Connecting People, Places, and Barriers: The Effect of These Connections on Adhe

连接人、地方和障碍：这些连接对 Adhe 的影响

• 批准号: 8730821
• 负责人: Debarchana Ghosh
• 金额: $ 17.27万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8730821
• 关键词: AIDS/HIV problem; Address; Adherence; Affect; Area; Behavior; Behavior Therapy; Behavioral; Biometry; Buprenorphine; Career Choice; Caring; Centers for Disease Control and Prevention (U.S.); Clinical; Communities; Consult; Data; Data Collection; Dependency; Development; Dimensions; District of Columbia; Drug abuse; Drug usage; Drug user; Ego; Epidemic; Epidemiology; Evaluation; Geographic Information Systems; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; Health; Health Communication; Imagery; Individual; Information Sciences; Intervention; Knowledge; Link; Literature; Location; Maps; Measures; Mentors; Mentorship; Methadone; Metric; Modeling; Neighborhoods; Opiate Addiction; Pathway Analysis; Pattern; Persons; Pharmaceutical Preparations; Phase; Population; Process; Protocols documentation; Psychosocial Factor; Public Health; Randomized Controlled Trials; Research; Research Methodology; Research Project Grants; Risk Factors; Science; Services; Shapes; Social Network; Structure; Substance Use Disorder; Substance abuse problem; System; Techniques; Testing; Time; Training; Treatment outcome; Value of Life; Viral; Visit; Vulnerable Populations; Work; Writing; arm; base; career; career development; design; effective intervention; experience; falls; health disparity; health training; high risk; improved; indexing; interest; intervention effect; mHealth; member; men; novel; peer; population health; public health relevance; sex; social; success; theories; therapy design; therapy development; transmission process

DESCRIPTION (provided by applicant): As a trained health geographer with expertise in the areas of social-ecological models, neighborhood effects, and Geographic Information System, I am further interested in expanding my research foci in the interface of substance abuse and HIV/AIDS, both from methodological and intervention perspectives. To that end, in the upcoming five years of training, I will devote my time to focused research on multidimensional correlates to adherence, retention, and HIV treatment outcomes among infected drug users using system science techniques. The ultimate goal is to design interventions to improve HIV treatment outcomes among this vulnerable population. To achieve this goal, I will work with an internationally recognized group of mentors to obtain training in the epidemiology of substance use disorders, HIV transmission and treatment, social network analysis, and design of interventions. My specific objectives to achieve this career goal are: 1. Enhance my background and understanding of existing literature on behavioral and clinical interventions to seek, test, treat, and retain in care among drug users with HIV infection. 2. A. Advance expertise in theory, visualization, and application of social network analysis, including egocentric network, whole network, and longitudinal networks. Incorporate spatial dependency to innovatively advance social network metrics to spatial-social network metrics. B. Develop expertise in research methods necessary to design, perform, and evaluate randomized controlled trials. 3. Gain experience in intervention development, testing, implementation, and dissemination that will address multidimensional barriers to adherence and retention in care among HIV positive drug users. 4. Development of an independent career path in behavioral intervention-oriented research focused on the intersection between substance abuse and HIV by successfully writing and receipt of a R01 grant. Given the vital importance of mentoring in the process of training and career development, I have assembled a strong interdisciplinary panel of mentors and consultants who will provide guidance throughout my five years of advanced training. Dr. Frederick Altice will serve as my primary mentor (substance abuse, HIV, intervention), with Drs. Michael Copenhaver (HIV, intervention) and Carl Latkin (social network analysis, neighborhood effects, intervention) as co-mentors. I will further consult Drs. Ofer Harel for biostatistics, Lesie Snyder for health communication, and Michael Emch for geographical theories of health research. The training will provide opportunities to conduct two research projects for vulnerable drug users with HIV infection. Study 1: To inform the development of an intervention by examining multidimensional (individual- social-ecological) correlates of adherence to ART, retention in care, and HIV treatment outcomes among drug using HIV positive population. [Year 1, 2, 3 (Part)] This is a secondary analysis using data from a randomized controlled trial (Project STRIDE, Altice, R01 DA030768) and its 'Social Network and Neighborhood' Supplement. To this I add the following aims: Specific Aim 1: Extend social network metrics (i.e., derived from network structure) to spatial-social metrics (based on both network structure and spatial proximity between subjects and their network members). Specific Aim 2: Visualize and map the 'activity space' patterns of subjects in a Geographic Information Science interface, including visits to routine locations of positive and negative influence. This is significantly different tha the just the residential location of the subjects. Specific Aim 3: Examine the combined effect of individual, social relationships, activity space, and neighborhood correlates of adherence to ART, retention, and HIV treatment outcomes modeled on a robust multidimensional social-ecological framework. Study 2: To develop and pilot a spatial-network driven intervention with short message services (SMS) that will optimize adherence to ART, retention in care, and HIV treatment outcomes for HIV positive drug users. [Year 3(Part), 4, 5] Phase 1: Select social network members (or alters) who will have stronger effect on the subjects (or egos) adherence to ART, retention, and HIV treatment outcomes. Formative evaluations of ego's activity space and composition and features of their social networks from Study 1 will determine the selection protocol. Phase 2: Conduct a pilot to test the feasibility, acceptability, and preliminary efficacyof a novel spatial- network driven intervention with SMS. The intervention has three arms: 1) Ego in HIV care with two alters assigned highest Interaction Index value, living inside ego's activity space receiving SMS, 2) Egos in HIV care with two alters assigned highest Interaction Index values, living outside the activity space receiving SMS, and 3) Egos in HIV care with no intervention (observational arm).

