Mechanisms and pilot intervention for addressing intimate partner violence and HIV in antenatal care

解决产前护理中亲密伴侣暴力和艾滋病毒问题的机制和试点干预措施

• 批准号: 10208681
• 负责人: Abigail Mae Hatcher
• 金额: $ 16.33万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208681
• 关键词: Address; Adherence; Affect; Africa South of the Sahara; Attention; Behavioral; Career Mobility; Caring; Clinic; Country; Data; Development Plans; Dose; Drug usage; Elements; Enrollment; Ensure; Epidemiology; Feasibility Studies; Focus Groups; Foundations; Future; Goals; HIV; HIV Infections; HIV Seropositivity; Hair; Health; Health Services Accessibility; Health behavior; Improve Access; Income; Infant; Intervention; Interview; Lead; Learning; Life; Life Cycle Stages; Link; Longitudinal cohort; Malawi; Maps; Maternal Health; Maternal Mortality; Maternal and Child Health; Measures; Mental Depression; Mental Health; Mentored Research Scientist Development Award; Mentors; Mentorship; Methods; Modeling; National Institute of Mental Health; North Carolina; Outcome; Participant; Pathway interactions; Perinatal; Personal Satisfaction; Pharmaceutical Preparations; Phase; Postpartum Period; Pregnancy; Pregnant Women; Prevention; Prospective cohort; Protocols documentation; Provider; Qualitative Research; Quasi-experiment; Regimen; Reporting; Research; Research Design; Research Personnel; Risk Factors; Role; Safety; Sampling; Scientist; Site Visit; Solid; South Africa; South African; Supervision; Testing; Therapeutic; Time; Training; Translating; Universities; Vertical Disease Transmission; Viral; Viremia; Woman; Women' s Health; Work; Zambia; advanced analytics; antenatal; antenatal care; antiretroviral therapy; base; career; career development; cohort; depression prevention; depressive symptoms; design; evidence base; experience; follow-up; global health; implementation research; implementation science; inner city; intervention effect; intimate partner violence; maternal morbidity; medication compliance; modifiable risk; motherhood; multiphase optimization strategy; novel; perinatal intervention; perinatal women; peripartum depression; preference; programs; prospective; psychological distress; scaffold; secondary analysis; skills; social; standard of care; statistics; therapy adherence; treatment adherence; violence prevention

ABSTRACT This application to the National Institutes of Mental Health will provide Dr. Abigail Hatcher with five years K01 support for further training and mentored research. Dr. Hatcher is a social scientist at the University of North Carolina (UNC) with experience studying social drivers of HIV-related health. She has lived in South Africa since 2005, where she has established a solid career foundation for behavioral and social research around HIV and maternal health. The K01 award will provide essential training and professional scaffolding for a critical career transition, during which Dr. Hatcher will return to Chapel Hill after considerable time abroad to be an independent investigator and integral part of UNC Department of Health Behavior's global health research. Prevention of mother-to-child transmission (PMTCT) programs are only effective if women take medication regularly, yet many perinatal women in sub-Saharan Africa have sup-optimal adherence. Intimate partner violence (IPV) worsens women's ability to adhere to antiretroviral therapy (ART), and leads to higher rates of depression. Dr. Hatcher proposes 3 aims, each linked to a robust career development plan advancing analytical, adaptation, and implementation science skills. First, she will lead secondary analysis of longitudinal cohort data to determine mechanisms linking IPV to HIV-related health outcomes (ART adherence, viremia), exploring a hypothesized pathway of mental health. Coursework and mentorship in statistics and epidemiology (Drs. Levin, Turan, B, and Myer) will support her analyses. Second, qualitative research with perinatal women and health workers will explore identified pathways and intervention ideas. Dr. Hatcher will systematically adapt evidence-based mental health programs, enhanced by site visits to Malawi and Zambia, and mentorship from IPV and mental health experts (Drs. Maman, Christofides, and Pence). Third, she will conduct a feasibility study to assess acceptability of intervention content, measures, and study conditions. In a quasi- experimental design, she will assign 2 inner-city Johannesburg clinics to intervention or enhanced standard of care conditions. Following 80 women in a prospective cohort will allow for preliminarily assessment of intervention effects on key pathways (perinatal depression and IPV) and refinement of HIV measures (ART adherence using drug levels in hair samples). The feasibility study will be underpinned by coursework in implementation research study design and intensive supervised practice from experts in implementation science for PMTCT (Drs. Turan, J, Brahmbhatt, and Chi). Overall, the research will provide preliminary results to inform design of a future trial testing an optimized lay health worker strategy. By supporting didactic and field-based learning and protected time for research, a K01 will advance Dr. Hatcher's career progression as an independent HIV behavioral scientist, leading to better health and wellbeing among HIV-positive women.

摘要