Developing an Instrument to Assess Adolescent Risk for Disengagement from HIV Care

开发一种工具来评估青少年脱离艾滋病毒护理的风险

基本信息

批准号：
10462495
负责人：
Leslie Anne Enane
金额：
$ 15.7万
依托单位：
INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-10-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10462495
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Acute Adolescent Adult Affect Africa African Age Algorithms Area Attention Beck depression inventory Caregivers Caring Case Management Cause of Death Cessation of life Childhood Clinic Clinical Clinical Management Clinical assessments Complex Counseling Databases Development Device or Instrument Development Early Intervention Enrollment Ensure Epidemic Epidemiology Evaluation Failure Family member Funding Goals HIV HIV-infected adolescents Health Health Personnel Individual Infection Infrastructure International Intervention Intervention Studies Interview Link Literature Mental Health Mental Health Services Mentors Mentorship Methods Modeling Outcome Patients Physicians Plant Roots Poverty Professional Competence Psychologist Questionnaires Research Research Methodology Research Personnel Resistance Resource-limited setting Resources Review Literature Risk Role Scientist Screening Result Screening procedure Social support Structure Tablets Testing Treatment outcome United States National Institutes of Health Viral Virus Wool Work age group antiretroviral therapy career clinical care cohort design evidence base high risk high-risk adolescents implementation science improved instrument mortality novel pediatric human immunodeficiency virus prevent research clinical testing retention rate scale up social stigma success successful intervention therapy design tool transmission process treatment optimization treatment program vulnerable adolescent

项目摘要

PROJECT SUMMARY / ABSTRACT HIV is a leading cause of death among adolescents globally, due to management challenges which result in poorer outcomes in the care cascade as compared to adults, including poor rates of retention in care. Reasons for disengagement from care have not been well-explored among adolescents, and are expected to be complex and heterogeneous. Interventions to improve retention can be resource intensive and are challenging to implement broadly. There is an urgent need to identify adolescents at high risk for disengagement from HIV care, and to intervene early to retain these adolescents, in order to prevent deaths and optimize treatment outcomes. Dr. Leslie Enane aims to become a productive independent investigator in HIV implementation science, focused on improving pediatric and adolescent outcomes in the HIV care cascade, particularly in resource-limited settings. The objectives of this application are to develop those career skills by 1) using a mixed-methods approach to investigate factors underlying disengagement among adolescents with HIV in East Africa, and 2) developing an instrument to identify adolescents at high risk for disengagement, for whom proactive interventions may support retention. This project will utilize the well-developed epidemiologic and implementation science infrastructure of the NIH-funded International Epidemiologic Database to Evaluate AIDS East Africa Consortium (IeDEA-EA). Dr. Enane will be mentored by Dr. Rachel Vreeman, Dr. Kara Wools-Kaloustian, Dr. J. Dennis Fortenberry, Dr. Edith Apondi, and Prof. Winstone Nyandiko. Dr. Enane will first refine a conceptual model for adolescent disengagement from HIV care. She will achieve this through systematic literature review; qualitative inquiry with disengaged adolescents, caregivers, and healthcare workers; and synthesis of these findings with quantitative work in IeDEA-EA defining predictors of adolescent outcomes in the care cascade. Next, she will work from this conceptual model to develop and pilot a reliable, developmentally- and culturally-relevant instrument to assess adolescent risk for disengagement from HIV care, the Clinical Assessment for Retention and Engagement (CARE). CARE will be designed for utility in busy clinical settings, to identify adolescents at high risk for disengagement, for whom early interventions should be considered. Dr. Enane will develop an evidence-based algorithm to support clinical evaluation and intervention for adolescents at risk for disengagement. The algorithm will link positive screening results in domains of CARE to administration of valid clinical questionnaires, and/or appropriate interventions, to optimally support clinical management of adolescents at risk for disengagement. Completing this work with strong mentorship and access to experts in implementation science in IeDEA-EA, Dr. Enane will develop independence as a physician-scientist in pediatric HIV implementation science, gaining expertise in 1) qualitative and mixed-methods research, 2) instrument development, and 3) the design of interventions to improve HIV outcomes. Findings will support her R01 proposal to study CARE as part of an intervention package to improve retention and HIV outcomes for adolescents.

