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）项目的延续和拟议扩展，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、新的研究和额外培训，以建立药物滥用研究、丙型肝炎病毒和肝病以及先进研究方法方面的能力。建议的指导计划在新的方向上扩展了他目前的指导计划，包括一个创新的大型指导计划，新的被指导者来源，基于在线团队的指导工具的开发，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地利用现有的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，解决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，以改善对艾滋病毒护理参与不理想的风险人群的保健赋权和临床结果，包括感染艾滋病毒的药物使用者（男性、女性和变性妇女）和艾滋病毒/丙型肝炎病毒合并感染的妇女。这些扶贫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跨性别妇女队列的基础设施内进行。新的POR的首要主题是调查在治疗结果不良风险最大的人群中参与护理和接受、坚持和坚持抗逆转录病毒治疗（ART）所面临的挑战。这些贫困地区活动将由学员积极参与，并将补充他们的发展计划和向独立过渡。所有的新目标都将在卫生保健授权模型中提出，并将为后续的观察性和介入性护理参与研究提供初步数据。通过有效地利用现有资源、协作、数据和与

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.