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

了解学校在支持艾滋病毒感染青少年的艾滋病毒治疗结果方面的作用

• 批准号: 10053349
• 负责人: Irene Nyambura Njuguna
• 金额: $ 12.27万
• 依托单位: KENYATTA NATIONAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-17 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10053349
• 关键词: Absenteeism; Achievement; Acquired Immunodeficiency Syndrome; Adherence; Adolescence; Adolescent; Adult; Africa; Africa South of the Sahara; Age; Authorization documentation; Award; Caregivers; Caring; Cessation of life; Child; Chronic Disease; Clinic; Clinic Visits; Clinical; Country; Decision Making; Development; Disclosure; Distant; Education; Enrollment; Environment; Fright; Future; Goals; Guidelines; HIV; HIV-infected adolescents; Health; Health Personnel; Health Services Accessibility; Hospitals; Human; Influentials; Infrastructure; Intervention; Interview; Kenya; Life; Link; Maps; Medicine; Mentors; Methods; Nurses; Outcome; Peer Group; Performance; Pharmaceutical Preparations; Policies; Policy Maker; Population; Positioning Attribute; Primary Schools; Privacy; Procedures; Process; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Training; Retrospective cohort study; Role; Sahara; Schedule; School Health Services; School Nursing; School Teachers; School-Age Population; Schools; Scientist; Secondary Schools; Secondary to; Services; Shapes; Stigmatization; Structure; Surveys; Teacher Professional Development; Testing; Training; Training Support; Treatment outcome; United States National Institutes of Health; Viral; Work; aged; antiretroviral therapy; base; career; clinical epidemiology; design; effective intervention; effectiveness testing; experience; group intervention; implementation science; improved; improved outcome; multidisciplinary; peer; peer support; pill; preference; school health; skills; social stigma; teacher; therapy design; therapy development; tool

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.

项目概要/摘要 拟议的 K43 新兴全球领袖奖（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。恩朱古纳博士是 肯尼亚内罗毕肯雅塔国家医院的研究科学家。拟议的工作研究了独特的 青少年艾滋病毒背景下教育与健康的交叉点。 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）、混合设计方面的专业知识 方法和青少年研究。这项工作还将提供与政策制定者密切合作的机会， 并将她之前获得的临床流行病学技能与现实世界的信息系统方法联系起来。提案 利用由导师和合作者组成的多学科团队，他们最终将支持 Njuguna 博士的目标 成为青少年艾滋病毒研究领域富有成效且有影响力的独立研究者。 该提案的研究目标是通过利用混合方法来使用以人为本的设计方法 研究以深入了解学校环境及其对实现治疗的贡献 目标，并协作和迭代地制定基于学校的干预措施，以改善学生的成果 感染艾滋病毒的在校青少年 (ALWHIV)。 ALWHIV 存活率不断增加 成年期。这些儿童需要支持以维持青春期和整个学校的药物使用 生活转变。尽管事实证明以学校为基础的干预措施支持治疗的证据有限 大多数 ALWHIV 都在学校就读（包括寄宿学校）。本提案的目的是： 1. 评估现有的针对 ALWHIV 的学校结构以及护理人员和 ALWHIV 的关键决定因素 学校选择决定，2.确定病毒抑制和护理保留与学校相关的相关性，3. 在选定的非健康学校制定并试点学校工作人员培训和同伴支持干预措施 结果（可接受性、可行性和适当性）。 据我们所知，这是第一项提出定量描述与学校相关的研究 撒哈拉以南非洲 (SSA) 的临床结果并评估影响 ALWHIV 学校选择的因素。这 研究汇集了来自肯尼亚国家教育和卫生部门的多元化利益相关者团队 并利用多步骤方法来实现研究目标。这种方法将允许严格的干预 开发过程，并为未来 R01 中的强有力的协作努力铺平道路，以测试 以学校为基础的干预措施，以改善在校 ALWHIV 患者的结果，包括病毒抑制， 这可能会使患有其他非艾滋病毒慢性疾病的青少年受益。 Njuguna 博士的研究目标 与她的培训目标相符，完成该奖项后，她将处于有利地位 提交 R01 申请以进一步推进 ALWHIV 的研究。