Understanding the role of schools in supporting HIV treatment outcomes among HIV infected adolescents

了解学校在支持艾滋病毒感染青少年的艾滋病毒治疗结果方面的作用

• 批准号: 10672257
• 负责人: Irene Nyambura Njuguna
• 金额: $ 11.96万
• 依托单位: KENYATTA NATIONAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-17 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10672257
• 关键词: Absenteeism; Achievement; Acquired Immunodeficiency Syndrome; Adherence; Adolescence; Adolescent; Adult; Africa; Africa South of the Sahara; Age; Authorization documentation; Award; Caregivers; Caring; Cessation of life; Child; Chronic Disease; Clinic; Clinic Visits; Clinical; Country; Decision Making; Development; Disclosure; Distant; Education; Enrollment; Fright; Future; Goals; Guidelines; HIV; HIV-infected adolescents; Health; Health Personnel; Health Services Accessibility; Hospitals; Influentials; Infrastructure; Intervention; Interview; Kenya; Life; Link; Maps; Medicine; Mentors; Methods; Nurses; Outcome; Peer Group; Performance; Pharmaceutical Preparations; Policies; Policy Maker; Population; Positioning Attribute; Primary Schools; Privacy; Procedures; Process; Productivity; Reporting; Research; Research Design; Research Methodology; Research Personnel; Research Training; Retrospective cohort study; Role; Sahara; Schedule; School Health Services; School Nursing; School-Age Population; Schools; Scientist; Secondary Schools; Secondary to; Services; Shapes; Stigmatization; Structure; Surveys; Teacher Professional Development; Testing; Training; Training Support; Treatment outcome; United States National Institutes of Health; Viral; Work; aged; antiretroviral therapy; career; clinical epidemiology; effective intervention; effectiveness testing; experience; group intervention; human centered design; implementation science; improved; improved outcome; multidisciplinary; peer; peer support; pill; preference; school environment; school health; skills; social stigma; teacher; therapy development; tool

PROJECT SUMMARY/ABSTRACT The overall goal of the proposed K43 Emerging Global Leader Award (non-clinical trials requirement) is to support Dr. Njuguna’s research training to develop an independent career in HIV research. Dr. Njuguna is a research scientist at the Kenyatta National Hospital, Nairobi, Kenya. The proposed work examines the unique intersection between education and health in the context of adolescent HIV. Dr. Njuguna’s training goals are to gain expertise in human centered design for intervention development, implementation science (IS), mixed methods and adolescent research. This work will also provide an opportunity to work closely with policy makers, and link clinical epidemiology skills she has previously acquired with real world IS methods. The proposal leverages a multidisciplinary team of mentors and collaborators who will ultimately support Dr. Njuguna’s goal to become a productive and influential independent investigator in adolescent HIV research. The research goal of this proposal is to use a human centered design approach by utilizing mixed methods research to gain an in-depth understanding of the school environment and its contribution to achieving treatment goals, and to collaboratively and iteratively develop a school-based intervention to improve outcomes among school-going adolescents living with HIV (ALWHIV). There is a growing population of ALWHIV surviving to adulthood. These children need support to sustain medication use during adolescence and across school and life transitions. There is limited evidence on school-based interventions to support treatment, despite the fact that most ALWHIV are enrolled in school (including boarding schools). The Aims of this proposal are: 1.To evaluate existing school-based structures available for ALWHIV and key determinants of caregiver and ALWHIV school choice decisions, 2.To determine school-related correlates of viral suppression and retention in care, 3.To develop and pilot a school staff training and peer support intervention in selected schools for non-health outcomes (acceptability, feasibility and appropriateness). This is the first study to our knowledge to propose to quantitatively characterize school-related correlates of clinical outcomes in sub-Sahara Africa (SSA) and evaluate factors influencing school choice for ALWHIV. The study brings together a diverse team of stakeholders from the Kenyan national Education and Health sectors and utilizes a multi-step approach to achieve study objectives. This approach will allow for rigorous intervention development process, and pave way for a strong collaborative effort in a future R01 to test effectiveness of a school-based intervention package to improve outcomes, including viral suppression, in school-going ALWHIV, that could potentially benefit adolescents with other non-HIV chronic illnesses. Dr. Njuguna’s research goals correspond with her training goals, and at the completion of this award, she will be in an excellent position to submit an R01 application to further advance research in ALWHIV.

项目摘要/摘要 拟议的K43新兴全球领导奖（非临床试验要求）的总体目标是 支持Njuguna博士的研究培训，以发展艾滋病毒研究的独立职业。 Njuguna博士是 肯尼亚内罗毕的肯雅塔国家医院的研究科学家。拟议的工作考试独特 在青春期艾滋病毒的背景下，教育与健康之间的交叉点。 Njuguna博士的培训目标是 在以人为中心的设计中获得干预开发，实施科学（IS）的专业知识，混合 方法和青少年研究。这项工作还将提供与政策制定者紧密合作的机会 她以前从现实世界中获得的临床流行病学技能是方法。提案 利用一个由导师和合作者组成的多学科团队，最终将支持Njuguna博士的目标 成为青少年艾滋病毒研究中的富有成效且有影响力的独立研究者。 该提案的研究目标是使用混合方法使用以人为中心的设计方法 研究以深入了解学校环境及其对治疗的贡献 目标，并进行协作，迭代地开发基于学校的干预措施，以改善 艾滋病毒（ALWHIV）的校青少年。越来越 成年。这些孩子需要支持以维持青少年和整个学校的药物使用以及 生活过渡。关于支持治疗的学校干预措施的证据有限，事实上 大多数Alwhiv都在学校（包括寄宿学校）上学。该提议的目的是：1。 评估现有的基于学校的结构，可用于Caregiver和Alwhiv的ALWHIV和关键决定者 学校选择决定，2。确定与学校相关的病毒抑制和保留在护理中的相关性，3. 开发和驾驶学校员工培训和同伴支持干预选定学校的非健康学校 结果（可接受性，可行性和适当性）。 据我们所知，这是提议定量特征与学校相关相关性的首次研究 撒哈拉以南非洲（SSA）的临床结果并评估因素会影响学校选择ALWHIV。这 研究汇集了来自肯尼亚国家教育和卫生部门的利益相关者的潜水团队 并利用多步骤方法来实现研究目标。这种方法将允许严格干预 开发过程，并为未来R01进行强有力的合作努力铺平了道路，以测试A的有效性 以学校为基础的干预措施，以改善在上学的阿尔维夫（Alwhiv）中改善包括病毒抑制的结果， 这可能会使其他非HIV慢性疾病的青少年受益。 Njuguna博士的研究目标 与她的培训目标相对应，并且在获得该奖项时，她将处于绝佳的位置 提交R01申请，以进一步提高Alwhiv的研究。