Understanding the role of schools in supporting HIV treatment outcomes among HIV infected adolescents

项目总结/摘要 K43新兴全球领导者奖（非临床试验要求）的总体目标是 支持Njuguna博士的研究培训，以发展艾滋病毒研究的独立职业生涯。Njuguna博士是一位 肯尼亚内罗毕肯雅塔国家医院的研究科学家。拟议的工作审查了独特的 在青少年艾滋病毒的背景下，教育和健康之间的交叉。Njuguna博士的培训目标是 获得以人为本的干预开发设计，实施科学（IS），混合 方法和青少年研究。这项工作还将提供与决策者密切合作的机会， 并将她以前获得的临床流行病学技能与真实的世界IS方法联系起来。该提案 利用一个多学科的导师和合作者团队，他们将最终支持Njuguna博士的目标， 成为青少年艾滋病毒研究中富有成效和有影响力的独立调查员。 本计画的研究目标是利用混合式的设计方法，以人为本 深入了解学校环境及其对实现治疗的贡献 目标，并协同和迭代地制定以学校为基础的干预措施，以改善 在校青少年艾滋病毒感染者。越来越多的艾滋病毒携带者存活到 成年这些儿童需要支持，以维持在青春期和整个学校的药物使用， 生活的转变。尽管事实上， 大多数艾滋病毒/艾滋病患者都在学校（包括寄宿学校）就读。这项建议的目的是：1. 评估现有的以学校为基础的结构，以供ALWHIV使用，以及照顾者和ALWHIV的关键决定因素 学校选择决定，2.确定学校相关的病毒抑制和保留在照顾，3. 在选定的学校开展和试行学校工作人员培训和同伴支助干预措施， 结果（可接受性、可行性和适当性）。 据我们所知，这是第一个提出定量描述学校相关因素的研究。 在撒哈拉以南非洲（SSA）的临床结果，并评估影响学校选择ALWHIV的因素。的 这项研究汇集了来自肯尼亚国家教育和卫生部门的不同利益相关者团队 并利用多步骤方法来实现研究目标。这种方法将允许进行严格的干预 开发过程，并为未来R 01中的强有力的协作努力铺平道路，以测试 以学校为基础的一揽子干预措施，以改善在校艾滋病毒携带者的结果，包括病毒抑制， 这可能会使患有其他非艾滋病毒慢性病的青少年受益。Njuguna博士的研究目标 符合她的培训目标，并在此奖项完成后，她将在一个很好的位置， 提交R 01申请以进一步推进ALWHIV研究。

PROJECT SUMMARY/ABSTRACT The overall goal of the proposed K43 Emerging Global Leader Award (non-clinical trials requirement) is to support Dr. Njuguna’s research training to develop an independent career in HIV research. Dr. Njuguna is a research scientist at the Kenyatta National Hospital, Nairobi, Kenya. The proposed work examines the unique intersection between education and health in the context of adolescent HIV. Dr. Njuguna’s training goals are to gain expertise in human centered design for intervention development, implementation science (IS), mixed methods and adolescent research. This work will also provide an opportunity to work closely with policy makers, and link clinical epidemiology skills she has previously acquired with real world IS methods. The proposal leverages a multidisciplinary team of mentors and collaborators who will ultimately support Dr. Njuguna’s goal to become a productive and influential independent investigator in adolescent HIV research. The research goal of this proposal is to use a human centered design approach by utilizing mixed methods research to gain an in-depth understanding of the school environment and its contribution to achieving treatment goals, and to collaboratively and iteratively develop a school-based intervention to improve outcomes among school-going adolescents living with HIV (ALWHIV). There is a growing population of ALWHIV surviving to adulthood. These children need support to sustain medication use during adolescence and across school and life transitions. There is limited evidence on school-based interventions to support treatment, despite the fact that most ALWHIV are enrolled in school (including boarding schools). The Aims of this proposal are: 1.To evaluate existing school-based structures available for ALWHIV and key determinants of caregiver and ALWHIV school choice decisions, 2.To determine school-related correlates of viral suppression and retention in care, 3.To develop and pilot a school staff training and peer support intervention in selected schools for non-health outcomes (acceptability, feasibility and appropriateness). This is the first study to our knowledge to propose to quantitatively characterize school-related correlates of clinical outcomes in sub-Sahara Africa (SSA) and evaluate factors influencing school choice for ALWHIV. The study brings together a diverse team of stakeholders from the Kenyan national Education and Health sectors and utilizes a multi-step approach to achieve study objectives. This approach will allow for rigorous intervention development process, and pave way for a strong collaborative effort in a future R01 to test effectiveness of a school-based intervention package to improve outcomes, including viral suppression, in school-going ALWHIV, that could potentially benefit adolescents with other non-HIV chronic illnesses. Dr. Njuguna’s research goals correspond with her training goals, and at the completion of this award, she will be in an excellent position to submit an R01 application to further advance research in ALWHIV.