权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Exploring the Impact of Illness Identity on Intersectional Stigma Through the Care Continuum

通过护理连续体探索疾病身份对交叉耻辱的影响

基本信息

批准号：
10794201
负责人：
Alanna J Bergman
金额：
$ 4.77万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-09-01 至 2024-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10794201
关键词：
AIDS prevention Active Learning Address Adherence Africa South of the Sahara Analysis of Variance Caring Clinic Clinical Cohort Studies Communicable Diseases Continuity of Patient Care Data Data Collection Diagnosis Directly Observed Therapy Disease Drug resistance in tuberculosis Enrollment Event Fostering Foundations Future Goals HIV HIV resistance HIV/TB Health Hospitals Human immunodeficiency virus test Illness impact Individual Infection Interruption Intervention Interview Measurement Measures Mediating Mental Depression Mentorship Methods Modeling Morbidity - disease rate Outcome Parents Participant Patient-Focused Outcomes Patients Persons Population Prejudice Prospective cohort Province Psychometrics Publishing Randomized Randomized, Controlled Trials Research Research Personnel Resource Allocation Resource-limited setting Risk Science South Africa South African Specific qualifier value Stereotyping Stigmatization Time Training Translating Treatment outcome Tuberculosis Variant Viral Viral Load result Well in self Work antiretroviral therapy barrier to care career cohort coping curative treatments design efficacy evaluation experience health care disparity health seeking behavior improved infectious disease treatment instrument low and middle-income countries marginalized population mortality participant enrollment physical conditioning predictive tools prevent programs prospective recruit research study response skills social social stigma theories tool treatment adherence treatment as usual treatment center tuberculosis treatment

项目摘要

PROJECT SUMMARY Tuberculosis (TB) and HIV stigma causes significant morbidity and mortality in South Africa. Despite curative treatments for TB and antiretroviral therapies that suppress HIV viral load, both diseases continue to spread in low- and middle-income countries. Stigma is a significant barrier to care engagement and treatment adherence for HIV and TB. Intersectional stigma theory acknowledges the infinite combination of identities that contribute to stigma and social erasure. However, this wholistic approach of social constructs is not easily translated into measurement science. The applicant's proposed study, Exploring the Impact of Illness Identity on Intersectional Stigma Through the Care Continuum, will address this gap. The purpose of this project is to explore intersectional TB/HIV stigma through the care continuum to determine whether HIV viral suppression, and TB culture/smear conversion represent changes in illness identity that mitigate stigma. Aim 1 will quantify TB/HIV stigma using the Van Rie Patient Perspectives on TB/HIV Scales and use repeated measures ANOVA to evaluate significance in changes of stigma over time. In Aim 2, the applicant will use in-depth qualitative interviews to explore nuance and variation of intersectional stigma throughout the care continuum as experienced by people living with TB and HIV in South Africa that may not be captured within the Van Rie Scales. From the qualitative interviews, the applicant will develop and pilot four to five additional instrument items to address the overlap in TB/HIV stigma that is not captured within the parallel items of the Van Rie Scales. Finally, in aim 3, the applicant will interpret and integrate the qualitative and quantitative data to create a deeper understanding of intersectional TB/HIV stigma in South Africa and to assess its impact on treatment engagement across the care continuum. The applicant will use data from this proposal to improve the accuracy of stigma measurement in South Africa. This study will lay the foundation for future career in global stigma analysis and intervention work. It is therefore, an important first step in an exciting program of research to reduce stigma and improve TB and HIV treatment outcomes for global populations.

项目总结结核病和艾滋病毒污名在南非造成了严重的发病率和死亡率。尽管治愈了结核病的治疗和抑制艾滋病毒病毒载量的抗逆转录病毒疗法，这两种疾病继续在低收入和中等收入国家。耻辱是关爱、参与和治疗的重大障碍对艾滋病毒和结核病的坚持。交叉污名理论承认身份的无限组合造成耻辱和社会抹杀。然而，这种社会建构的整体方法并不容易转化为测量科学。申请人提出的研究，探索疾病身份的影响通过护理连续体的跨部门污名，将解决这一差距。这个项目的目的是通过护理连续体探索交叉的结核病/艾滋病毒污名，以确定艾滋病毒病毒抑制，结核病培养/涂片转换代表了疾病身份的变化，减轻了耻辱。目标1将量化使用Van RIE患者对结核病/HIV量表的看法和使用重复测量的方差分析得出结核病/HIV污名评价柱头随时间变化的意义。在目标2中，申请者将使用深入的定性访谈以探索在整个护理连续过程中交叉污名的细微差别和变异南非结核病和艾滋病毒携带者经历的可能不会在范里岛捕获的情况比例。从定性面试中，申请者将开发和试用另外四到五种工具旨在解决结核病/艾滋病毒污名重叠问题的项目，这些项目没有在《范里报告》的平行项目中得到体现比例。最后，在目标3中，申请人将对定性和定量数据进行解释和整合，以创建加深对南非跨部门结核病/艾滋病毒污名的了解，并评估其对治疗的影响整个护理过程中的参与度。申请者将使用本提案中的数据来改进南非污名测量的准确性。这项研究将为未来在全球的职业生涯奠定基础污名分析和干预工作。因此，这是一个令人兴奋的研究计划的重要的第一步减少耻辱，改善全球人口的结核病和艾滋病毒治疗结果。