Strengthening Families Living with HIV in Kenya

加强肯尼亚艾滋病毒感染者家庭的力量

• 批准号: 10244887
• 负责人: Michael Goodman
• 金额: $ 17.35万
• 依托单位: UNIVERSITY OF TEXAS MED BR GALVESTON
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10244887
• 关键词: Address; Adherence; Adolescent; Adult; Africa South of the Sahara; Anxiety; Area; Behavioral; Businesses; Caregivers; Caring; Child; Child Support; Chronic Disease; Clinic; Clinical; Clinical Data; Communities; Comprehension; Data; Data Analyses; Development; Disease; Economics; Elements; Enrollment; Ensure; Epidemiologic Research Design; Evaluation; Family; Family Violence; Functional disorder; Funding; Future; Goals; Grant; Group Interviews; HIV; HIV-infected adolescents; Health; Health behavior; Household; Income; Intervention; Intervention Studies; Kenya; Knowledge; Learning; Low income; Maternal and Child Health; Mental Depression; Mental Health; Mentors; Mentorship; Modeling; Orphan; Outcome; Participant; Patient Recruitments; Patient Self-Report; Patients; Population; Population Intervention; Post-Traumatic Stress Disorders; Poverty; Problem Solving; Process; Production; Provider; Psyche structure; Psychometrics; Psychosocial Factor; Public Health; Reading; Research; Research Personnel; Research Project Grants; Rural; Savings; Schools; Social support; Socioeconomic Factors; Source; Statistical Data Interpretation; Street Child; Support Groups; Testing; Training; Trust; Tuberculosis; United States National Institutes of Health; Violence; Viral; Viral Load result; base; behavioral health; care outcomes; career; career development; clinical care; cohort; community clinic; community reintegration; cost; design; early childhood; empowerment; epidemiology study; expectation; experience; follow-up; food insecurity; food security; health care delivery; implementation science; improved; informant; insight; intervention mapping; meetings; member; migration; novel; post intervention; post-traumatic stress; prevent; programs; psychologic; randomized trial; skills; social; social capital; social epidemiology; social exclusion; symposium; synergism; therapy design; therapy development; violence prevention; viral transmission; vulnerable adolescent

PROJECT SUMMARY/ABSTRACT HIV is a social disease with biomedical implications, wreaking havoc on families and communities far beyond what can be addressed in clinics alone. The majority of research and intervention funding goes towards clinical care to suppress viral transmission. Behavioral, social, economic and psychological consequences and determinants of HIV progression go largely unaddressed in global funding priorities. Families with HIV experience more violence, poverty, food insecurity, dysfunction, social exclusion and street- migration by their children than families who are not living with HIV. Research is required to determine the most effective, low-cost and scalable mechanisms to address the wide range of factors unaddressed by clinical care. This project adapts our intervention, Kuja Pamoja (“Come Together”), to empower families living with HIV. We developed Kuja Pamoja in the broader population in rural Kenya to prevent street-migration of children and support community reintegration of former street children. Kuja Pamoja-HIV will utilize a group- savings model to develop social capital (e.g. trust, expectations of mutual benefit and normative influence). Accrued social capital is then leveraged to address a wide range of determinants (e.g. economic and food insecurity, family violence and dysfunction, social exclusion, and ART adherence), mental health (e.g. reduce depression, anxiety and post-traumatic stress), and behavioral health (e.g. improved retention in care and ART adherence). Among families living with HIV, we aim to improve mental health and viral suppression among adolescents and adults with HIV. The project will develop a new care model that can scale across low-income settings and improve HIV-related outcomes. If successful, the model will provide a template to improve health care delivery and outcomes in other areas – e.g. Maternal/child health, chronic disease conditions, and tuberculosis. The project also contributes to my career development. A well-established team of mentors and advisors will serve to advance my career by guiding me through coursework, reading, conferences, and other sources of professional research networking to ensure that I gain essential research skills, mental health and clinical knowledge, and improved understanding of the determinants of health. Specifically, I will undergo mentored coursework in implementation science, intervention mapping, mental health, interventions to improve economic and food security, and advanced skills in statistical analysis and epidemiological research design. I will meet with established researchers with NIH funding. Through these activities, I will receive mentorship and formal training in grantsmanship, longitudinal data analysis, cohort retention, intervention development and mapping, implementation science and improved comprehension of family violence and mental health. The career development portion plus the research project will lead to the development of a competitive R01 application.

项目总结/摘要 艾滋病毒是一种具有生物医学影响的社会性疾病， 这些都是诊所无法解决的问题大部分研究和干预资金都花在了 用于临床治疗以抑制病毒传播行为、社会、经济和心理 全球供资优先事项基本上没有处理艾滋病毒进展的后果和决定因素。 感染艾滋病毒的家庭经历更多的暴力、贫困、粮食不安全、功能失调、社会排斥和街头暴力。 与未感染艾滋病毒的家庭相比，儿童移民的人数更多。需要进行研究以确定 最有效、低成本和可扩展的机制，以解决临床未解决的广泛因素 在乎该项目调整了我们的干预措施，Kuja Pamoja（“走到一起”）， 艾滋病。我们在肯尼亚农村更广泛的人群中开发了Kuja Pamoja，以防止 儿童和支持前街头儿童重返社区。Kuja Pamoja-HIV将利用一组- 储蓄模式，以发展社会资本（如信任、互利期望和规范影响）。 累积的社会资本然后被用来解决一系列广泛的决定因素（如经济和粮食）。 不安全感、家庭暴力和功能障碍、社会排斥和抗逆转录病毒疗法依从性）、心理健康（例如减少 抑郁、焦虑和创伤后应激）和行为健康（例如，改善护理和抗逆转录病毒治疗的保留率 坚持）。在感染艾滋病毒的家庭中，我们的目标是改善心理健康和病毒抑制， 青少年和成年艾滋病毒感染者。该项目将开发一种新的护理模式，可以在低收入人群中推广。 并改善与艾滋病毒有关的成果。如果成功，该模型将为改善健康提供模板 其他领域的保健服务和成果-如妇幼保健、慢性疾病状况， 结核 该项目也有助于我的职业发展。一个完善的导师团队， 顾问将通过指导我完成课程作业、阅读、会议和其他活动来促进我的职业发展。 专业研究网络的来源，以确保我获得必要的研究技能，心理健康和 临床知识，并提高对健康决定因素的认识。具体来说，我将接受 实施科学，干预绘图，心理健康，干预措施，以改善 经济和粮食安全以及统计分析和流行病学研究设计方面的先进技能。我 将与NIH资助的知名研究人员会面。通过这些活动，我将得到指导， 正规培训，包括研究、纵向数据分析、队列保留、干预措施制定和 规划、实施科学和提高对家庭暴力和心理健康的理解。的 职业发展部分加上研究项目将导致一个有竞争力的R 01的发展 应用程序.