Agricultural Intervention to Improve Health of HIV-infected and Affected Children

改善艾滋病毒感染和受影响儿童健康的农业干预措施

基本信息

批准号：
8263268
负责人：
Lisa Michelle Butler
金额：
$ 21.44万
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：
2012
资助国家：
美国
起止时间：
2012-04-01 至 2013-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8263268
关键词：
5 year old Acquired Immunodeficiency Syndrome Adherence Adult Affect Africa Africa South of the Sahara Age Age-Years Agricultural Development Agriculture Anti-Retroviral Agents Applications Grants Area Beds Behavior Behavioral Caregiver Burden Caregivers Child Child Care Child Development Child Mortality Child health care Data Development Diarrhea Diet Disease Economic Development Economics Effectiveness of Interventions Enrollment Epidemic Evaluation Exploratory/Developmental Grant Family Farming environment Food Funding Future Growth Growth and Development function HIV HIV Seropositivity Health Health Status Health behavior Healthcare Height Home environment Home visitation Hospitalization House Call Household Hygiene Immunization Incidence Income Infant Infant Mortality Insecticides Institution Intervention Intervention Studies Interview Irrigation Kenya Learning Life Malnutrition Measures Mechanics Mental Health Methods Morbidity - disease rate Nutritional status Occupational activity of managing finances Outcome Parents Participant Pilot Projects Poverty Process Province Pump Research Research Infrastructure Resources Respiratory Tract Infections Risk Risk Behaviors Role Rural Rural Community Structure Sustainable Development Techniques Training Translating United States National Institutes of Health Water Weight Woman cohort design empowerment feeding follow-up food security foot health care service utilization high risk improved informant interest intervention effect member mortality nutrition prevention service response transmission process

项目摘要

DESCRIPTION (provided by applicant): HIV and AIDS have had a devastating effect on family food security and household wealth in sub-Saharan Africa through the debilitation of the most productive household members, decreased household income, and increased caregiver burden. Children under five living in households affected by HIV and AIDS are at high risk for food insecurity and its subsequent negative impacts on nutrition, somatic growth, illness, and development. While interventions to increase food security and reduce poverty may be effective for those outcomes, there is little prior research on the impact of those interventions on the health and development of young children living in those HIV-affected households. The objective of this project is to determine the impact of an agricultural intervention targeting HIV-affected households in Nyanza Province, Kenya, on important health measures for children under five years old, including nutritional status, disease incidence, and development. This project will take advantage of existing resources, infrastructure, and a cohort provided by an NIH-funded pilot intervention study, 'Shamba Maisha' (R34 MH094215, PIs: Weiser and Cohen, the "parent study"). Shamba Maisha is an agricultural intervention that centers around the provision of a "KickStart" foot-operated mechanical irrigation pump, a microeconomic loan, and training in sustainable farming techniques and financial management provided by the Kenyan Ministry of Agriculture. The parent study will include 120 HIV-infected adults (60 intervention and 60 control) from two rural communities. The parent study aims to assess the impact of Shamba Maisha on household food security, economic indicators, primary health outcomes, HIV transmission risk, and women's empowerment. The present project will assess the impact of Shamba Maisha on behavioral outcomes, including child diet, health care utilization of caregivers for children, child-care-related behaviors (e.g., immunizations, hygiene practices, and use of insecticide-treated bednets) and child health outcomes, including growth, disease, and development for children, age 0 to 59 months old, of the HIV-infected adults in the parent study. Children's HIV status will be ascertained, and children will be followed for one year and assessed at regular intervals for the outcomes of interest. Our specific aims are to: Aim 1. Assess the preliminary impact of Shamba Maisha on behavioral outcomes among HIV-affected children ages 0 to 59 months old. Aim 2. Assess the preliminary impact of Shamba Maisha on the primary child health outcomes of interest for the planned cluster RCT on HIV-affected children ages 0 to 59 months old. Aim 3. To understand the acceptability and feasibility of conducting health and developmental assessments at children's homes, and translate lessons learned in the development study into the design of a cluster RCT. PUBLIC HEALTH RELEVANCE: Children in households affected by HIV and AIDS are at high risk for food insecurity and undernutrition. This project will examine the impact of an agricultura intervention targeting HIV-affected households in Nyanza Province, Kenya on somatic growth, disease incidence and development of children age 0 to 59 months. The project has the potential to improve the ways in which sustainable development and HIV health care and prevention services are conceptualized and delivered throughout rural Africa by demonstrating the role of sustainable agricultural and economic development in improving the health of HIV-affected children.

描述（由申请人提供）：艾滋病毒和艾滋病对撒哈拉以南非洲地区的家庭粮食安全和家庭财富造成了破坏性影响，导致生产力最高的家庭成员衰弱、家庭收入减少和照顾者负担增加。生活在受艾滋病毒和艾滋病影响的家庭中的五岁以下儿童面临粮食不安全的高风险，并随后对营养、身体生长、疾病和发育产生负面影响。虽然加强粮食安全和减少贫困的干预措施可能对这些结果有效，但之前很少研究这些干预措施对生活在受艾滋病毒影响的家庭中的幼儿的健康和发展的影响。该项目的目标是确定针对肯尼亚尼安萨省受艾滋病毒影响的家庭的农业干预措施对五岁以下儿童重要健康措施的影响，包括营养状况、疾病发病率和发育。该项目将利用现有资源、基础设施以及 NIH 资助的试点干预研究“Shamba Maisha”（R34 MH094215，PI：Weiser 和 Cohen，“母研究”）提供的队列。 Shamba Maisha 是一项农业干预措施，其核心是提供“KickStart”脚踏式机械灌溉泵、小额经济贷款以及肯尼亚农业部提供的可持续农业技术和财务管理培训。母研究将包括来自两个农村社区的 120 名 HIV 感染成年人（60 名干预组和 60 名对照组）。母研究旨在评估 Shamba Maisha 对家庭粮食安全、经济指标、初级健康结果、艾滋病毒传播风险和妇女赋权的影响。本项目将评估 Shamba Maisha 对行为结果的影响，包括儿童饮食、儿童护理人员的医疗保健利用、儿童保育相关行为（例如免疫接种、卫生习惯和使用经杀虫剂处理的蚊帐）和儿童父母研究中感染艾滋病毒的成年人的健康结果，包括 0 至 59 个月大的儿童的生长、疾病和发育。将确定儿童的艾滋病毒状况，并对儿童进行为期一年的跟踪，并定期评估感兴趣的结果。我们的具体目标是：目标 1. 评估 Shamba Maisha 对 0 至 59 个月大的 HIV 感染儿童行为结果的初步影响。目标 2. 评估 Shamba Maisha 对计划对 0 至 59 个月大受艾滋病毒影响的儿童进行的集群随机对照试验感兴趣的主要儿童健康结果的初步影响。目标 3. 了解在儿童家庭进行健康和发育评估的可接受性和可行性，并将发育研究中吸取的经验教训转化为集群随机对照试验的设计。公共卫生相关性：受艾滋病毒和艾滋病影响的家庭中的儿童面临粮食不安全和营养不良的高风险。该项目将研究针对肯尼亚尼安萨省受艾滋病毒影响的家庭的农业干预措施对 0 至 59 个月儿童的躯体生长、疾病发病率和发育的影响。该项目有潜力通过展示可持续农业和经济发展在改善受艾滋病毒影响的儿童健康方面的作用，改善在整个非洲农村地区构思和提供可持续发展以及艾滋病毒保健和预防服务的方式。