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

项目总结/摘要 全球有超过10亿人患有精神疾病，占全球所有精神疾病负担的7%。 疾病和19%的所有年生活残疾。这一负担在老年人和 艾滋病毒感染者（PLWH），这两个群体在情感和身体健康方面面临着独特的挑战。 坦桑尼亚是一个中低收入国家，是世界上第五大艾滋病毒携带者和艾滋病病毒携带者国家。目前，41% 在基利曼哈罗基督教医疗中心接受治疗的艾滋病毒携带者年龄在50岁或以上， 正在稳步上升我们最近的工作表明，坦桑尼亚的艾滋病毒携带者精神疾病的发生率极高， 健康挑战，包括抑郁、焦虑和自杀倾向。区域研究表明， 艾滋病毒感染者中的老年人负担甚至更大（艾滋病毒/艾滋病办公室）。在过去的10年里，我们福格蒂资助的 项目，“改善坦桑尼亚艾滋病毒感染护理的社会行为科学研究”（D43 TW 009595， PI：Mmbaga）在KCMC及其附属机构开发了重要的心理健康研究和治疗能力， 医学院然而，赠款尚未解决护士研究培训方面的差距，特别是在 心理健康、艾滋病和老龄化等关键领域。该补充的目的是培养护士科学家， KCMC能够领导临床研究，解决艾滋病毒护理中老年人的心理健康挑战。在 目标1，我们将为三名精神卫生护士提供先进的专业培训， 研究解决艾滋病毒和老龄化的心理健康方面。目前有一个硕士培训 KCMC的心理健康护士，她最近开始攻读博士学位。在护理方案。我们会支持这位学员 和另外两名护士，每月进行一次小组教学，每两周进行一次个人指导，重点是 培养研究技能。培训生也将得到支持，参加正式的，以研究为重点的学习课程 在一所地区性大学。在为期两周的杜克暑期研究所，研究技能将得到进一步强调 大学，学员将与护理科学的全球领导者进行结构化指导。在目标2中， 我们将通过领导为期两天的专业发展， 在KCMC护士研讨会和评估结果的混合方法程序评估研究。在这 最终顶点项目，学员将设计，交付，并严格评估一个为期两天的专业 KCMC护士的发展研讨会，重点是建立筛查，临床评估，安全 规划，简短的咨询支持，并适当的转介OALWH之间的心理健康挑战。的 评价将包括讲习班前后的定性访谈和对下列方面的定量评估： 知识和技能。在这个项目结束时，我们预计提交一份申请， 更新D43补助金，重点是建立研究能力，以解决心理健康问题， OALWH。学员还将获得支持，以追求独立的研究事业，以解决心理健康问题 此外，还在妇女法律和健康办公室之间开展了一系列活动，包括协助编写K43新兴全球领袖奖提案。

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.