权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Addressing health and social care needs of older people with HIV suffering from mental health disorders in Georgia

满足格鲁吉亚患有精神健康障碍的艾滋病毒老年人的健康和社会护理需求

基本信息

批准号：
10870232
负责人：
Jack A DeHovitz
金额：
$ 10万
依托单位：
PARTNERSHIP FOR RESEARCH/ACTION/HEALTH
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-22 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10870232
关键词：
Acquired Immunodeficiency Syndrome Address Affect Aging Anxiety Attitude Caring Clinics and Hospitals Communities Community Health Comprehensive Health Care Continuity of Patient Care Country Data Analyses Development Elderly Equipment and supply inventories Future Goals Grant HIV HIV/AIDS Health Health Services Accessibility Health care facility Health system High Prevalence Individual Institution Intervention Interview Location Mental Depression Mental Health Mental Health Services Mental disorders Modeling Outcome Persons Privatization Psychiatric Hospitals Qualitative Research Research Research Design Research Methodology Research Training Services Substance Use Disorder Survey Methodology Surveys Testing Training United States National Institutes of Health alcohol use disorder barrier to care brain health care systems community center design doctoral student expectation experience improved innovation novel person centered service organization service providers skills social social health determinants social stigma therapy development vascular cognitive impairment and dementia virtual

项目摘要

The evidence generated from the current Georgian study (NIH/FIC grant 3D43TW011532-03S1, Vascular contributions to cognitive impairments and dementia (VCID) among people living with HIV in the country of Georgia), demonstrates a high prevalence of depression (50%), anxiety (45%), as well as substance use disorders (SUD; 26%) and alcohol use disorders (AUD; 21%) among OPWH who are >40 years in Georgia. However, significant challenge remains how to provide appropriate person-centered health and social care services to such OPWH in Georgia, which has a post-Soviet health system with services organized within silos. Currently, OPWH receive HIV/AIDS care in a highly centralized and vertical model, but with poorly integrated mental health and virtually non-existent social care services. On the other hand, mental health services are mainly delivered through specialized psychiatric clinics and mental hospitals. It is unclear how these existing service silos can be bridged in order to serve the mental health needs of OPWH who need both mental health as well as HIV care, and need such services in the community, not within institutions. Because Georgia lacks community-based health and social care services and interventions for OPWH; novel person- and community- centered approaches, at both community and health system levels, will need to be developed if OPWH are to receive comprehensive care for their needs. This application is a supplement to Fogarty HIV Research Training Grant (D43TW011532; Strategic Training Partnership to End AIDS in Georgia). We propose to address the negative impact of brain health outcomes on HIV care continuum among OPWH in Georgia. Georgian MPH graduate training will be operationalized via: Aim 1. Advanced didactic training in HIV-aging (focus on mental health disorders, and the related health and social care needs) and mixed methods research (focus on health and social care services), as well as health and social care services survey methods; and Aim 2. Hands-on training in health and social care services survey and data analysis, the goals of which are to: Aim 2.a. Develop an inventory of health and social care services via conducting mental health and social care services survey in relevant public and private healthcare facilities, as well as the respective service provider CBOs/NGOs; Aim 2b. Explore health and social care service needs, barriers to services (e.g., barriers to care at the individual level, the social or interpersonal level, and structural level, including HIV-associated stigma, as well as other social determinants of health affecting access to services), and attitudes and expectations for health and social care services (e.g., acceptability of current services, including setting, location, content, etc.) among OPWH via conducting qualitative research among 28 OPWH (seven in-depth interviews per group of OPWH with (1) depression, (2) anxiety, (3) SUD, (4) AUD). Our results will inform development of interventions to reduce the negative impact of mental health disorders among this target group and improve HIV care continuum in the long term. This project's successful completion will catalyze new research that can focus on designing and testing relevant, innovative interventions using a more rigorous study design (e.g., RCT). These future deliverables will be achieved through HIV-aging-mental health research capacity building of one Georgian trainee, doctoral student with previous experience in HIV research, who will receive advanced didactic and hands-on training in the development of a strategic skillset.

来自当前格鲁吉亚研究的证据(NIH/FIC授权3D43TW011532-03S1，血管中国艾滋病毒携带者对认知障碍和痴呆(VCID)的贡献 (佐治亚州)，抑郁症(50%)、焦虑症(45%)以及吸毒的患病率很高乔治亚州40岁的OPWH患者中有精神障碍(26%)和酒精使用障碍(21%)。然而，重大挑战仍然是如何提供适当的以人为本的保健和社会护理向格鲁吉亚的此类OPWH提供服务，格鲁吉亚有一个后苏联时代的卫生系统，其服务是在竖井内组织的。目前，OPWH以高度集中和垂直的模式接受艾滋病毒/艾滋病护理，但一体化程度较低精神健康和几乎不存在的社会护理服务。另一方面，精神健康服务是主要通过专门的精神科诊所和精神病院提供。目前还不清楚这些生物是如何存在的可以搭建服务筒仓，以满足需要精神健康的OPWH的精神健康需求以及艾滋病毒护理，并需要在社区内而不是在机构内提供此类服务。因为格鲁吉亚缺乏 OPWH以社区为基础的健康和社会护理服务和干预措施；新的个人和社区- 如果OPWH要做到这一点，就需要在社区和卫生系统两级制定以人为本的方法接受全面照顾，照顾他们的需要。本申请是对Fogarty HIV研究培训补助金(D43TW011532；战略培训)的补充在格鲁吉亚结束艾滋病的伙伴关系)。我们建议解决大脑健康结果对以下方面的负面影响佐治亚州妇幼保健院的艾滋病毒护理连续体。格鲁吉亚公共卫生硕士研究生培训将通过：AIM实施 1.艾滋病毒--老龄化方面的高级教学培训(重点关注精神健康障碍以及相关的健康和社会问题保健需求)和混合方法研究(侧重于保健和社会保健服务)以及保健和社会保健服务护理服务调查方法；和目标2.保健和社会护理服务调查和数据方面的实践培训分析，其目标是：目标2.a。通过以下途径制定健康和社会护理服务清单在相关的公共和私营医疗机构进行精神健康和社会护理服务调查，如以及各自的服务提供者社区组织/非政府组织；目标2b。探索健康和社会护理服务需求，服务障碍(例如，个人层面的护理障碍、社会或人际层面的障碍以及结构性障碍一级，包括与艾滋病毒有关的耻辱以及其他影响获得健康的社会决定因素服务)，以及对保健和社会护理服务的态度和期望(例如，对当前服务的可接受性服务，包括设置、位置、内容等)通过在28个OPWH中进行定性研究 OPWH(OPWH每组7次深度访谈，内容包括(1)抑郁、(2)焦虑、(3)SUD、(4)AUD)。我们的结果将为减少精神健康障碍的负面影响的干预措施的发展提供信息在这一目标群体中开展工作，从长远来看，改善艾滋病毒护理的连续性。这个项目的圆满完成将促进新的研究，这些研究可以专注于使用更严格的研究设计(例如，随机对照试验)。这些未来的可交付成果将通过艾滋病毒-老龄化-心理 1名格鲁吉亚实习生、有艾滋病毒研究经验的博士生的卫生研究能力建设研究，谁将接受先进的教学和实践培训，以发展战略技能。