Traditional Healers as Adherence Partners for PLHIV in Rural Mozambique

传统治疗师是莫桑比克农村地区艾滋病毒感染者的依从伙伴

• 批准号: 9070781
• 负责人: Carolyn Audet
• 金额: $ 16.4万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9070781
• 关键词: AIDS/HIV problem; Address; Adherence; Adult; Adverse effects; Advocate; Africa South of the Sahara; Appointment; Attitude; Award; Behavior; Belief; Caring; Centers for Disease Control and Prevention (U.S.); Chronic Disease; Clinic; Clinical; Collaborations; Communities; Community Health; Counseling; Country; Coupled; Crowding; Development; Diagnosis; Disclosure; Disease; Effectiveness; Enrollment; Ensure; Experimental Designs; Faculty; Family; Fellowship; Focus Groups; Food; Fostering; Friends; Fright; Funding; Future; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Health; Health Personnel; Health Services; Health care facility; Health system; Healthcare; Healthcare Systems; Herb-Drug Interactions; Institution; Intervention; Interview; K-Series Research Career Programs; Knowledge; Language; Leadership; Life; Link; Malaria; Measures; Medical; Mentored Research Scientist Development Award; Mentors; Michigan; Modeling; Mozambique; NIH Program Announcements; National Institute of Mental Health; Nurses; Outcome; Patient Preferences; Patient-Focused Outcomes; Patients; Perception; Persons; Pharmaceutical Preparations; Pharmacy facility; Physicians; Policies; Population; Positioning Attribute; Pregnant Women; Prevalence; Prevention; Provider; Province; Public Health; Quality of Care; Recruitment Activity; Reporting; Research; Research Personnel; Research Training; Rural; Rural Community; Scientist; Self Care; Self Efficacy; Series; Services; Site; Surveys; System; Testing; Time; Traditional Birth Attendants; Traditional Medicine; Training; Training Programs; Transportation; Trust; Tuberculosis; Universities; Viral Load result; Visit; Work; antiretroviral therapy; arm; career; clinical research site; compliance behavior; design; field study; follow-up; gender-based violence; global health; improved; innovation; interest; intervention effect; medically underserved; member; men; novel; post intervention; preference; professor; programs; role model; skills; social stigma; stem; success; therapy adherence; treatment adherence; tuberculosis treatment; uptake; willingness

 DESCRIPTION (provided by applicant): This career award application seeks to foster the development of Dr. Audet's career as an independent global health researcher. With the support from an NIMH K01 award, Dr. Audet plans to develop a harmonized health system linking complementary and allopathic providers to improve HIV outcomes in countries in under- resourced countries. Dr. Audet's goals are to improve and formalize relationships between allopathic and alternative providers to improve adherence among patients with HIV disease, with a geographic focus in Mozambique. High rates of HIV infection in central Mozambique (12.5%) coupled with high rates of loss to follow up among patients (50%) have resulted in a public health crisis. Major barriers to HIV treatment adherence have been fear of disclosure/ stigma, patient misunderstanding/ not believing their diagnosis, poor perceived treatment at the health facility and patient preference for traditional medicine. Healers are ideally positioned to support patient adherence by: (1) maintaining confidentiality and/or assisting with partner disclosure; (2) explaining HIV using local languages and in local cultural context; (3) advocating for their health at clinical sites; and (4) ensuring patients do not abandon care for traditional medicines. The applicant, Dr. Carolyn Audet, an Assistant Professor at Vanderbilt University, has been in the forefront of Mozambique's attempt to engage healers in a culturally appropriate manner. Her interest in working with healers to improve patient health outcomes has led to the development of National level Ministry of Health referral forms, as healers are `task shifting' int community health agents. In collaboration with the Ministry of Health, she has field-tested referral forms and training programs, establishing that healers can effectively partner with the Ministry. She is also the PI of two grants: a CDC-funded grant to improve clinical delivery of positive prevention messages among clinicians in rural Mozambique and a ViiV Health Care grant to engage men and traditional birth attendants to improve uptake of ART among HIV infected pregnant women. Responsive to NIMH's K01 program announcement, Dr. Audet seeks `protected time' for pursuing a career as an independent scientist. She will engage in additional training in the design and implementation of health messaging interventions to address culturally entrenched beliefs and behaviors at Vanderbilt University and University of Michigan (with her co-primary Mentor Dr. Amico). Dr. Audet aims to provide on-site research leadership to current funded initiatives coupled with ongoing research training and capacity building efforts at the collaborating institutions, with whom her partnerships will focus on developing a sustainable, practical, and effective relationship between traditional healers and the health care system.

 描述（由申请人提供）：此职业奖申请旨在促进Audet博士作为独立全球健康研究人员的职业发展。在NIMH K 01奖的支持下，Audet博士计划建立一个协调的卫生系统，将补充和对抗疗法提供者联系起来，以改善资源不足国家的艾滋病毒结果。Audet博士的目标是改善对抗疗法和替代提供者之间的关系并使其正规化，以提高艾滋病毒患者的依从性，重点是莫桑比克。莫桑比克中部艾滋病毒感染率高（12.5%），加上病人失访率高（50%），导致公共卫生危机。坚持艾滋病毒治疗的主要障碍是害怕披露/污名化、病人误解/不相信自己的诊断、保健设施的治疗效果差以及病人偏爱传统医学。治疗师的理想定位是通过以下方式支持患者坚持治疗：（1）保密和/或协助伴侣披露;（2）使用当地语言和当地文化背景解释艾滋病毒;（3）在临床现场倡导他们的健康;（4）确保患者不会放弃传统药物的护理。 申请人Carolyn Audet博士是范德比尔特大学的助理教授，她一直在莫桑比克努力以文化上适当的方式聘用治疗师。她对与治疗师合作改善病人健康结果的兴趣促使卫生部制定了国家一级的转诊表，因为治疗师在社区卫生工作者中“转移任务”。她与卫生部合作，对转诊表和培训方案进行了实地测试，确定治疗师可以与卫生部有效合作。她还是两项赠款的主要负责人：一项是由疾病预防控制中心资助的赠款，用于改善莫桑比克农村临床医生积极预防信息的临床传播，另一项是ViiV保健赠款，用于让男子和传统助产士参与，以改善艾滋病毒感染孕妇接受抗逆转录病毒治疗的情况。 响应NIMH的K 01计划公告，Audet博士寻求“受保护的时间”追求作为一个独立的科学家的职业生涯。她将参与设计和实施健康信息干预措施的额外培训，以解决范德比尔特大学和密歇根大学（与她的共同主要导师Amico博士）的文化根深蒂固的信仰和行为。Audet旨在为当前资助的计划提供现场研究领导，并在合作机构进行持续的研究培训和能力建设工作，她的合作伙伴关系将专注于发展传统治疗师和医疗保健系统之间的可持续，实用和有效的关系。