Forging sustainable solutions for HIV continuity of care through medical-legal partnerships

通过医疗法律合作伙伴关系，打造艾滋病毒连续性护理的可持续解决方案

• 批准号: 10326453
• 负责人: MIGUEL A MUNOZ-LABOY
• 金额: $ 25.51万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-21 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10326453
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Advanced Development; Affect; Appointment; Area; Behavioral; COVID-19; COVID-19 pandemic; COVID-19 prevention; COVID-19 treatment; Caring; Case Management; Client; Clinical; Clinical Trials; Communication; Communities; Comparison arm; Continuity of Patient Care; Development; Disease; Economics; Ensure; Epidemic; Evaluation; Evidence based intervention; Funding; Goals; Grant; HIV; HIV diagnosis; Health; Health Services; Healthcare; Homelessness; Housing; Income; Individual; Intervention; Intervention Studies; Legal; Literature; Location; Low income; Measures; Medical; Medical Care Costs; Methodology; Methods; National Institute of Mental Health; Outcome; Participant; Patient Recruitments; Patients; Persons; Pharmaceutical Preparations; Philadelphia; Population; Prevention Research; Process; Protocols documentation; Provider; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Regimen; Research; Research Priority; Resources; Risk; Service delivery model; Services; Site; Social Problems; Social Work; Structure; Testing; Time; Training; Treatment outcome; United States National Institutes of Health; Viral; Viral Load result; Vulnerable Populations; Work; acceptability and feasibility; arm; base; behavioral outcome; care outcomes; clinical care; collaborative environment; data management; efficacy trial; evidence base; feasibility testing; forging; health care availability; health care delivery; health care service organization; human data; improved; innovation; intervention mapping; medication compliance; meetings; operation; programs; prototype; psychosocial; public health emergency; response; service delivery; service organization; social; social determinants; social structure; standard of care; success; therapy development; treatment services

Project Summary A health-harming legal need is a social problem that adversely affects a person's health or access to health care and which is better remedied through the combination of legal care and health care. Medical legal partnerships (MLPs) have been underutilized as structural interventions; however, they could help improve HIV care continuum outcomes in health care organizations. The goal of this study is to test the Organizational Partnerships for Healthy Living (OPAHL) intervention through a feasibility and acceptability trial. OPAHL is an innovative, multilevel intervention package intended for health care organizations serving people living with HIV (PLWH). It was developed through a prior study (grant #: R21 MH115820) using intervention mapping methodology and community-scientific collaborative boards. OPAHL consists of: 1) training (7/8hours) for all MLP staff (clinical, social and behavioral services, and legal) on HIV continuum of care, health harming legal risks and needs, and MLP structure and operations to ensure that an integrated and collaborative environment is established from the earliest stages of the program; 2) case management training on the legal continuum of care; 3) embedding of legal expertise within regularized case management team meetings; 4) co- location of legal services in health care agencies through MLP inter-organizational partnership within 3 months; and 5) organizationally tailored implementation of best-practice communication and information-sharing protocols among providers within MLP, anchored in patient autonomy and choice. The specific aims of this study are: 1) to refine the OPAHL intervention prototype for implementation with PLWH with detectable viral loads and 2) to test the feasibility, acceptability and preliminary effects sizes of OPAHL. Given the current COVID-19 pandemic, the study will also explore MLP opportunities that respond at the intersection of HIV/AIDS and COVID-19 prevention and treatment. Two health care organizations serving PLWH Philadelphia, PA that do not currently provide any form of legal services to their patients will participate in this trial (n=200 PLWH). The proposed study is in response to PA-20-141: Formative and Pilot Intervention Research for Prevention and Treatment of HIV/AIDS (R34 Clinical Trial Optional). It is also responsive to two of the areas of high priority research of NIMH Division of AIDS Research (Develop and test interventions to improve HIV treatment outcomes; Advance the development and testing of interventions delivered beyond the individual level). Completion of this project will result in the development of an intervention package to optimize HIV services for a highly vulnerable population whose HIV care is affected by health-harming legal needs.

项目摘要 健康损害的法律需求是一个社会问题，会对一个人的健康产生不利影响 为医疗保健，通过法律护理和医疗保健的结合可以更好地纠正。医疗的 法律合作伙伴关系（MLP）被认为是结构性干预措施；但是，他们可以帮助 改善卫生保健组织中的艾滋病毒护理连续性结果。这项研究的目的是测试 通过可行性和可接受性试验，健康生活的组织伙伴关系（OPAHL）干预。 Opahl是专门为医疗保健组织提供服务的创新，多层次的干预套餐 与艾滋病毒（PLWH）同住。它是通过先前的研究（赠款＃：R21 MH115820）开发的 映射方法和社区科学协作委员会。 Opahl包括：1）培训（7/8小时） 对于所有有关HIV的护理，健康损害的MLP员工（临床，社会和行为服务以及法律） 法律风险和需求以及MLP结构和运营，以确保综合和协作 环境是从该计划的最早阶段建立的； 2）法律案件管理培训 连续护理； 3）在正规案件管理团队会议中嵌入法律专业知识； 4）共同 法律服务在3个月内通过MLP组织间合作伙伴关系在医疗保健机构中的位置； 5）最佳实践沟通和信息共享的组织量身定制的实施 MLP中提供商之间的协议，锚定在患者的自主权和选择中。这个特定的目的 研究是：1）完善具有可检测病毒的PLWH实施的Opahl干预原型 负载和2）测试Opahl的可行性，可接受性和初步效果。给定电流 COVID-19大流行，该研究还将探索MLP机会，这些机会在 HIV/AIDS和COVID-19预防和治疗。两个为PLWH费城服务的医疗保健组织， 目前不提供任何形式的法律服务的PA将参加此试验（n = 200 PLWH）。拟议的研究是对PA-20-141的回应：形成性和试点干预研究 艾滋病毒/艾滋病的预防和治疗（R34临床试验可选）。它也对两个领域的反应 NIMH AIDS研究部的高优先研究（开发和测试干预措施以改善HIV 治疗结果；推进对个人超出个人的干预措施的开发和测试 等级）。该项目的完成将导致开发干预措施以优化艾滋病毒 为高度脆弱的人群提供服务，其艾滋病毒护理受到健康损害法律需求的影响。