Feasibility and acceptability of Enhanced Patient Care (EPC) for adult HIV patients with unsuppressed viral loads in western Kenya

项目总结 撒哈拉以南非洲(SSA)在提供和接受抗逆转录病毒疗法(ART)方面取得了巨大进展。 在艾滋病毒感染者中。尽管取得了这些进展，但该区域的遵从率仍然很低。 以及在艾滋病毒护理的级联过程中的保留。在与患者进行有效的ART坚持对话的同时 在连续护理过程中纳入针对患者的干预措施是提高患者对艾滋病毒参与度的关键 关心。不幸的是，系统层面的因素，如等待时间长、人员短缺、提供商缺乏连续性- 病人关系，糟糕的提供者沟通技巧，以及不方便的门诊时间，造成了ART的障碍 坚持不懈。解决这些系统层面的障碍是提供有利的以患者为中心的护理系统的根本 帮助患者坚持艺术，克服其他人际和个人护理障碍。我的长期目标是 成为一名独立的实施科学研究员，成功地开发、实施和评估 多层次干预措施，以解决系统一级阻碍患者参与艾滋病毒护理的障碍。这款K43将为我提供 以及实现这些研究目标所需的额外培训和初步数据。我的培训重点是：1. 实施科学，2.先进的量化研究方法，3.健康的经济评估 干预措施。为了做到这一点，我将借鉴由主要导师艾拉博士领导的导师团队的专业知识。 威尔逊(美国布朗大学)和亚伯拉罕·西卡(肯尼亚莫伊大学)，两人都有丰富的经验 指导初级调查员。我的指导团队由具有临床专业知识的健康专业人员组成。 研究、实施科学、以患者为中心的护理、流行病学、生物统计学和经济评估 艾滋病毒护理环境中的干预。K43奖助金的授予和完成将为我提供坚实的基础 与其他有经验的调查人员合作竞争R01，将我的研究扩展到专注于多 在以患者为中心的框架内促进患者参与护理的水平方法，该框架结合了其他 慢性病。我之前的培训、研究经验和指导团队使我处于战略地位 实现我的研究目标。

PROJECT SUMMARY Sub-Saharan Africa (SSA) has made tremendous strides in the provision and uptake of antiretroviral therapy (ART) among HIV-infected persons. Despite these advancements, the region continues to experience low rates of adherence and retention along the cascade of HIV care. Initiating effective ART adherence dialogue with patients while incorporating patient-specific interventions along the continuum of care is key to improving patient engagement in HIV care. Unfortunately, system-level factors such as long waiting times, staff shortages, lack of continuity in provider- patient relationship, poor provider communication skills, and inconvenient clinic hours create barriers to ART adherence. Addressing these system-level barriers is fundamental to provide a conducive patient-centered care system that help patients adhere to ART and overcome other interpersonal and individual barriers to care. My long-term goal is to become an independent implementation science researcher who successfully develops, implements and evaluates multilevel interventions to address system-level barriers to patient engagement in HIV care. This K43 will provide me with the additional training and preliminary data necessary to achieve these research goals. My training will focus on: 1. Implementation science, 2. Advanced quantitative research methods, and 3. Economic evaluation of health interventions. To accomplish this, I will draw from the expertise of my mentorship team lead by primary mentors Drs. Ira Wilson (Brown University, USA) and Abraham Siika (Moi University, Kenya), both of whom have a wealth of experience mentoring junior investigators. My mentorship team is comprised of health professionals who have expertise in clinical research, implementation science, patient-centered care, epidemiology, biostatistics, and economic evaluation of interventions in HIV care settings. The award and completion of this K43 grant will provide me with a strong foundation to compete for an R01 in collaboration with other experienced investigators to extend my research to focus on multi- level approaches to promote patient engagement in care within a patient-centered framework that incorporates other chronic diseases. My prior training, research experience, and mentorship team, places me in a strategic position to achieve my research goals.