项目摘要 /摘要艾滋病毒是全球青少年死亡的主要原因，这是由于管理挑战导致与成年人相比，护理级联的结果较差，包括保留率较差。原因为了脱离护理，青少年没有得到充分探索，预计会很复杂和异质。改善保留的干预措施可能是资源大量的，并且具有挑战性广泛实施。迫切需要识别有可能脱离艾滋病毒护理的高风险的青少年，并尽早干预以保留这些青少年，以防止死亡并优化治疗结果。莱斯利·埃纳（Leslie Enane）博士的目标是成为艾滋病毒实施科学领域的一名富有成效的独立研究者关于改善艾滋病毒护理级联的小儿和青少年结果，特别是在资源有限的设置。此应用程序的目标是通过1）使用混合方法来发展这些职业技能研究东非艾滋病毒青少年脱离接触的因素的方法，2）开发一种识别有脱离接触风险高风险的青少年的工具，主动干预措施可能支持保留。该项目将利用发达的流行病学和实施科学 NIH资助的国际流行病学数据库的基础设施评估艾滋病东非财团（iedea-ea）。 Enane博士将由Rachel Vreeman博士，Kara Wools-Kaloustian博士，J。Dennis博士指导 Fortenberry，Edith Apondi博士和Winstone Nyandiko教授。 Enane博士将首先完善一个概念模型青少年脱离艾滋病毒护理。她将通过系统的文献综述来实现这一目标；定性与青少年，看护人和医护人员的裁员；以及这些发现与 IEDEA-AEA中的定量工作定义了护理级联中青少年结果的预测指标。接下来，她会的从这个概念模型的工作，开发和试行一种可靠的，发展和文化与文化相关的评估青少年脱离艾滋病毒护理风险的工具，保留的临床评估和参与（护理）。护理将是为忙碌的临床环境中的实用程序而设计的，以确定青少年脱离接触的高风险，应考虑早期干预措施。 Enane博士将发展基于证据的算法，以支持有风险的青少年临床评估和干预措施脱离接触。该算法将把护理领域的积极筛查结果与有效的管理联系起来临床问卷和/或适当的干预措施，以最佳支持青少年的临床管理有脱离接触的风险。通过强大的指导和与实施专家的访问完成这项工作 IEDEA-EA的科学，Enane博士将发展独立，成为儿科艾滋病毒的医师科学家实施科学，在1）定性和混合方法研究中获得专业知识，2）开发和3）设计改善艾滋病毒结局的干预措施。调查结果将支持她的R01提案作为干预套餐的一部分学习护理，以改善青少年的保留率和HIV结果。

项目成果

期刊论文数量（6）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Ethical considerations for research involving pregnant women living with HIV and their young children: a systematic review of the empiric literature and discussion.

DOI：
10.1186/s12910-021-00601-x
发表时间：
2021-04-01
期刊：
BMC medical ethics
影响因子：
2.7
作者：
Raciti CG;Enane LA;MacDonald KR;Whipple EC;Ott MA;McHenry MS
通讯作者：
McHenry MS

Impacts of the COVID-19 pandemic on access to HIV and reproductive health care among women living with HIV (WLHIV) in Western Kenya: A mixed methods analysis.

DOI：
10.3389/fgwh.2022.943641
发表时间：
2022
期刊：
FRONTIERS IN GLOBAL WOMENS HEALTH
影响因子：
0
作者：
Bernard, Caitlin;Hassan, Shukri A.;Humphrey, John;Thorne, Julie;Maina, Mercy;Jakait, Beatrice;Brown, Evelyn;Yongo, Nashon;Kerich, Caroline;Changwony, Sammy;Qian, Shirley Ru W.;Scallon, Andrea J.;Komanapalli, Sarah A.;Enane, Leslie A.;Oyaro, Patrick;Abuogi, Lisa L.;Wools-Kaloustian, Kara;Patel, Rena C.
通讯作者：
Patel, Rena C.

Global emerging resistance in pediatric infections with TB, HIV, and gram-negative pathogens.

DOI：
10.1080/20469047.2020.1853350
发表时间：
2021-03
期刊：
Paediatrics and international child health
影响因子：
1.8
作者：
Enane LA;Christenson JC
通讯作者：
Christenson JC

Notes from the Field: Cronobacter sakazakii Meningitis in a Full-Term Neonate Fed Exclusively with Breast Milk - Indiana, 2018.

DOI：
10.15585/mmwr.mm6744a7
发表时间：
2018-11-09
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
0
作者：
Sundararajan M;Enane LA;Kidwell LA;Gentry R;Danao S;Bhumbra S;Lehmann C;Teachout M;Yeadon-Fagbohun J;Krombach P;Schroeder B;Martin H;Winkjer J;Waltz T;Strysko J;Cope JR
通讯作者：
Cope JR