Development and Validation of a Multidimensional Index of Engagement in HIV Care

艾滋病毒护理多维参与指数的制定和验证

基本信息

批准号：
8721488
负责人：
Katerina A Christopoulos
金额：
$ 66.8万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-14 至 2018-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8721488
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Affect Ambulatory Care Analgesics Appointment Beryllium Caring Cities Clinic Clinical Clinical Research Cognitive Commit Consensus Data Data Collection Databases Development Dimensions Elements Factor Analysis Feeling Focus Groups Foundations Future Goals Government Agencies HIV Healthcare Individual Intervention Interview Life Link Measures Medical Mental Depression Methods Metric Misinformation Modeling Morbidity - disease rate Outcome Patient Outcomes Assessments Patients Pattern Persons Population Prevention Primary Health Care Procedures Process Provider Public Health Research Research Personnel Risk Sampling Schedule Site Structure Surveys System Testing Translating Treatment outcome Trust Uncertainty United States Validation Viral Load result Visit Work antiretroviral therapy base care delivery clinical care cohort effective intervention empowerment experience health care model improved indexing intravenous drug use member men mortality patient oriented planetary Atmosphere prospective public health relevance sex shared decision making social stigma therapy design tool transmission process

项目摘要

DESCRIPTION (provided by applicant): Less than half of individuals living with HIV in the United States are receiving ongoing care, and only one- quarter have an undetectable viral load. The National HIV/AIDS Strategy prioritizes care and treatment of HIV- infected individuals, yet improvement in care retention rates is clearly needed. Research on HIV care has used attendance at primary care appointments to assess whether patients are in care. While medical visits are necessary, they are not sufficient and do not necessarily reflect a patient's level of engagement. Engagement in care is about the patient experience and interactions with providers and the care site. We propose to create a patient-centered Index of Engagement in HIV Care that will be framed within a model of Health Care Empowerment, which refers to participation in care in a way that is engaged, informed, collaborative, committed, and tolerant of uncertainty. We will create the index through a collaborative process of consensus- building with patients, providers, and research experts using iterative online Delphi surveys and in-person focus groups. We will then translate these narrative findings into scale items and develop them further through cognitive interviewing with patients. We will validate the index by administering i to a sample of patients undergoing the Patient Reported Outcomes within the CFAR Network of Integrated Clinical Systems (CNICS) and examining retrospective, cross-sectional, and prospective appointment and viral load data. The resulting Index of Engagement in HIV Care will have implications for both clinical care and research, identifying patients who are at risk fo poor clinical outcomes and providing a metric by which to develop and evaluate interventions aiming to improve engagement in care.

描述（由申请人提供）：在美国，只有不到一半的艾滋病毒患者正在接受持续的护理，只有一季度的病毒负荷不可发现。国家艾滋病毒/艾滋病战略优先考虑对艾滋病毒感染者的护理和治疗，但显然需要提高护理保留率。关于艾滋病毒护理的研究已利用参加初级保健任命来评估患者是否在护理中。尽管需要医疗访问，但它们还不够，不一定反映了患者的参与水平。从事护理的参与是关于患者的经验以及与提供者和护理网站的互动。我们建议创建一个以患者为中心的艾滋病毒护理参与指数，该指数将在赋予医疗保健授权的模型中构建，该指数是指从事护理的参与，以一种敬业，知情，协作，承诺和宽容的方式参与护理。不确定。我们将通过使用迭代在线Delphi调查和面对面的焦点小组与患者，提供者和研究专家共识的协作过程来创建指数。然后，我们将将这些叙事发现转化为规模项目，并通过与患者的认知访谈进一步开发它们。我们将通过对接受患者综合临床系统（CNICS）CFAR网络的患者的样本进行管理来验证该指数，并检查回顾性，横断面，前瞻性任命和病毒负荷数据。由此产生的参与艾滋病毒护理的指数将对临床护理和研究产生影响，确定临床结果较差的患者，并提供了一个指标，以制定和评估旨在改善护理参与的干预措施。