Identifying Factors to Improve Dental and Mental Health Care among People with HIV

确定改善艾滋病毒感染者牙科和心理保健的因素

• 批准号: 10906440
• 负责人: LARRY K BROWN
• 金额: $ 77.35万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-22 至 2024-09-21
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10906440
• 关键词: Acquired Immunodeficiency Syndrome; Adherence; Adoption; Anxiety; Behavior assessment; Behavioral; Boston; Bruxism; Candidiasis; Caregiver Burden; Caring; Clinic; Clinical; Communicable Diseases; Cross-Sectional Studies; Data; Dental; Dental Care; Dental Clinics; Dental Hygiene; Dental caries; Dentists; Discrimination; Disease; Drug Prescriptions; Dysplasia; Effectiveness; Evaluation; Focus Groups; Food; Fright; HIV; HIV/AIDS; Health; Health Care Costs; Health Personnel; Healthcare; Hemorrhage; Impairment; Individual; Interview; Lead; Leukoplakia; Longitudinal Studies; Maps; Mental Depression; Mental Health Services; Mental disorders; Methods; Modeling; Morbidity - disease rate; Mucous Membrane; Nature; Oral; Oral health; Oral mucous membrane structure; Outcome; Participant; Patients; Periodontal Diseases; Periodontitis; Persons; Pharmaceutical Preparations; Provider; Psychiatric therapeutic procedure; Quality of life; Recommendation; Research; Salivary Gland Diseases; Social support; Structure; Substance Use Disorder; Surveys; Symptoms; System; Time; Tooth Attrition; Tooth Loss; Ulcer; Validation; Viral Load result; Work; Xerostomia; acceptability and feasibility; barrier to care; behavioral health; care coordination; care providers; cost; craving; future implementation; illicit drug use; implementation intervention; implementation strategy; improved; member; mortality; neglect; oral condition; oral lesion; prevent; programs; prospective; protective factors; psychiatric symptom; response; screening; social; social stigma; substance misuse; substance use; substance use treatment; system-level barriers

Project Summary Identifying Factors to Improve Dental and Mental Health Care among People with HIV Impaired oral health and psychiatric disorders, including substance use, disproportionally impact people with HIV and AIDS (PWH). Conditions such as dental caries, salivary gland disease, ulcers, periodontitis, leukoplakia, and candidiasis are associated with HIV and can negatively impact quality of life. Depression, anxiety, substance use and other psychiatric disorders in PWH are also associated with more dental problems and unmet oral health needs. In addition, patient, provider, and system barriers interfere with the receipt of oral health care for PWH. HIV care, behavioral health care, and dental care are largely siloed, making it difficult for different health care clinics and different professionals to work together to provide coordinated care. There is great need to investigate further how individual and system-level barriers, behavioral health, and oral health intersect for PWH. In response to RFA-DE-23-002, this proposed project will conduct biannual assessments over two years of 400 PWH, from the Providence/Boston Center for AIDS Research HIV clinics, to identify modifiable individual and system-level barriers and facilitators for engagement and adherence in oral, HIV, and behavioral health care. Associations of longitudinal changes in oral, behavioral, and HIV symptoms and their relationships with barriers and facilitators will also be examined. In addition, in-depth interviews with 40 PWH from the longitudinal study, and 20 health care workers (from dental, behavioral, and HIV clinical settings) will provide further details on the nature of the barriers and facilitators to care, and suggest opportunities for improvement. Using this combined quantitative and qualitative data, strategies will be selected for clinic-based programs to improve oral and behavioral health care among PWH. Member checking, also known as participant validation, will examine the feasibility and acceptability of the selected strategies and actions through focus groups with 20 PWH from the longitudinal study and 10 health care workers from dental, behavioral, and HIV clinical settings. This will be one the largest, in-depth, prospective assessments to date of oral health among PWH that assesses behavioral health and other factors that directly influence oral health outcomes. These results will directly inform a research agenda beyond this study to improve oral and behavioral health among PWH.

项目摘要 确定艾滋病毒患者之间改善牙科和心理保健的因素 口腔健康和精神疾病受损，包括使用物质，不成比例 影响艾滋病毒和艾滋病（PWH）的人。龋齿，唾液腺等疾病 疾病，溃疡，牙周炎，白细胞和念珠菌病与HIV有关，可以 负面影响生活质量。抑郁，焦虑，吸毒和其他精神病学 PWH中的疾病还与更多的牙齿问题和未满足的口腔健康需求有关。 此外，患者，提供者和系统障碍会干扰接受口腔医疗保健的 PWH。艾滋病毒护理，行为医疗保健和牙科护理在很大程度上是孤立的，这使得很难 不同的医疗保健诊所和不同的专业人员共同努力以提供协调 关心。非常需要进一步调查个人和系统级别的障碍， 行为健康和口腔健康相交的PWH。为了回应RFA-DE-23-002， 拟议的项目将在两年的400 PWH中进行两年一次的评估，从 普罗维登斯/波士顿艾滋病研究艾滋病毒诊所中心，以确定可修改的个体和 系统级别的障碍和辅助因子，用于口服，艾滋病毒和行为 卫生保健。口服，行为和艾滋病毒症状的纵向变化的关联以及 他们与障碍和促进者的关系也将进行检查。另外，深入 纵向研究中对40个PWH的访谈，以及20名卫生保健工作者（来自牙科， 行为和艾滋病毒临床环境）将提供有关障碍性质的更多详细信息 促进者要照顾，并提出改进的机会。使用此组合定量 和定性数据，将选择基于诊所的计划以改善口头的策略 PWH中的行为保健。会员检查，也称为参与者验证，将 通过重点检查所选策略和行动的可行性和可接受性 纵向研究中有20个PWH的小组和10名来自牙科的卫生保健工作者， 行为和HIV临床环境。这将是最大的，深入的，潜在的 PWH评估了评估行为健康和其他的评估PWH的评估 直接影响口腔健康结果的因素。这些结果将直接告知一项研究 这项研究以外的议程可以改善PWH之间的口服和行为健康。