Self-Management among adolescents living with HIV in Uganda

乌干达艾滋病毒感染青少年的自我管理

基本信息

批准号：
10291139
负责人：
Scholastic Ashaba
金额：
$ 10.83万
依托单位：
MBARARA UNIVERSITY/SCIENCE/ TECHNOLOGY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-22 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10291139
关键词：
Address Adherence Adolescence Adolescent Adolescent and Young Adult Adult Africa South of the Sahara Anti-Retroviral Agents Applications Grants Area Award Behavior Therapy Behavioral Behavioral Sciences Caregivers Caring Cause of Death Childhood Clinic Clinical Cognitive Complement Data Development Education Elements Epidemic Focus Groups Funding Goals HIV Health Health Personnel Intervention Interview Knowledge Mediation Mental Depression Mentors Mentorship Outcome Patient Self-Report Peer Review Pharmaceutical Preparations Pharmacy facility Population Preparation Problem Solving Provider Psychiatry Psychosocial Assessment and Care Public Health Qualitative Research Quality of life Randomized Randomized Controlled Trials Research Research Infrastructure Research Personnel Resources Rural Sampling Self Efficacy Self Management Testing Time Training Treatment outcome UNICEF Uganda Viral Viral Load result acceptability and feasibility age group base behavior test care systems career critical developmental period critical period design effectiveness evaluation follow-up improved journal article mortality pill post intervention primary outcome psychoeducation public health relevance randomized trial resilience secondary outcome skills skills training social stigma standard of care success theories treatment adherence

项目摘要

PROJECT SUMMARY/ABSTRACT There are over 73,000 adolescents living with HIV (ALHIV) in Uganda constituting 4% of the worldwide population of ALHIV. HIV remains a leading cause of death among adolescents despite widespread availability of antiretroviral medication. Generally, ALHIV have poor outcomes with higher rates of loss to follow up compared with other age groups. Mortality rates and loss to follow up are highest during the transition period. Transition success may be maximized for ALHIV who are better prepared to negotiate care in adult HIV clinic settings. This preparation can include skills training to improve self-efficacy, resilience, and education to address lack of HIV knowledge, both of which are predictive of better outcomes following transition. Provision of psychosocial support and preparatory information to navigate adult HIV care services have also been associated with successful transition. The overall goal of the proposed K43 application is to complement my clinical background in psychiatry with advanced coursework and focused mentoring in behavioral science and development and testing of behavioral interventions to improve transition in care. This training will enable me to achieve my scientific objective: to develop and test a self-management intervention for ALHIV transitioning to adult HIV care. This training will enable me to achieve my scientific objective: to develop and test a self- management intervention for ALHIV. This application proposes to develop a self-management intervention for ALHIV transitioning to adult HIV care and test the impacts of the intervention on HIV outcomes. Conducting the proposed studies in this application will complement my prior training in psychiatry while filling key gaps in three areas: (a) behavioral science theories and their application to behavioral interventions, (b) adaptation and design of behavioral interventions, and (c) testing of behavioral interventions through randomized trials. To fill these gaps, I will conduct qualitative research to elaborate a conceptual framework of the barriers faced by ALHIV transitioning to adult HIV care in Uganda (Aim 1), develop a self-management intervention that will enable ALHIV to successfully transition to adult HIV care (Aim 2), and assess feasibility, acceptability, and preliminary effects of the self-management intervention on HIV outcomes for ALHIV transitioning to adult HIV care (Aim 3). This study will be the first to develop a self-management intervention targeting the critical transition period from pediatric to adult HIV care in sub-Saharan Africa and the first to use a randomized design to test the effect of a self-management intervention on health outcomes among ALHIV in Uganda who are transitioning to adult HIV care. These findings will have significant public health impact by optimizing health outcomes for a key population in the global HIV epidemic. The proposed research will serve as the basis for a competitive R01 grant proposal, submitted in year 4, to conduct a fully-powered, randomized controlled trial to evaluate the effectiveness of a behavioral intervention to improve retention in care and viral suppression among ALHIV in Uganda who are navigating the critical period of transition to adult HIV care.

项目摘要/摘要乌干达有超过73,000名艾滋病毒（ALHIV）的青少年，占全球4％ Alhiv的人口。尽管广泛可用，但艾滋病毒仍然是青少年死亡的主要原因抗逆转录病毒药物。通常，ALHIV的结果差，损失率更高与其他年龄组相比。在过渡期间，死亡率和随访的损失最高。对于已经准备好在成人艾滋病毒诊所进行谈判的ALHIV可能会最大化过渡成功设置。此准备可以包括提高自我效能感，韧性和教育的技能培训解决缺乏艾滋病毒知识，这两者都可以预测过渡后更好的结果。条款为成人艾滋病毒护理服务导航的社会心理支持和准备信息也已经与成功过渡有关。建议的K43申请的总体目标是补充我精神病学的临床背景，具有高级课程，并专注于行为科学和指导开发和测试行为干预措施以改善护理过渡。这项培训将使我为了实现我的科学目标：开发和测试自我管理干预措施以实现ALHIV过渡接受成人艾滋病毒护理。这项培训将使我能够实现我的科学目标：发展和测试自我 ALHIV的管理干预。该申请建议为 ALHIV过渡到成人HIV护理并测试干预对HIV结果的影响。进行该应用程序中的拟议研究将补充我先前在精神病学上的培训，同时填补关键空白三个领域：（a）行为科学理论及其对行为干预的应用，（b）适应和行为干预的设计，以及（c）通过随机试验测试行为干预措施。填充这些差距，我将进行定性研究，以阐述面临的障碍的概念框架 ALHIV过渡到乌干达的成人艾滋病毒护理（AIM 1），制定自我管理干预措施使ALHIV能够成功过渡到成人艾滋病毒护理（AIM 2），并评估可行性，可接受性和自我管理干预对艾滋病毒结果的初步影响，以使ALHIV过渡到成人艾滋病毒护理（目标3）。这项研究将是第一个开发针对关键的自我管理干预措施的研究从儿科到撒哈拉以南非洲的成人艾滋病毒护理的过渡期，也是第一个使用随机的设计以测试自我管理干预对乌干达ALHIV健康状况的影响正在过渡到成人艾滋病毒护理。这些发现将通过优化健康产生重大的公共卫生影响全球HIV流行中关键人群的结果。拟议的研究将作为在第4年提交的竞争性R01赠款提案，以进行全面的，随机对照试验评估行为干预以改善护理和病毒抑制的保留率的有效性在乌干达的ALHIV中，他们正在浏览过渡到成人艾滋病毒护理的关键时期。