Peer Intervention to Link HIV Positive Substance Abusers to Outpatient Care

同伴干预将艾滋病毒阳性药物滥用者与门诊护理联系起来

基本信息

批准号：
7417259
负责人：
Hannah Wolfe
金额：
$ 24.39万
依托单位：
ST. LUKE'S-ROOSEVELT INST FOR HLTH SCIS
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-03-01 至 2010-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7417259
关键词：
AIDS/HIV problem Acute Alcohol or Other Drugs use Ambulatory Care Appointment Attention Behavior Therapy Behavioral Caring Centers for Disease Control and Prevention (U.S.)Complex Condition Development Diagnosis Disease Distress Drug abuse Drug usage Elements Exploratory/Developmental Grant Funding HIV HIV Seropositivity Health Health Care Costs Hospitalization Hospitals Individual Infection Intervention Life Link Mental Health Mental disorders Methods Minority Mood Disorders Morbidity - disease rate Nature Numbers Outcome Outpatients Patients Persons Pharmaceutical Preparations Pilot Projects Poverty Primary Health Care Process Quality of life Randomized Clinical Trials Rate Research Research Design Risk Services Staging Substance Use Disorder Substance abuse problem Suicide System Testing Time Training Trauma Viral Load result Vulnerable Populations base coping health care delivery improved motivational enhancement therapy motivational intervention peer pressure prevent response substance abuser therapy design transmission process

项目摘要

DESCRIPTION (provided by applicant): We propose to develop and pilot a single-session, peer-led intervention (PEERLINK) to increase linkage of hospitalized HIV+ substance abusers to HIV primary care and/or drug treatment. We believe this is a timely and important project because (1) a high percentage of individuals hospitalized for HIV-related illnesses have co-morbid substance use disorders; (2) a significant minority are not in care for either condition; (3) without care, both conditions will worsen, leading to declining health, increased hospitalizations, and higher health care costs; and (4) no at the bedside intervention currently exists to enhance care linkage. Motivational interventions have been shown to change substance use and increase participation in drug treatment, while peer interventions have been shown to improve utilization of HIV services. Thus, development of a peer-led motivational intervention to improve linkage to care for individuals with this co-morbidity is warranted. Specifically, our aims are to: 1) Develop and refine PEERLINK (a single-session, peer- delivered bedside intervention based on Motivational Interviewing) through an iterative process; 2) Train peers to deliver PEERLINK with fidelity (feasibility) and determine its acceptability to both patients and peers (acceptability); 3) Determine the promise of PEERLINK with regard to the following outcomes: (1) acceptance of an HIV and/or substance use treatment referral; (2) time to 1st kept appointment; and (3) evidence of a connection to care (HIV and/or substance abuse) based on number of appointments made/ kept . Engagement in HIV care can save lives, enhance quality of life, save money, and prevent further transmission of HIV. Effective, inexpensive, brief behavioral interventions targeted to patients in the hospital who are not connected to HIV care and have complex substance use and/or mental health issues may successfully link HIV-positive patients to comprehensive HIV care, thereby gaining improvements in their health outcomes. Patients linked to HIV care have improved quality of life, lengthened life, and reduced viral loads, which decreases the risk of HIV transmission.

描述（由申请人提供）：我们建议开发并试点一项单次、同行主导的干预措施 (PEERLINK)，以加强住院 HIV+ 药物滥用者与 HIV 初级保健和/或药物治疗的联系。我们认为这是一个及时而重要的项目，因为 (1) 因艾滋病毒相关疾病而住院的患者中，有很高比例患有共病物质使用障碍； (2) 相当一部分人不关心这两种情况； (3) 如果不加以护理，两种情况都会恶化，导致健康状况恶化、住院次数增加以及医疗费用更高； (4) 目前不存在用于加强护理联系的床边干预。动机干预已被证明可以改变物质使用并增加对戒毒治疗的参与，而同伴干预已被证明可以提高艾滋病毒服务的利用率。因此，有必要开发一种同伴主导的动机干预措施，以改善对患有这种共病的个体的护理联系。具体来说，我们的目标是： 1) 通过迭代过程开发和完善 PEERLINK（基于动机访谈的单次、同伴提供的床边干预）； 2) 培训同行保真地提供 PEERLINK（可行性），并确定其对患者和同行的可接受性（可接受性）； 3) 确定 PEERLINK 对以下结果的承诺： (1) 接受 HIV 和/或药物使用治疗转介； (2) 第一次预约的时间； (3) 根据已预约/保留的预约次数证明与护理（艾滋病毒和/或药物滥用）相关的证据。参与艾滋病毒护理可以挽救生命、提高生活质量、节省资金并防止艾滋病毒进一步传播。针对医院中未接受艾滋病毒护理且有复杂药物使用和/或心理健康问题的患者的有效、廉价、简短的行为干预措施可以成功地将艾滋病毒阳性患者与全面的艾滋病毒护理联系起来，从而改善他们的健康结果。接受艾滋病毒护理的患者生活质量得到改善，寿命延长，病毒载量减少，从而降低了艾滋病毒传播的风险。