A Web-Based Approach to Evaluating HIV-Associated Neurocognitive Disorders

基于网络的方法来评估 HIV 相关的神经认知障碍

• 批准号: 8466512
• 负责人: Steven Paul Woods
• 金额: $ 23.25万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-20 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8466512
• 关键词: AIDS neuropathy; Adult; Affect; Attention; Biological Markers; Car Phone; Classification; Clinic; Clinical; Clinical Management; Cognitive; Communication; Development; Diagnosis; Diagnostic; Disease; Disease Outcome; Electronic Mail; Engineering; Evaluation; Feedback; Functional disorder; Goals; Grant; HIV; HIV Infections; Harm Reduction; Health; Health Resources; Healthcare; Household; Impairment; Individual; Inflammation; Insurance; Internet; Intervention; Knowledge; Left; Life; Marketing; Measures; Medical; Medication Management; Memory; Mental Depression; Methods; Multiple Sclerosis; National Institute of Mental Health; Nature; Neurocognition; Neurocognitive; Neurologic; Occupational activity of managing finances; Online Systems; Outcome; Participant; Patient Self-Report; Performance; Persons; Pharmacy facility; Population; Prevalence; Provider; Public Health; Recruitment Activity; Research; Resources; Screening procedure; Series; Simulate; Social Network; System; Technology; Testing; Transportation; Traumatic Brain Injury; United States National Institutes of Health; Validation; antiretroviral therapy; base; clinical Diagnosis; cognitive function; cost; daily functioning; design; executive function; experience; health literacy; health related quality of life; improved; innovation; instrumental activity of daily living; multitask; neurobehavioral; neuropsychiatry; next generation; novel; portability; programs; psychologic; psychosocial; severe mental illness; skills; tool; user-friendly; working group; AIDS neuropathy; Adult; Affect; Attention; Biological Markers; Car Phone; Classification; Clinic; Clinical; Clinical Management; Cognitive; Communication; Development; Diagnosis; Diagnostic; Disease; Disease Outcome; Electronic Mail; Engineering; Evaluation; Feedback; Functional disorder; Goals; Grant; HIV; HIV Infections; Harm Reduction; Health; Health Resources; Healthcare; Household; Impairment; Individual; Inflammation; Insurance; Internet; Intervention; Knowledge; Left; Life; Marketing; Measures; Medical; Medication Management; Memory; Mental Depression; Methods; Multiple Sclerosis; National Institute of Mental Health; Nature; Neurocognition; Neurocognitive; Neurologic; Occupational activity of managing finances; Online Systems; Outcome; Participant; Patient Self-Report; Performance; Persons; Pharmacy facility; Population; Prevalence; Provider; Public Health; Recruitment Activity; Research; Resources; Screening procedure; Series; Simulate; Social Network; System; Technology; Testing; Transportation; Traumatic Brain Injury; United States National Institutes of Health; Validation; antiretroviral therapy; base; clinical Diagnosis; cognitive function; cost; daily functioning; design; executive function; experience; health literacy; health related quality of life; improved; innovation; instrumental activity of daily living; multitask; neurobehavioral; neuropsychiatry; next generation; novel; portability; programs; psychologic; psychosocial; severe mental illness; skills; tool; user-friendly; working group

