指数，该指数将在卫生保健授权模型中框架化，该模型指的是以参与、知情、协作、承诺和宽容的方式参与护理。 不确定性我们将通过与患者、供应商和研究专家建立共识的协作过程，使用迭代在线德尔菲调查和面对面焦点小组来创建该指数。然后，我们将把这些叙述性发现转化为量表项目，并通过与患者的认知访谈进一步发展它们。我们将通过对在CFAR综合临床系统网络（CNICS）中接受患者报告结局的患者样本进行i管理，并检查回顾性、横断面和前瞻性预约和病毒载量数据，来验证该指数。由此产生的艾滋病毒护理参与指数将对临床护理和研究产生影响，确定临床结果不佳的风险患者，并提供一个衡量标准，以制定和评估旨在改善护理参与的干预措施。