Data Science to Inform Coordinated Behavioral Health and HIV Care Re-Engagement

项目摘要/摘要 让最边缘化的艾滋病毒携带者(PWH)接受治疗对于在世界各地结束艾滋病毒流行至关重要 美国华盛顿州金县的结束艾滋病毒流行(EHE)战略旨在改善艾滋病毒 为有复杂护理障碍的人提供的服务，包括无家可归或住房不稳定，严重的精神障碍 疾病和物质使用障碍。金县的卫生部门开发了一种强有力的信息 与艾滋病毒监测、监狱登记和急诊室就诊数据交换系统，以指导公共卫生 让威尔斯亲王重新参与护理的干预措施(“从数据到护理”)。拟议项目的总体目标是使用 数据科学改善公共卫生数据到护理活动并建立社区参与的伙伴关系 该团队将协作开发一个未来以数据为导向的移动外展和治疗团队，用于高需求的威尔斯亲王医院。 对于目标1，我们将开发和验证一种算法，以确定个别威尔斯亲王医院的优先顺序，以便进行干预以改进 参与艾滋病毒护理和行为健康服务。使用机器学习方法(分类和 回归树模型)，我们将分析&gt；14年的病例调查数据和目前的健康状况 部门信息交换系统。在项目年期间，我们将新整合行为健康和 将住房数据纳入信息交换。在这项工作中，我们将吸收社会各界的意见。 关于我们使用数据进行护理重新参与的合作伙伴。对于目标2，我们将建立一个社区参与的 合作团队，为金县的高需求威尔斯亲王医院开发流动外展和治疗干预。这 团队将包括主要服务机构和卫生部门的代表，以及 经验，和大学研究人员。我们将在社区参与中使用创新框架 实施科学研究，以开发基于自信的移动外展和参与团队 社区治疗方法，使用多学科团队的循证服务提供模式 为患有严重精神病的个人提供以社区为基础的精神卫生治疗。预期中的 该项目的成果包括：1)用于HIV护理重新参与的有效的病例优先排序算法 将立即通知卫生部门数据的干预措施，以帮助护理工作并指导未来的移动通信 外展和治疗团队；2)社区机构、社区成员和LIFE的巩固伙伴关系 Experience、卫生部门和研究人员，他们将协作实施和评估未来 流动外展和治疗团队；以及3)完善的干预、实施战略和实施 研究逻辑模型，用于在拨款提案中研究数据引导的流动外展和治疗团队。

PROJECT SUMMARY / ABSTRACT Engaging the most marginalized people with HIV (PWH) in treatment is crucial to end the HIV epidemic in the U.S. The Ending the HIV Epidemic (EHE) strategy in King County, Washington is designed to improve HIV services for people with complex barriers to care, including homelessness or unstable housing, severe mental illness, and substance use disorders. The health department in King County has developed a robust information exchange system with data from HIV surveillance, jail booking, and emergency room visits to guide public health interventions to re-engage PWH in care (“Data to Care”). The overall goals of the proposed project are to use data science to improve public health Data to Care activities and to establish a community-engaged partnership team that will collaboratively develop a future data-guided mobile outreach & treatment team for high-need PWH. For Aim 1, we will develop and validate an algorithm to prioritize individual PWH for interventions to improve engagement in HIV care and behavioral health services. Using a machine learning method (classification and regression tree models), we will analyze data from >14 years of case investigations and the current health department information exchange system. During the project year, we will newly integrate behavioral health and housing data into the information exchange. Throughout this work, we will incorporate input from our community partners on our use of data for care re-engagement. For Aim 2, we will establish a community-engaged partnership team to develop a mobile outreach & treatment intervention for high-need PWH in King County. This team will include representatives of key service agencies and the health department, people with lived experience, and university researchers. We will use the Transcreation Framework for community-engaged implementation science research to develop a mobile outreach and engagement team based on the Assertive Community Treatment approach, an evidence-based service delivery model that uses a multidisciplinary team to deliver community-based mental health treatment to individuals with severe mental illness. The expected outcomes of this project include: 1) a validated case prioritization algorithm for HIV care re-engagement interventions that will immediately inform health department Data to Care efforts and guide a future mobile outreach & treatment team; 2) a solidified partnership of community agencies, community members with lived experience, the health department, and researchers, which will collaboratively implement and evaluate the future mobile outreach & treatment team; and 3) a refined intervention, implementation strategy, and implementation research logic model to be used in a grant proposal to study the data-guided mobile outreach & treatment team.