Supplement: Implementation Research Strategies for Heart, Lung, and Blood Co-morbidities in People Living with HIV - Research Coordinating Center

补充：艾滋病毒感染者心、肺和血液合并症的实施研究策略 - 研究协调中心

• 批准号: 10655889
• 负责人: Victor G. Davila-Roman
• 金额: $ 75.21万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-30 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655889
• 关键词: Administrative Supplement; Africa South of the Sahara; African; Blood; Botswana; Caring; Communities; Cost Effectiveness Analysis; Country; Data; Data Collection; Economics; Effectiveness of Interventions; Ensure; Evaluation; Funding; Grant; HIV; Health Benefit; Heart; Heart Diseases; Hematological Disease; Hypertension; Individual; Infrastructure; Intervention; Investments; Lung; Lung diseases; Mozambique; National Heart, Lung, and Blood Institute; Nigeria; Persons; Research; Research Personnel; Resources; Scientific Advances and Accomplishments; Site; Sleep Disorders; South Africa; Standardization; Subgroup; Testing; Time; Uganda; Zambia; budget impact; care systems; comorbidity; cost; cost effectiveness; cost-effectiveness evaluation; economic evaluation; experience; hypertension control; implementation evaluation; implementation research; improved; instrument; low and middle-income countries; pressure; programs; standard of care; symposium

Project Summary Low- and middle-income countries (LMICs) are facing an escalating burden of heart, lung, blood, and sleep (HLBS) disorders among people with HIV (PWH). In implementing interventions to ameliorate this burden, evaluation of cost, cost-effectiveness, and budget impact are increasingly important. Furthermore, implementing integrated care in LMICs involves unique economic considerations. For example, launching such interventions often involves major up-front costs (e.g., reorganizing systems of care, investing in technological or other infrastructure), whereas health benefits are more uncertain and only accrue over time. Similarly, it is difficult to compare the costs of integrated care against an “unintegrated” standard of care in which non- communicable diseases (NCDs) such as hypertension are often not diagnosed or treated at all. The HLB- SIMPLe Alliance is a highly collaborative consortium that is evaluating the implementation of diverse and culturally relevant interventions for hypertension control among PWH in six sub-Saharan African countries (South Africa, Botswana, Zambia, Mozambique, Uganda, and Nigeria). Led by a designated Cost- Effectiveness Subgroup, the HLB-SIMPLe Alliance is taking a coordinated approach to evaluating the cost and cost-effectiveness of these interventions. Currently, funding exists through the individual grants of the HLB- SIMPLe Alliance to develop a set of standardized instruments and to collect data on costs in four of the six participating sites. This Supplement will build on these activities through three Specific Aims to optimize the scientific impact of NHLBI’s investment in the HLB-SIMPLe Alliance infrastructure in the field of economic evaluation. In Aim 1, we will expand our coordinated cost data collection efforts to the two remaining sites, thereby enhancing the generalizability and relevance of our findings. In Aim 2, we will create an accessible toolkit for use by other researchers and investigators seeking to evaluate the costs and cost-effectiveness of integrated HIV/NCD care. We will also use the HLB-SIMPLe studies to “pressure-test” and refine this toolkit, making our findings openly available to both scientific and implementation communities. In this way, we will ensure that lessons learned through the HLB-SIMPLe experience inform a broader array of decision-makers and advance scientific understanding of the economics of implementing integrated HIV/NCD care. In Aim 3, we will develop a year-long capacity building program, culminating in a ten-day summit in one of our African sites, to ensure that our African collaborators use the experience of the HLB-SIMPLe Alliance as a springboard to become leaders in this emerging research niche. Successful completion of the Aims in this Administrative Supplement will therefore enable us to take full advantage of the infrastructure of the HLB-SIMPLe Alliance to improve economic evaluation of integrated HIV/NCD care – both within the Alliance and (led by our African partners) throughout the scientific community as a whole.

项目概要 低收入和中等收入国家 (LMIC) 面临着不断增加的心、肺、血液和睡眠负担 （HLBS）艾滋病毒感染者（PWH）中的疾病。在实施干预措施以减轻这一负担时， 对成本、成本效益和预算影响的评估变得越来越重要。此外， 在中低收入国家实施综合护理涉及独特的经济考虑。例如，推出这样的 干预措施通常涉及重大的前期成本（例如，重组护理系统、投资技术 或其他基础设施），而健康益处则更加不确定，并且只会随着时间的推移而增加。同样，它是 很难将综合护理的成本与“非综合”护理标准进行比较，其中非综合护理 高血压等传染病 (NCD) 通常根本没有得到诊断或治疗。 HLB- SIMPLe 联盟是一个高度协作的联盟，正在评估多样化和 撒哈拉以南非洲六个国家的感染者高血压控制文化相关干预措施 （南非、博茨瓦纳、赞比亚、莫桑比克、乌干达和尼日利亚）。由指定成本领导 HLB-SIMPLe 联盟有效性小组正在采取协调一致的方法来评估成本和 这些干预措施的成本效益。目前，资金通过 HLB 的个人赠款提供 SIMPLe 联盟将开发一套标准化工具并收集六个领域中四个领域的成本数据 参与网站。本补充文件将以这些活动为基础，通过三个具体目标来优化 NHLBI 对 HLB-SIMPLe 联盟基础设施投资在经济领域的科学影响 评估。在目标 1 中，我们将把我们协调的成本数据收集工作扩展到剩下的两个地点， 从而增强我们研究结果的普遍性和相关性。在目标 2 中，我们将创建一个可访问的 供其他研究人员和调查人员使用的工具包，以评估成本和成本效益 艾滋病毒/非传染性疾病综合护理。我们还将使用 HLB-SIMPLe 研究来“压力测试”并完善该工具包， 向科学界和实施界公开我们的研究结果。这样，我们将 确保通过 HLB-SIMPLe 经验获得的经验教训为更广泛的决策者提供信息 促进对实施艾滋病毒/非传染性疾病综合护理的经济学的科学理解。在目标 3 中，我们 将制定一项为期一年的能力建设计划，最终在我们的一个非洲地点举行为期十天的峰会， 确保我们的非洲合作者利用 HLB-SIMPLe 联盟的经验作为跳板 成为这个新兴研究领域的领导者。圆满完成本次行政管理目标 因此，补充协议将使我们能够充分利用 HLB-SIMPLe 联盟的基础设施 改善对艾滋病毒/非传染性疾病综合护理的经济评估——无论是在联盟内部还是（由我们的非洲国家领导） 合作伙伴）整个科学界。