Data-informed Stepped Care (DiSC) to Improve Adolescent HIV Outcomes

以数据为依据的分级护理 (DiSC) 可改善青少年艾滋病毒治疗结果

• 批准号: 10579767
• 负责人: Grace John-Stewart
• 金额: $ 29.97万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-04-06 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10579767
• 关键词: Adherence; Administrative Supplement; Adolescent; Adolescent and Young Adult; Adult; Age; Assessment tool; Biological Assay; Caregiver support; Caregivers; Caring; Childhood; Client; Client satisfaction; Clinic; Clinical; Cluster randomized trial; Consent; Data; Development; Educational workshop; Effectiveness; Effectiveness of Interventions; Enrollment; Ethics; Failure; Family; Frequencies; Funding; HIV; HIV Seropositivity; HIV-infected adolescents; Health Personnel; Health Services; Intensive Care; Intervention; Kenya; Mental Health Services; Modeling; Outcome; Participant; Patients; Policies; Prospective cohort; Research; Resources; Risk; Risk Assessment; Services; Testing; Treatment outcome; Viral; Viral Load result; Wait Time; Work; Workload; base; care outcomes; cofactor; cohort; design; effectiveness evaluation; effectiveness trial; follow-up; improved; improved outcome; insight; multidisciplinary; parent grant; primary outcome; programs; recruit; routine care; secondary outcome; standard of care; therapy development; tool; treatment as usual

ABSTRACT This administrative supplement requests funds to provide viral load assays for DiSC participants to optimize utility of stepped tool and to retain cluster a RCT design that includes viral suppression as an outcome. Our data- informed stepped care (DiSC) intervention assigns adolescents and young adults (AYA) in HIV care in Kenya to different intensities of health services according to their need. To assign AYA to specific services, health care workers use a risk assessment tool to identify AYA needing intensified care. They also identify AYA thriving in HIV care needing less intensive services to enable programs to appropriately allocate limited resources. Unfortunately, viral load supplies have been limited in Kenya resulting in absence of viral load assays for over a year for many AYA HIV care clients. We request budgetary support to cover viral load assays for participating AYA at two points: at enrollment into the trial to inform step allocation and at exit for secondary outcome of viral suppression. This will provide important insights on the effectiveness of the intervention and mechanisms of effectiveness and will add important value to the DiSC RCT. Scientific aims are unchanged.

抽象的 此行政补充要求资金提供病毒负载分析，以使光盘参与者优化 阶梯式工具的实用程序，并保留群集的RCT设计，其中包括病毒抑制作为结果。我们的数据 - 知情的阶梯护理（DISC）干预分配肯尼亚的青少年和年轻人（AYA） 卫生服务的不同强度根据他们的需要。为特定服务分配AYA，医疗保健 工人使用风险评估工具来识别需要加强护理的AYA。他们还确定艾雅在 艾滋病毒护理需要不太密集的服务才能使计划适当分配有限的资源。 不幸的是，肯尼亚的病毒负荷供应受到限制，导致没有病毒负荷测定超过 许多AYA HIV护理客户的一年。我们要求预算支持以涵盖参与的病毒负荷分析 AYA在两个点上：入学时，以告知步骤分配和出口，以获取病毒的次要结果 抑制。这将提供有关干预和机制有效性的重要见解 有效性，并将为光盘RCT增加重要的价值。科学目标没有改变。

项目成果

Data-informed stepped care to improve youth engagement in HIV care in Kenya: a protocol for a cluster randomised trial of a health service intervention.

• DOI: 10.1136/bmjopen-2022-062134
• 发表时间: 2022-10-31
• 期刊: BMJ OPEN
• 影响因子: 2.9
• 作者: Kohler, Pamela;Agot, Kawango;Njuguna, Irene N.;Dyer, Jessica;Badia, Jacinta;Jiang, Wenwen;Beima-Sofie, Kristin;Chhun, Nok;Inwani, Irene;Shah, Seema K.;Richardson, Barbra A.;Chaktoura, Nahida;John-Stewart, Grace
• 通讯作者: John-Stewart, Grace