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

描述（由申请人提供）：Dang博士是贝勒医学院（Baylor College of Medicine）传染病科的临床医学讲师。她还即将完成在休斯敦退伍军人事务部卫生服务研究与发展卓越中心的卫生服务研究博士后奖学金。Dang博士将于2013年7月1日起被任命为清华大学助理教授。她的首要目标是成功地作为一个独立的临床研究人员进行有意义的，可操作的研究，以提高艾滋病毒护理的质量。具体而言，她有兴趣使用患者体验指标作为创新重点，以提高艾滋病毒护理的保留率和对高效抗逆转录病毒疗法（HAART）的坚持。Dang博士将通过与艾滋病毒护理保留方面的国家专家托马斯佐丹奴博士、客户满意度和保留方面的频繁行业顾问罗伯特韦斯特布鲁克博士、具有干预开发专业知识的行为科学家克莉丝汀马卡姆博士和Amico博士的指导研究来实现这些目标。他是国际公认的专家，研究与坚持和参与艾滋病毒感染者弱势群体护理有关的因素。指导研究，辅以结构化的职业发展活动。活动将包括先进的，研究生水平的课程和/或客户/患者评估和经验管理，行为科学和变化理论，行为和社会科学数据的分析，艾滋病毒的保留和坚持的指导阅读。K23申请中的拟议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护理的可变因素，特别是那些服务不足的少数群体。总体假设是，患者的满意度越高，将有更多的保留在艾滋病毒护理和坚持HAART。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，方法是在前6个月内对新到诊所的患者进行纵向深入访谈，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）确定基线时患者总体满意度与HIV护理保留率和进入护理后12个月坚持HAART之间的关系，并确定该关系的调节因素。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人员，拥有使用患者经验指标的专业知识，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.