Mentoring and Empowerment in the Context of HIV Care for At-Risk Populations

描述（由申请人提供）：本K24申请的目的是支持马洛里约翰逊博士在社会和行为方法方面的指导和以患者为导向的研究（POR）计划的延续和拟议扩展，以优化吸毒人群中艾滋病毒护理的参与。候选人提出新的指导，新的研究和额外的培训，以建立在药物滥用研究，HCV和肝病，以及先进的研究方法的能力。拟议的指导计划将他目前的指导计划扩展到新的方向，包括创新的大型指导计划，新的学员来源，开发在线团队指导工具，以及指导最佳实践的奖学金。这些计划强调了通过利用和战略性利用现有NIH资助的研究网络、培训计划和资助机制提供的数据、基础设施和专业知识，在预算限制期间成功过渡到独立的挑战的重要性。提出了新研究的三个目标，这将为未来的干预措施提供数据，以改善医疗保健能力和艾滋病毒护理次优参与风险人群的临床结果，包括艾滋病毒感染的物质使用者（男性，女性和变性女性）和艾滋病毒/HCV合并感染的女性。这些POR活动将在妇女机构间健康研究（WIHS），CFAR综合临床系统网络（CNICS）和由候选人的一名学员领导的变性妇女队列的基础设施内进行。新POR的首要主题是调查在治疗效果不佳的风险最大的人群中参与抗逆转录病毒治疗（ART）的护理和吸收，持久性和依从性的挑战。这些POR活动将涉及学员的积极参与，并将补充他们的发展计划和向独立的过渡。所有新目标都将纳入保健赋权模式，并将为随后的参与保健的观察性和干预性研究提供初步数据。通过有效利用现有资源、协作、数据和与 NIH资助的网络，该应用程序的总体目标是支持早期职业调查人员，新导师的发展，并为我自己的培训/能力建设提供机会，并促进在高危人群中参与艾滋病毒护理领域的新项目。

DESCRIPTION (provided by applicant): The purpose of this K24 application is to support the continuation and proposed expansions of Dr. Mallory Johnson's programs of mentoring and patient-oriented research (POR) in social and behavioral approaches to optimizing engagement in HIV care among drug-using populations. The candidate proposes new mentoring, new research, and additional training to build competency in drug abuse research, HCV and liver disease, and advanced research methodologies. The proposed plan for mentoring expands his current mentoring program in new directions, including an innovative grand mentoring program, new sources of mentees, development of online team-based mentoring tools, and scholarship in best practices of mentoring. These plans emphasize the importance of addressing challenges to successful transition to independence during periods of budgetary constraint through the leveraging and strategic use of data, infrastructure, and expertise available through existing NIH-funded research networks, training programs, and funding mechanisms. Three aims for new research are proposed, which will provide data for future interventions to improve health care empowerment and clinical outcomes for populations at risk for suboptimal engagement in HIV care, including HIV-infected substance users (men, women, and transgender women) and HIV/HCV co-infected women. These POR activities will be conducted within the infrastructure of the Women's Interagency Health Study (WIHS), the CFAR Network of Integrated Clinical Systems (CNICS) and a cohort of transgender women led by one of the candidate's mentees. The overriding theme of the new POR is to investigate the challenges of engagement in care and uptake, persistence, and adherence, to antiretroviral therapy (ART) among populations at greatest risk for poor treatment outcomes. These POR activities will involve active participation by mentees and will complement their development plans and transitions to independence. All of the new aims will be framed in the Model of Health Care Empowerment and will provide preliminary data for subsequent observational and interventional studies of engagement in care. Through the efficient leveraging of existing resources, collaborations, data, and affiliations with NIH-funded networks, the overarching goal of this application is to support the development of early career investigators, new mentors, and to provide opportunities for my own training/competency-building, and to catalyze new projects in the area of engagement in HIV care among at- risk populations.