Building Research Capacity for Mental Health Nursing to Support Healthy Aging Among People Living with HIV in Kilimanjaro, Tanzania

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PROJECT SUMMARY / ABSTRACT Mental health disorders affect more than 1 billion people globally, accounting for 7% of all global burden of disease and 19% of all years lived with disability. This burden is even higher among older adults and among people living with HIV (PLWH), two groups that face unique challenges in their emotional and physical health. Tanzania is a lower-middle income country with the world’s fifth largest population of PLWH. Currently, 41% of PLWH receiving care at Kilimanjaro Christian Medical Centre (KCMC) are age 50 or older, and this percentage is steadily rising. Our recent work shows that PLWH in Tanzania experience extremely high rates of mental health challenges, including depression, anxiety, and suicidality. Regional studies suggest the mental health burden is even greater among older adults living with HIV (OALWH). For the past 10 years, our Fogarty-funded project, “Sociobehavioral Sciences Research to Improve Care for HIV Infection in Tanzania” (D43 TW009595, PI: Mmbaga) has developed crucial mental health research and treatment capacity at KCMC and its affiliated Medical College. However, the grant has not yet addressed gaps in research training for nurses, particularly in the key areas of mental health, HIV, and aging. The objective of this supplement is to train nurse-scientists at KCMC capable of leading clinical research addressing mental health challenges for older adults in HIV care. In Aim 1, we will provide three mental health nurses with advanced, specialized training to design and conduct research addressing the mental health aspects of HIV and aging. There is currently one Master’s-trained mental health nurse at KCMC, who recently began a Ph.D. program in Nursing. We will support this trainee and two additional nurses with monthly group didactic sessions and biweekly individual mentoring focused on building research skills. Trainees will also be supported to enroll in a formal, research-focused course of study at a regional university. Research skills will be further emphasized during a two-week summer institute at Duke University, where trainees will engage in structured mentoring with global leaders in nursing science. In Aim 2, we will support trainees to apply their research training by leading a two-day professional development workshop for nurses at KCMC and assessing outcomes in a mixed-methods program evaluation study. In this final Capstone project, trainees will design, deliver, and rigorously evaluate a two-day professional development workshop for KCMC nurses focused on building skills for screening, clinical assessment, safety planning, brief counseling support, and appropriate referral for mental health challenges among OALWH. The evaluation will include pre- and post-workshop qualitative interviews and quantitative assessments of knowledge and skills. At the conclusion of this project, we anticipate submitting an application for competitive renewal of the parent D43 grant with a focus on building research capacity to address mental health among OALWH. Trainees will also receive support to pursue independent research careers to address mental health among OALWH, including assistance with the preparation of K43 Emerging Global Leader Award proposals.