DESCRIPTION (provided by applicant): HIV-associated neurocognitive disorders (HAND) are common in the era of combined antiretroviral therapy (ART) and are a significant burden on public health resources. Yet current standard-of-practice methods for screening and ascertaining the everyday functioning impact of HAND are generally insensitive, outdated, and/or highly impractical for routine use in clinic, which may adversely affect health outcomes by leaving many individuals with syndromic HAND undiagnosed and untreated. Advances in Internet technology may provide an especially germane, naturalistic, user-friendly, and contemporary platform upon which to develop the next generation of everyday functioning assessments for HAND. Of note, the everyday functioning independence of individuals living with HIV infection is increasingly dependent on navigation of the World Wide Web to engage medical (e.g., pharmacy and health information), household (e.g., shopping and banking), and even psychosocial (e.g., social networking) resources. As such, the ecological validity and viability of the next generation of everyday functioning outcomes in neuroAIDS necessitates the development of Internet-specific performance- based tasks in order to enhance diagnosis and treatment of HAND. The aim of this R21 is to validate a series of novel, innovative tasks of everyday functioning (i.e., household shopping, financial management) that use a realistic, state-of-the-art web-based approach to evaluating HAND. The portability and health-relevance of these assessments are enhanced by a developmental aim that will engineer and pilot a naturalistic online health literacy search measure and a pharmacy refill and communication task on a mobile platform. We propose to recruit 100 persons with HIV infection (with a 50% prevalence of HAND) and 50 seronegative subjects from ongoing studies within the UCSD HIV Neurobehavioral Research Program (HNRP), thereby leveraging the comprehensive clinical characterization of these subjects at no cost to this grant. It is hypothesized that HIV infection will be associated with worse "real world" functioning on these web-based tasks, which will correlate with well-validated measures of health literacy (e.g., knowledge), neurocognition (e.g., executive dysfunction), and everyday functioning (e.g., medication management). It is expected that the web-based assessments will improve the diagnostic classification of HAND as compared to current standard- of-practice approaches. Accordingly, this R21 application proposes an important first step in determining whether Internet technology can be used to more accurately and effectively determine the "real world" impact of HIV infection. PUBLIC HEALTH RELEVANCE: People living with HIV infection commonly experience declines in cognitive functions (e.g., attention and memory) and related difficulties in managing their daily affairs (e.g., financial management) that represent a major burden to public health. HIV-infected individuals are increasingly using the Internet to manage their health (e.g., pharmacy), household (e.g., shopping and finances), and even psychosocial (e.g., social networking) affairs, but we presently have no clinical or research tools to detect the nature or extent of problems with this critical aspect of health and daily functioning. This study therefore takes an important first step in determining whether Internet technology can be used to more accurately and effectively determine the "real world" impact of HIV infection by developing web-based tests of health and household management.

描述（由申请人提供）：与HIV相关的神经认知障碍（手）在抗逆转录病毒疗法（ART）时代很常见，并且是公共卫生资源的重大负担。然而，当前用于筛查和确定手的日常功能影响的实践标准方法通常不敏感，过时和/或高度不切实际地在临床中常规使用，这可能会使许多人没有综合性手没有诊断和未经治疗，从而对健康结果产生不利影响。互联网技术的进步可能会提供特别具有印度，自然主义，用户友好和现代平台，以开发下一代的日常功能评估。值得注意的是，艾滋病毒感染感染者的日常运作独立性越来越依赖于全球网络的导航，以参与医疗（例如药房和健康信息），家庭（例如购物和银行业），甚至是社会心理（例如社交网络）。因此，下一代神经辅助中下一代日常功能结果的生态有效性和生存能力需要开发基于互联网的绩效任务，以增强手的诊断和治疗。 R21的目的是验证一系列新颖的，创新的工作，即日常运作（即家庭购物，财务管理），这些任务使用现实，最先进的基于Web的方法来评估手。这些评估的可移植性和健康状况通过开发目标增强，该发展目标将在移动平台上设计自然主义的在线健康素养搜索措施以及药房的补充和通信任务。我们建议在UCSD HIV神经行为研究计划（HNRP）中招募100名患有HIV感染的人（手患病率50％）和50名血清核受试者，从而利用这些受试者的全面临床表征无需支付这笔赠款的全面临床表征。假设艾滋病毒感染将与这些基于网络的任务相关的“现实世界”的功能更糟，这将与健康素养（例如，知识），神经认知（例如执行功能障碍）和日常功能（例如，药物管理（例如，药物管理）的验证良好的措施相关。预计与当前的实践方法相比，基于Web的评估将改善手的诊断分类。因此，该R21应用程序提出了确定互联网技术是否可以更准确，有效地确定艾滋病毒感染的“现实世界”影响的重要第一步。 公共卫生相关性：患有艾滋病毒感染的人通常在认知功能（例如注意力和记忆）方面有所下降，以及管理日常事务（例如财务管理）的相关困难，这代表了对公共卫生的重大负担。受艾滋病毒感染的人越来越多地使用互联网来管理其健康（例如药房），家庭（例如购物和财务），甚至是社会心理（例如社交网络）事务，但是我们目前没有临床或研究工具来检测健康和日常功能的问题的性质或程度。因此，这项研究迈出了重要的第一步，可以通过开发基于Web的健康和家庭管理测试来确定互联网技术是否可以用于更准确有效地确定HIV感染的“现实世界”影响。