Using Medicaid data to advance care for people with schizophrenia at risk for HIV (Medicaid-DASH)

利用医疗补助数据促进对有艾滋病毒风险的精神分裂症患者的护理 (Medicaid-DASH)

• 批准号: 9899823
• 负责人: Christina Mangurian
• 金额: $ 65.65万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-01 至 2022-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9899823
• 关键词: Acquired Immunodeficiency Syndrome; Adult; Aging; Biometry; Bipolar Disorder; California; Cardiovascular Diseases; Caring; Cause of Death; Clinical Psychology; Cohort Studies; Communities; Continuity of Patient Care; County; Crystallization; Data; Department chair; Disease; Doctor of Philosophy; Epidemiology; Ethnic Origin; Faculty; Frequencies; Funding; Future; General Population; Geography; Goals; Grant; HIV; Health; Healthcare Systems; Human; Human immunodeficiency virus test; Individual; Intervention; Interview; Longitudinal cohort study; Measurement; Medicaid; Medicine; Mental Health; Meta-Analysis; Methods; Patient Self-Report; Policies; Population; Prevalence; Prevention; Primary Health Care; Procedures; Psychiatrist; Psychiatry; Public Health; Qualitative Research; Race; Research; Research Design; Research Personnel; Risk; Sample Size; San Francisco; Schizophrenia; Services; Therapeutic; Time; Universities; Variant; Vulnerable Populations; Work; antiretroviral therapy; base; beneficiary; cohort; comorbidity; data sharing; dual eligible; education research; effective intervention; improved; innovation; medical specialties; mid-career faculty; multidisciplinary; professor; programs; retention rate; severe mental illness; systematic review; transmission process

ABSTRACT This R01 application will provide support for Christina Mangurian, MD, MAS, a psychiatrist at the University of California, San Francisco (UCSF), to conduct research to examine HIV care received by Medicaid recipients with schizophrenia throughout the U.S. Dr. Mangurian has assembled a multidisciplinary team at UCSF, Rutgers University, and Columbia University to facilitate this research. At UCSF, her Co-Investigators include James Dilley, MD, Vice Chair of UCSF Department of Psychiatry; Eric Vittinghoff, Professor of Biostatistics and Epidemiology; Emily Arnold, PhD, Associate Professor, Department of Medicine based at the Center for AIDS Prevention Studies (CAPS); and Kim Koester, PhD, Director of Qualitative Research at CAPS. At Rutgers University, Co-Investigators include Stephen Crystal, PhD, Chair of the Division on Aging and Director of the Center for Education and Research on Mental Health Therapeutics; and James Walkup, PhD, Chair of the Department of Clinical Psychology. Dr. Mangurian also has three consultants: Francine Cournos, MD, Professor of Psychiatry, Columbia University; Mark Olfson, MD, Professor of Psychiatry, Columbia University; and Grant Colfax, MD, Chief of Marin County's Health & Human Services and former Director of the Office of National AIDS Policy. Over 9 million US adults have severe mental illnesses like schizophrenia and bipolar disorder. These people die, on average, 25 years earlier than the general population. Although the most common cause of death is cardiovascular disease, a recent meta-analysis found that people with severe mental illness are up to 10 times more likely than the general population to have HIV. Despite this risk, a systematic review found that HIV testing rates among people with severe mental illnesses such as schizophrenia are quite low. Additionally, the quality of HIV care is poorly understood for people with severe mental illness. This study aims to fill this gap by becoming the largest to examine the HIV continuum of care among people with schizophrenia. There is an urgent need to understand HIV care along the continuum received by people with schizophrenia served in the public healthcare system. In Aim 1, Dr. Mangurian proposes to examine HIV testing of Medicaid recipients with schizophrenia. In Aim 2, she will examine HIV care along the continuum for Medicaid recipients with schizophrenia. In Aim 3, she will identify key strategies used by high performing states. This study will meaningfully contribute to the current understanding of problems along the HIV care continuum for people with schizophrenia. By identifying specific individual-, organizational-, community-, and policy- targets, this study will inform future interventions to close the HIV care continuum gap for people with schizophrenia. If these interventions are effective, this study will be a first step towards improving the HIV care received by people with severe mental illness. As treatment is increasingly understood and accepted as prevention, this work also has public health implications for reducing HIV transmission.

摘要 此R01应用程序将为Christina Mangurian，MD，MAS，大学精神病学家提供支持 的加州，旧金山弗朗西斯科（加州大学旧金山分校），进行研究，以检查艾滋病毒的医疗补助受助人收到的照顾 精神分裂症患者 曼古里安博士在加州大学旧金山分校、罗格斯大学和哥伦比亚大学组建了一个多学科团队 大学，以促进这项研究。在加州大学旧金山分校，她的合作研究者包括詹姆斯迪利，医学博士，副主席 UCSF精神病学系; Eric Vittinghoff，生物统计学和流行病学教授;艾米丽阿诺德， 艾滋病预防研究中心医学系博士、副教授; 以及CAPS定性研究主任Kim Koester博士。在罗格斯大学， 包括斯蒂芬·克里斯托博士，老龄化司主席和教育中心主任， 心理健康治疗研究;和詹姆斯·沃卡普博士，临床系主任 心理学Mangurian博士还有三位顾问：Francine Cournos，医学博士，精神病学教授， 哥伦比亚大学; Mark Olfson，医学博士，精神病学教授，哥伦比亚大学;和Grant科尔法克斯，医学博士， 马林县卫生与公众服务部主任，国家艾滋病政策办公室前主任。 超过900万美国成年人患有严重的精神疾病，如精神分裂症和躁郁症。这些 平均而言，人们的死亡比一般人口早25年。虽然最常见的原因是 死亡是心血管疾病，最近的一项荟萃分析发现，患有严重精神疾病的人 比普通人群感染艾滋病毒的可能性高10倍。尽管存在这种风险，但一项系统性综述发现， 患有精神分裂症等严重精神疾病的人的艾滋病毒检测率相当低。此外，本发明还 对严重精神疾病患者的艾滋病护理质量知之甚少。本研究旨在填补这一 成为最大的差距，以检查艾滋病毒的连续照顾精神分裂症患者。 迫切需要了解艾滋病毒护理沿着的人所接受的连续性， 精神分裂症在公共医疗系统中的服务。在目标1中，Mangurian博士建议检查艾滋病毒 精神分裂症患者的医疗补助接受者的测试。在目标2中，她将研究艾滋病毒护理沿着连续体， 精神分裂症的医疗补助受助人。在目标3中，她将确定高绩效企业使用的关键策略， states.这项研究将有意义地有助于目前的理解问题沿着艾滋病护理 精神分裂症患者的连续体。通过确定具体的个人、组织、社区和 政策目标，这项研究将为未来的干预措施提供信息，以缩小艾滋病毒护理连续体的差距， 精神分裂症如果这些干预措施有效，这项研究将成为改善艾滋病毒护理的第一步 由患有严重精神疾病的人接收。随着治疗越来越被理解和接受， 这项工作还对减少艾滋病毒传播具有公共卫生意义。