Patient Satisfaction, Retention in HIV Care, and Adherence to ART

简介（由申请人提供）：Dang博士是贝勒医学院（BCM）传染病科的临床医学讲师。她也即将完成休斯顿退伍军人事务健康服务卓越研究与发展中心的博士后研究。邓博士将于2013年7月1日被任命为BCM助理教授。她的首要目标是成功地作为一个独立的临床研究者进行有意义的，可操作的研究，以提高艾滋病毒护理的质量。具体来说，她感兴趣的是使用患者体验指标作为一个创新的重点，以提高艾滋病毒护理的保留率和高活性抗逆转录病毒治疗（HAART）的依从性。Dang博士将通过与Thomas Giordano博士（HIV护理保留方面的国家专家）、Robert Westbrook博士（客户满意度和保留方面的行业顾问）、Christine Markham博士（干预发展方面的专业行为科学家）和Amico博士（国际公认的HIV弱势群体护理依从性和参与相关因素的专家）的指导研究来实现这些目标。有指导的研究将辅以有组织的职业发展活动。活动将包括高级，研究生水平的课程和/或指导阅读客户/患者评估和经验管理，行为科学和变革理论，行为和社会科学数据分析，以及艾滋病毒的保留和坚持。本K23申请中提出的研究旨在了解患者满意度的基本行为科学，因为它与HIV护理的保留和HAART的坚持有关。此外，这项研究将确定影响患者如何评估其艾滋病毒治疗的可变因素，特别是那些服务不足的少数民族人群。总体假设是，满意度越高的患者在艾滋病毒护理和HAART治疗方面的坚持程度越高。采用混合方法，具体目标是：1)了解患者如何预期、体验和评估他们的艾滋病毒护理，通过对新到诊所的患者进行纵向、深入的访谈，在他们的护理开始的前6个月，2)开发和预测试一项定量调查，全面评估艾滋病毒患者的体验和满意度，3)确定基线时患者的总体满意度与艾滋病毒护理的保留和进入护理后12个月坚持HAART之间的关系。并确定这种关系的调节者。本申请中提出的指导研究和职业发展活动将扩展Dang博士目前的技能和过去的工作，并使她能够发展成为一名独立的研究者，具有使用患者体验指标的专业知识，以战略性地影响艾滋病毒护理的质量。

DESCRIPTION (provided by applicant): Dr. Dang is a Clinical Instructor of Medicine in the Section of Infectious Diseases at Baylor College of Medicine (BCM). She is also nearing completion of a postdoctoral fellowship in health services research at the Houston Veterans Affairs Health Services Research and Development Center of Excellence. Dr. Dang will be appointed Assistant Professor at BCM effective July 1, 2013. Her overarching goal is to succeed as an independent clinical investigator conducting meaningful, actionable research to improve the quality of HIV care. Specifically, she is interested in using patient experience metrics as an innovative focus for improving retention in HIV care and adherence to highly active antiretroviral therapy (HAART). Dr. Dang will accomplish these goals through mentored research with Dr. Thomas Giordano, a national expert on retention in HIV care, Dr. Robert Westbrook, a frequent industry consultant on customer satisfaction and retention, Dr. Christine Markham, a behavioral scientist with expertise in intervention development, and Dr. Amico, an internationally recognized expert on factors related to adherence and engagement in care for vulnerable populations with HIV. Mentored research with be supplemented with structured career development activities. Activities will include advanced, graduate-level coursework and/or directed readings in customer/patient evaluation and experience management, behavioral science and change theory, analysis of behavioral and social science data, and HIV retention and adherence. The proposed research in this K23 application seeks to understand the basic behavioral science of patient satisfaction as it relates to retention in HIV care and adherence to HAART. Furthermore, this research will identify mutable factors that shape how patients evaluate their HIV care, particularly those in underserved, minority populations. The overall hypothesis is that patients with higher satisfaction will have greater retention in HIV care and adherence to HAART. Applying mixed-methods, the Specific Aims are to: 1) understand how patients anticipate, experience and evaluate their HIV care by conducting longitudinal, in-depth interviews with patients new to clinic as their care unfolds in the first 6 months, 2) develop and pre-test a quantitative survey that comprehensively assesses HIV patient experience and satisfaction, 3) determine the relationship between overall patient satisfaction at baseline and retention in HIV care and adherence to HAART 12-months after entering care, and identify moderators of that relationship. The mentored research and career development activities proposed in this application will expand upon Dr. Dang's current skills and past work and allow her to evolve as an independent investigator with expertise in the use of patient experience metrics to strategically impact the quality of HIV care.