Forging sustainable solutions for HIV continuity of care through medical-legal partnerships

通过医疗法律合作伙伴关系，打造艾滋病毒连续性护理的可持续解决方案

• 批准号: 10653169
• 负责人: MIGUEL A MUNOZ-LABOY
• 金额: $ 23.09万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-21 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10653169
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Advanced Development; Affect; Appointment; Area; Behavioral; COVID-19; COVID-19 pandemic; COVID-19 prevention; COVID-19 treatment; Caring; Case Management; Client; Clinical; Clinical Trials; Communication; Communities; Comparison arm; Continuity of Patient Care; Development; Disease; Economics; Epidemic; Evidence based intervention; Funding; Goals; Grant; HIV; HIV diagnosis; HIV/AIDS; Health; Health Services; Healthcare; Homelessness; Housing; Human; Income; Individual; Inequity; Intervention; Intervention Studies; Legal; Literature; Low income; Measures; Medical; Medical Care Costs; Methodology; Methods; National Institute of Mental Health; Outcome; Participant; Patient Recruitments; Patients; Persons; Pharmaceutical Preparations; Philadelphia; Population; Prevention Research; Process; Protocols documentation; Provider; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Regimen; Research; Research Priority; Resources; Risk; Service delivery model; Services; Site; Social Problems; Social Work; Structure; Testing; Time; Training; Treatment outcome; United States National Institutes of Health; Viral; Viral Load result; Vulnerable Populations; Work; acceptability and feasibility; arm; behavioral outcome; care outcomes; clinical care; collaborative environment; data management; efficacy trial; evidence base; feasibility testing; forging; health care availability; health care delivery; health care service organization; improved; innovation; intervention mapping; medication compliance; meetings; operation; patient engagement; process evaluation; programs; prototype; psychosocial; public health emergency; response; service organization; social; social determinants; standard of care; structural health determinants; success; therapy development; treatment services

Project Summary A health-harming legal need is a social problem that adversely affects a person's health or access to health care and which is better remedied through the combination of legal care and health care. Medical legal partnerships (MLPs) have been underutilized as structural interventions; however, they could help improve HIV care continuum outcomes in health care organizations. The goal of this study is to test the Organizational Partnerships for Healthy Living (OPAHL) intervention through a feasibility and acceptability trial. OPAHL is an innovative, multilevel intervention package intended for health care organizations serving people living with HIV (PLWH). It was developed through a prior study (grant #: R21 MH115820) using intervention mapping methodology and community-scientific collaborative boards. OPAHL consists of: 1) training (7/8hours) for all MLP staff (clinical, social and behavioral services, and legal) on HIV continuum of care, health harming legal risks and needs, and MLP structure and operations to ensure that an integrated and collaborative environment is established from the earliest stages of the program; 2) case management training on the legal continuum of care; 3) embedding of legal expertise within regularized case management team meetings; 4) co- location of legal services in health care agencies through MLP inter-organizational partnership within 3 months; and 5) organizationally tailored implementation of best-practice communication and information-sharing protocols among providers within MLP, anchored in patient autonomy and choice. The specific aims of this study are: 1) to refine the OPAHL intervention prototype for implementation with PLWH with detectable viral loads and 2) to test the feasibility, acceptability and preliminary effects sizes of OPAHL. Given the current COVID-19 pandemic, the study will also explore MLP opportunities that respond at the intersection of HIV/AIDS and COVID-19 prevention and treatment. Two health care organizations serving PLWH Philadelphia, PA that do not currently provide any form of legal services to their patients will participate in this trial (n=200 PLWH). The proposed study is in response to PA-20-141: Formative and Pilot Intervention Research for Prevention and Treatment of HIV/AIDS (R34 Clinical Trial Optional). It is also responsive to two of the areas of high priority research of NIMH Division of AIDS Research (Develop and test interventions to improve HIV treatment outcomes; Advance the development and testing of interventions delivered beyond the individual level). Completion of this project will result in the development of an intervention package to optimize HIV services for a highly vulnerable population whose HIV care is affected by health-harming legal needs.

项目总结