Cost-effectiveness of cardiovascular disease prevention in HIV care: a systems science approach

艾滋病毒护理中心血管疾病预防的成本效益：系统科学方法

• 批准号: 10661850
• 负责人: Karla Ivette Galaviz
• 金额: $ 13.28万
• 依托单位: TRUSTEES OF INDIANA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10661850
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adoption; Age; Aging; American; Behavior; Behavioral; Blood Pressure; Body Composition; Calibration; Cardiometabolic Disease; Cardiovascular Diseases; Caring; Clinical; Cohort Studies; Collaborations; Communities; Computer Models; Computer Simulation; Consolidated Framework for Implementation Research; Counseling; Data; Decision Support Systems; Development; Disease Outcome; Engineering; Epidemiology; Event; Face; Future; General Population; Goals; Guidelines; HIV; HIV Seronegativity; Health; Health Care Costs; Incidence; Individual; Infrastructure; Intervention; Intervention Studies; Life Style; Life Style Modification; Mentored Research Scientist Development Award; Methodology; Methods; Mission; Modeling; Motivation; National Heart, Lung, and Blood Institute; Persons; Pharmaceutical Preparations; Physical activity; Population; Prevalence; Prevention strategy; Process; Protocols documentation; Public Health Schools; Publishing; Recommendation; Research; Research Personnel; Research Priority; Resources; Risk Factors; Running; Sampling; Science; Scientist; Sorting; Structure; System; Testing; Training; Universities; Validation; Veterans; adjudication; blood lipid; cardiorespiratory fitness; cardiovascular disorder prevention; cardiovascular disorder risk; career; cohort; comparative cost effectiveness; cost; cost effective; cost effective intervention; cost effectiveness; cost estimate; design; design verification; dietary; economic evaluation; effective intervention; effectiveness trial; evidence base; experience; experimental study; global health; implementation research; implementation strategy; improved; intervention cost; intervention delivery; intervention effect; knowledge translation; model development; mortality; multiphase optimization strategy; novel; professor; programs; provider behavior; research to practice; simulation; skills; systemic inflammatory response; virtual experiments

PROJECT SUMMARY Implementing effective cardiovascular disease (CVD) prevention strategies is critical for reducing the disproportionately greater burden of adverse CVD outcomes facing people living with HIV. Lifestyle modification has been identified as a first-line CVD prevention strategy for the general population and recommended in HIV clinical guidelines. Yet, evidence-based lifestyle modification interventions such as behavioral counseling and referrals to community resources are rarely used in routine HIV care workflows. Addressing this research-to-practice gap requires understanding what processes and structures are needed for effective intervention delivery in HIV care, estimating the costs of interventions, and identifying leverage points in existing systems to integrate interventions. Agent-based modeling (ABM) is a novel systems science approach that can sort through these intervention and system complexities to find the most cost-effective intervention solutions and delivery paths. Thus, the overall goal of this study is to engineer a cost-effective strategy to integrate lifestyle modification interventions in HIV care using ABM. With guidance from experts in HIV (Dr. Ofotokun), CVD (Dr. Ali), ABM (Dr. Bodner), and economic evaluation (Dr. Rask), this goal will be accomplished through the following specific aims: 1) assess the contributions of traditional and HIV-specific risk factors to CVD development in people living with HIV; 2) develop, calibrate, and validate an exploratory ABM that simulates the cost-effectiveness of implementation strategies focused on integrating lifestyle counseling and referral in HIV care; and 3) engineer an optimized strategy for integrating lifestyle counseling and referral in HIV care using ABM and the Multiphase Optimization Strategy. Leveraging these novel computer modeling and engineering methods will allow us to preemptively model intervention solutions and delivery paths to address research-to-practice gaps in HIV care. I am an Assistant Professor of Global Health in the Rollins School of Public Health at Emory University. I have expertise in health intervention research, knowledge translation and epidemiology and possess the ability, experience, motivation, and determination to successfully complete the proposed training and research plans. This K01 award will equip me with new systems science and economic evaluation skills and broaden my understanding and abilities to effect true change in CVD prevention in the HIV population. Because this application aligns with NHLBI's HIV-CVD research priorities and its strategic mission to optimize implementation research, it represents a strong platform on which to build my career as an independent implementation scientist working at the intersection of cardiometabolic diseases and HIV.

项目摘要 实施有效的心血管疾病（CVD）预防策略对于减少 艾滋病毒感染者面临的不利CVD结果负担不成比例。生活方式 修改已被确定为一般人群的一线CVD预防策略， 推荐用于HIV临床指南。但是，基于证据的生活方式修改干预措施，例如 行为咨询和推荐社区资源很少用于常规的艾滋病毒护理工作流程。 解决此研究对实践差距需要了解需要哪些过程和结构 有效的艾滋病毒护理干预措施，估计干预措施的成本并确定杠杆点 在现有的系统中以整合干预措施。基于代理的建模（ABM）是一门新型的系统科学 可以通过这些干预和系统复杂性进行分类以找到最具成本效益的方法 干预解决方案和交付路径。因此，这项研究的总体目标是设计一种经济高效的 使用ABM整合艾滋病毒护理中生活方式修改干预措施的策略。在专家的指导下 HIV（Ofotokun博士），CVD（Ali博士），ABM（博士博士）和经济评估（Rask博士），此目标将是 通过以下特定目的完成：1）评估传统和艾滋病毒特定的贡献 艾滋病毒患者中CVD发展的风险因素； 2）开发，校准和验证探索性 ABM模拟了专注于整合生活方式的实施策略的成本效益 艾滋病毒护理中的咨询和转诊； 3）设计一种整合生活方式咨询的优化策略 使用ABM和多相优化策略中的艾滋病毒护理和转诊。利用这些小说 计算机建模和工程方法将使我们能够预先建模干预解决方案和 解决艾滋病毒护理中研究差距的交付途径。 我是埃默里大学罗林斯公共卫生学院全球健康助理教授。我 在健康干预研究，知识翻译和流行病学方面拥有专业知识，并拥有 能力，经验，动力和决心成功完成拟议的培训和研究 计划。这个K01奖将使我具备新的系统科学和经济评估技巧，并扩大我的 理解和能力实现艾滋病毒人群中CVD预防的真正变化的能力。因为这个 应用程序与NHLBI的HIV-CVD研究重点及其优化的战略使命一致 实施研究，它代表了一个强大的平台，以建立我作为独立的职业 在心脏代谢疾病与艾滋病毒的交集中的实施科学家。

项目成果

Results from the 2022 Mexican report card on physical activity for children and adolescents.

• DOI: 10.3389/fpubh.2023.1304719
• 发表时间: 2023
• 期刊: FRONTIERS IN PUBLIC HEALTH
• 影响因子: 5.2
• 作者: Argumedo, Gabriela;Lopez y Taylor, Juan Ricardo;Brunel, Julissa Ortiz;Gaytan-Gonzalez, Alejandro;Gonzalez-Casanova, Ines;Villalobos, Martin Francisco Gonzalez;Jauregui, Alejandra;Ulloa, Edtna Jauregui;Medina, Catalina;Miranda, Yoali Selene Pacheco;Rodriguez, Marcela Perez;Pelayo, Ricardo Alejandro Retano;Martinez, Maria del Pilar Rodriguez;Galaviz, Karla I.
• 通讯作者: Galaviz, Karla I.