An implementation science approach to monitoring engagement in HIV care

监测艾滋病毒护理参与度的实施科学方法

• 批准号: 9410597
• 负责人: Angela Bengtson
• 金额: $ 9.16万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-23 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9410597
• 关键词: Africa South of the Sahara; Anti-Retroviral Agents; Area; Attitude; Award; Breast Feeding; CD4 Lymphocyte Count; Car Phone; Caring; Cellular Phone; Clinic; Cost Analysis; Data; Development; Effectiveness; Enhancement Technology; Enrollment; Epidemic; Epidemiologist; Epidemiology; Evaluation; Evidence based intervention; Fingerprint; Focus Groups; Future; Goals; HIV; Health Personnel; Health behavior; Intervention; Interview; Malawi; Maternal Health; Medicine; Mentors; Mentorship; Methods; Monitor; Mother-to-child HIV transmission; Ohio; Outcome; Participant; Penetration; Perinatal; Phase; Population; Positioning Attribute; Postpartum Period; Postpartum Women; Pregnancy; Pregnant Women; Privacy; Qualitative Research; Research; Research Personnel; Research Project Grants; Scanning; Sensitivity and Specificity; Surveys; System; Technology; Text; Time; Training; Visit; Woman; Work; base; career; career development; cohort; cost; experience; follow-up; i(19); implementation science; improved; innovation; insight; low and middle-income countries; multidisciplinary; pregnant; primary outcome; programs; scale up; science teacher; secondary outcome; skills; success; tenure track; theories; treatment adherence; treatment program

PROJECT SUMMARY/ABSTRACT Career Goal: My career goal is to become a leading epidemiologist focused on improving engagement in HIV care in low and middle income countries (LMIC). Through this K99/R00 proposal, I hope to merge my training as an epidemiologist with the field of implementation science. With this skill set, I plan to build a career focused on implementing interventions to retain or re-engage HIV-infected women in HIV care in the peripartum period. Career Development: I will focus on training in implementation science and professional development during the mentored (K99) phase of this award. Training in implementation science will focus in 3 key areas: 1) core concepts and theories 2) using technology to implement more effective HIV program monitoring systems, and 3) qualitative research to inform implementation strategies. Professional development training will include coursework, seminars, building my reputation as an emerging HIV researcher, and a detailed plan for a successful transition to a tenure-track position. Research Project: The scale-up of antiretroviral treatment (ART) to all pregnant and breastfeeding women under Option B+ has the potential to change the trajectory of the HIV epidemic. However, in order for the potential of Option B+ to be realized, women must be retained in HIV care and those who are lost to follow-up (LTFU) must be re-engaged in care. Few efforts to re-engage women in HIV care exist. Routine HIV program monitoring is an evidence-based intervention that is vital to track women's engagement in HIV care under Option B+, but is limited in its ability accurately distinguish women who are LTFU from those who have transferred to another HIV clinic. Identifying women who are LTFU is essential for timely re-engagement in HIV care. The goal of the proposed project is to evaluate whether enhancing HIV program monitoring with technology may be an implementation strategy to accurately identify women who are LTFU. The project goal will be achieved through the following four Specific Aims: K99/1) To explore attitudes towards using technology for HIV program monitoring, K99/2) To assess the feasibility and acceptability of 3 implementation strategies to improve HIV program monitoring, R00/3) To evaluate enhanced HIV program monitoring as an implementation strategy, R00/4) To evaluate the effectiveness of enhanced program monitoring to improve the accuracy of HIV program monitoring. Mentorship: A highly accomplished, multidisciplinary team of experts will mentor me in the first two years of this award and provide ongoing guidance as I transition to independence. This mentoring team includes: Dr. Mina Hosseinipour (Primary Mentor, Department of Medicine, UNC; UNC-Project Malawi), Dr. Vivian Go (Co-mentor, Department of Health Behavior, UNC) and Dr. William Miller (Co-mentor, Department of Epidemiology, Ohio State), and Dr. Lisa Hightow-Weidman (Adviser, Department of Medicine, UNC). Future Directions: The training and research in this proposal will prepare me to submit an R01 application that uses technology-enhanced HIV program monitoring to identify women who are LTFU and develops a re-engagement in HIV care intervention.

项目总结/摘要 职业目标：我的职业目标是成为一名领先的流行病学家，专注于提高艾滋病毒的参与度 低收入和中等收入国家（LMIC）。通过这个K99/R 00提案，我希望合并我的培训 作为一名流行病学家，在实施科学领域。有了这些技能，我计划建立一个专注于 实施干预措施，使感染艾滋病毒的妇女在围产期继续接受或重新接受艾滋病毒护理。 职业发展：我将专注于实施科学和专业发展的培训， 此奖项的指导（K99）阶段。实施科学的培训将集中在3个关键领域：1）核心 概念和理论2）利用技术来实施更有效的艾滋病毒项目监测系统， 3)为执行战略提供信息的定性研究。专业发展培训将包括 课程，研讨会，建立我作为一个新兴的艾滋病研究人员的声誉，以及一个详细的计划， 成功过渡到终身教职研究项目：扩大抗逆转录病毒治疗 (ART)在备选方案B+下向所有孕妇和哺乳期妇女提供的服务有可能改变 艾滋病的流行。然而，为了实现备选方案B+的潜力，必须在下列领域留住妇女： 艾滋病毒护理和那些失去后续行动（LTFU）必须重新参与护理。重新参与的努力很少 存在接受艾滋病毒护理的妇女。常规的艾滋病毒项目监测是一种基于证据的干预措施， 跟踪妇女在选项B+下参与艾滋病毒护理的情况，但其准确区分 从那些转到另一个艾滋病毒诊所的妇女中获得长期随访的妇女。识别LTFU女性 对于及时重新参与艾滋病毒护理至关重要。该项目的目标是评估是否 利用技术加强艾滋病毒项目监测可能是一种实施战略， LTFU的女性项目目标将通过以下四个具体目标实现：K99/1） 探讨对使用技术进行艾滋病毒项目监测的态度，K99/2）评估可行性， 改善艾滋病毒方案监测的3项执行战略的可接受性，R 00/3） 作为一项执行战略的艾滋病毒方案监测，R 00/4） 项目监测，提高艾滋病项目监测的准确性。导师：一个高度成就， 一个多学科的专家团队将在这个奖项的前两年指导我，并提供持续的 在我向独立过渡的过程中给予指导该指导团队包括：Mina Hosseinipour博士（小学） 导师，医学系，马拉维; UNC-Project Malawi），Vivian Go博士（联合导师，卫生部 行为学博士）和William米勒博士（共同导师，流行病学系，俄亥俄州），以及丽莎博士 海托-韦德曼（北卡罗来纳大学医学系顾问）。未来方向：培训和研究 该提案将使我准备提交一份使用技术增强的艾滋病毒项目的R 01申请 进行监测，以确定长期未治愈的妇女，并重新参与艾滋病毒护理干预。