描述（由申请人提供）：作为一名受过训练的健康地理学家，在社会生态模型，邻里效果和地理信息系统领域具有专业知识，我对从方法论和干预的角度来扩展我的研究重点在药物滥用和艾滋病毒/艾滋病的界面中更加感兴趣。为此，在接下来的五年培训中，我将花时间研究使用系统科学技术在受感染的药物使用者中依从性，保留和HIV治疗结果的多维相关性。最终目标是设计干预措施，以改善该脆弱人群中的艾滋病毒治疗结果。为了实现这一目标，我将与一群国际认可的导师群体合作，以获取有关物质使用障碍，艾滋病毒传播和治疗，社交网络分析以及干预措施设计的培训。我实现这一职业目标的具体目标是：1。增强我对有关艾滋病毒感染的药物使用者寻求，测试，治疗和保留行为和临床干预措施现有文献的背景和理解。 2。将空间依赖性纳入创新的社交网络指标到空间社会网络指标。 B.开发设计，执行和评估随机对照试验所需的研究方法的专业知识。 3.在干预，测试，实施和传播方面获得经验，这些经验将解决艾滋病毒阳性吸毒者在护理中遵守和保留的多维障碍。 4。以行为干预为导向研究的独立职业道路的发展，重点是成功地撰写和收到R01赠款，以滥用药物与艾滋病毒之间的交集。 鉴于在培训和职业发展过程中进行指导至关重要，我组建了一个强大的导师和顾问跨学科小组，这些小组将在我的五年高级培训中提供指导。 Frederick Altice博士将担任我的主要导师（滥用药物，艾滋病毒，干预），并与博士一起担任。 Michael Copenhaver（艾滋病毒，干预）和卡尔·拉特金（Carl Latkin）（社交网络分析，邻里效应，干预措施）作为联合委员会。我将进一步咨询Drs。 Ofer Harel生物统计学，莱斯·斯奈德（Lesie Snyder）的健康传播和迈克尔·埃姆奇（Michael Emch）的健康研究理论。该培训将为艾滋病毒感染的弱势吸毒者提供两个研究项目。研究1：通过检查遵守艺术的多维（个人生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生态生物，保留率），使用HIV阳性人群中的艾滋病毒治疗结果来告知干预措施的发展。 [1年级2，3（部分）]这是使用随机对照试验的数据（项目）的二级分析 大步，Altice，R01 DA030768）及其“社交网络和社区”补充。为此，我添加了以下目的：特定目标1：将社交网络指标（即源自网络结构衍生）扩展到空间社会指标（基于受试者与其网络成员之间的网络结构和空间接近性）。 特定目的2：可视化和映射地理信息科学界面中受试者的“活动空间”模式，包括访问正常和负面影响的常规位置。这与受试者的住宅位置大不相同。 特定目的3：检查个人，社会关系，活动空间以及遵守艺术，保留和艾滋病毒治疗结果的综合作用，该结果建立在强大的多维社会生态生态框架上。研究2：使用短消息服务（SMS）开发和试行一种空间网络驱动的干预措施，该干预将优化遵守艺术，保留护理和HIV治疗结果，为HIV阳性吸毒者提供。 [3年级（部分），4，5]第1阶段：选择社交网络成员（或变化），他们将对对艺术，保留和HIV治疗结果的遵守受试者（或自负）的影响更强。对自我的活动空间和组成以及研究1的社交网络的形成性评估将决定选择方案。第2阶段：进行试点以测试新型空间网络驱动的SMS的可行性，可接受性和初步效果。干预措施有三个臂：1）在艾滋病毒护理中的自我，有两个变化的最高相互作用指数价值，生活在自我的活动空间内，2）艾滋病毒中的自我护理中，艾滋病毒护理中的自我护理中，有两个分配的最高交互作用指数值，居住在接收SMS的活动空间之外，而3）在艾滋病毒护理中没有干预（无干预措施）。