Organizational Factors in the Early Detection of HIV

HIV早期检测的组织因素

• 批准号: 6784747
• 负责人: OSCAR None GRUSKY
• 金额: $ 69.83万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-10 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6784747
• 关键词: AIDS /HIV diagnosis; AIDS /HIV test; HIV infections; behavioral /social science research tag; decision making; early diagnosis; health behavior; health care service; health care service utilization; health services research tag; human subject; interview; managed care; outcomes research; patient care personnel relations; patient oriented research

DESCRIPTION (provided by applicant): Detection of HIV is increasingly important given major advances in HIV treatment in recent years, yet among seropositive persons at least one-third of adults & 90 percent of adolescents are unaware of their serostatus. Variations in the organizational settings & contexts in which seropositive and at-risk persons may get tested appear to have a great influence on HIV testing, yet these contexts are rarely studied. Furthermore, the existing data come almost solely from public sector settings, which reflects only 10 percent of the HIV testing currently being conducted. To increase early detection of HIV, organizations must increase the percentage of clients offered testing who accept testing, the number of high-risk clients tested, the percentage tested who return for results, and the percentage of seropositive who are tested and linked to care. These outcomes should also lead to a reduction in time from infection to detection. This proposal examines the organizational factors (structures, processes, and intra- and inter-organizational relationships) that are likely to be associated with these outcomes in a two-phase project. In Phase I a qualitative study of these organizational factors will be conducted over 18 months in 5 major types of organizational settings that provide HIV testing in Los Angeles County: a publicly operated agency; a private non-profit organization; an HMO; a private, for-profit organization; and private practice offices. Multiple administrative and clinical staff in various roles within each organization will be surveyed in semi-structured interviews and self-report inventories, in addition to clinic observations and audits of existing records and polices. These data will be used to design and conduct a survey of a representative sample of organizational settings in LA County in Phase 2. Data will be collected on the HIV testing outcomes and organizational factors influencing the testing outcomes from 200 agencies within those five types of organizational settings in L.A. County. Within each agency, surveys will be conducted with various informants (n = 7-8 per agency), supplemented with clinical, administrative, and laboratory records. This survey will provide empirical data on the organizational structures, processes, intra- and inter-organizational relationships that influence early detection of HIV; this data will be used as the basis for developing and testing a future intervention on HIV testing organizations to improve their outcomes.

描述（由申请人提供）：艾滋病毒的检测越来越重要 鉴于近年来艾滋病毒治疗的重大进展，但在血清阳性中 至少三分之一的成年人和90％的青少年不知道 他们的血清。组织环境和环境中的变化 血清阳性和高危人可能会经过测试似乎很棒 对艾滋病毒测试的影响，但很少研究这些情况。此外， 现有数据几乎仅来自公共部门的设置， 目前仅反映了目前正在进行的HIV测试的10％。到 增加对艾滋病毒的早期发现，组织必须增加 客户提供了接受测试的测试，高风险客户的数量 经过测试，测试的百分比返回结果，以及 经过测试并与护理相关的血清阳性。这些结果也应该引导 从感染到检测的时间减少。该提案检查了 组织因素（结构，过程以及内部和内部 可能与这些关系相关的组织间关系） 两相项目的结果。在第一阶段对这些的定性研究 组织因素将在18个月内以5种主要类型进行 在洛杉矶县提供艾滋病毒测试的组织环境： 公开经营机构；私人非营利组织； hmo;私人， 营利组织；和私人执业办公室。多重行政 每个组织中的各种角色的临床人员将受到调查 在半结构化访谈和自我报告清单中 对现有记录和政策的诊所观察和审核。这些数据将 用于设计和进行对代表样本的调查 第2阶段的洛杉矶县的组织环境。 HIV测试结果和组织因素影响测试 这五种类型的组织环境中的200个机构的成果 在洛杉矶县。在每个机构中，将与各种调查进行调查 线人（每个机构n = 7-8），并补充临床，行政， 和实验室记录。这项调查将提供有关的经验数据 组织结构，过程，组织内和组织间 影响早期发现艾滋病毒的关系；这些数据将被用作 开发和测试未来对艾滋病毒测试的干预的基础 组织改善其结果。