Patient-provider communication and patient engagement in HIV programs in Mali

马里艾滋病毒项目中患者与提供者的沟通和患者参与

• 批准号: 8993282
• 负责人: Emily Anne Hurley
• 金额: $ 4.31万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-11-16 至 2018-11-15
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8993282
• 关键词: Address; Adherence; Africa South of the Sahara; Appointment; Area; Attention; Behavioral; Biological; Caring; Client satisfaction; Clinical; Code; Communication; Country; Data; Data Analyses; Discipline of Nursing; Disease; Doctor of Philosophy; Educational Curriculum; Educational Intervention; Educational process of instructing; Effectiveness; Enrollment; Epidemic; Fellowship; Focus Groups; Foundations; Future; Goals; HIV; Health; Income; International; Intervention; Interview; Language; Learning; Life; Link; Literature; Mali; Measures; Medical; Methods; Modeling; Nature; Nursing Schools; Outcome; Patient Preferences; Patient-Centered Care; Patients; Pharmaceutical Preparations; Primary Health Care; Provider; Public Health Schools; Qualitative Methods; Reaction; Regression Analysis; Reporting; Research; Research Design; Research Personnel; Role; School Nursing; Services; Site; Students; Surveys; Testing; Training; Universities; Variant; antiretroviral therapy; base; design; experience; follow-up; improved; medical schools; patient oriented; programs; psychosocial; public health relevance; skills; social; theories; therapy adherence

 DESCRIPTION (provided by applicant): Specific Aims: The goal of this study is to collect formative data that will provide a foundation for future interventions to improve patient engagement in antiretroviral therapy (ART) programs in Mali through targeted improvements in provider communication skills. Specifically, the study aims to (1) examine the nature and content of patient-provider communication (PPC) and how it influences patient engagement in ART programs and (2) measure patient preferences toward different styles of PPC. Significance: As access to ART in sub-Saharan Africa expands, optimizing patient engagement in ART programs becomes increasingly important. Mali's 12-month retention rate of ART patients is one of the lowest in the region at 64%. Recently, there has been growing attention to the role of PPC in patient retention and adherence in ART programs in sub-Saharan Africa. Positive effects of implementing pre- service PPC trainings have been documented in medical and nursing schools in high-income countries, yet similar trainings in sub-Saharan Africa are limited or non-existent. Integrating PPC training interventions in medical and nursing curricula is a potentially effective and sustainable opportunity to improve patient engagement in ART programs. Formative research for such efforts is needed. Approach: This study will build of the applicant's previous experience in Mali and partnership with the University of Bamako. It will be based at three major clinical ART sites. This mixed method study with a foundation in patient-centered care theory. Aim 1 will be achieved with qualitative interviews and focus groups with people living with HIV and ART clinical providers. This qualitative data will be analyzed with thematic coding and conversation analysis. Aim 2 will be achieved through a factorial survey that will test ART patient reactions to systematic variations of communication styles in video vignettes. Multiple regression analyses will be used to analyze the data. Fellowship Information: This study will serve as the doctoral dissertation for Ms. Emily Hurley, a current PhD student in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Ms. Hurley has chosen one primary sponsor and three co-sponsors who have complementary expertise in the methods and topics of this project. The training plan is designed with research, coursework and teaching opportunities to help Ms. Hurley achieve her long-term goal of becoming a leading researcher in the social, cultural, and behavioral aspects of primary health care and HIV in sub-Saharan Africa.

 描述（由申请人提供）：具体目的：本研究的目标是收集形成性数据，为未来的干预措施提供基础，通过有针对性地改善提供者的沟通技能，改善马里患者参与抗逆转录病毒治疗（ART）计划。具体而言，本研究旨在（1）检查患者-提供者沟通（PPC）的性质和内容，以及它如何影响患者参与ART计划和（2）测量患者对不同类型PPC的偏好。意义：随着撒哈拉以南非洲地区获得抗逆转录病毒治疗的机会扩大，优化患者参与抗逆转录病毒治疗计划变得越来越重要。马里抗逆转录病毒疗法患者12个月的保留率留存率为64%，是该地区最低的国家之一。最近，人们越来越关注PPC在撒哈拉以南非洲ART项目中患者保留和依从性方面的作用。在高收入国家的医学院和护士学校中，实施职前PPC培训的积极效果已被记录在案，但在撒哈拉以南非洲，类似的培训有限或根本不存在。将PPC培训干预纳入医疗和护理课程， 这是一个潜在的有效和可持续的机会，以改善患者参与ART计划。需要对这种努力进行形成性研究。方法：这项研究将建立申请人以前在马里的经验和与巴马科大学的伙伴关系。它将设在三个主要的临床ART地点。这种混合方法的研究与以病人为中心的护理理论的基础。目标1将通过与艾滋病毒感染者和抗逆转录病毒疗法临床提供者进行定性访谈和焦点小组来实现。这些定性数据将被分析与主题编码和会话分析。目标2将通过析因调查来实现，该调查将测试ART患者对视频小插曲中通信风格的系统变化的反应。将使用多元回归分析来分析数据。研究金信息：这项研究将作为艾米丽赫尔利女士的博士论文，她目前是约翰霍普金斯彭博公共卫生学院国际卫生系的博士生。赫尔利女士选择了一个主要赞助商和三个共同赞助商，他们在这个项目的方法和主题方面具有互补的专门知识。该培训计划旨在提供研究，课程和教学机会，以帮助赫尔利女士实现她的长期目标，成为撒哈拉以南非洲初级卫生保健和艾滋病毒的社会，文化和行为方面的领先研究人员。