HIV Clinic-based Screening for Geriatric Syndromes in Older Adults with HIV

基于艾滋病毒临床的艾滋病毒感染者老年综合症筛查

基本信息

批准号：
10761940
负责人：
Mary Clare Masters
金额：
$ 16.3万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-09-01 至 2028-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10761940
关键词：
Academic achievement Address Adopted Adoption Age Aging Brain Caring Clinic Clinical Clinical Investigator Clinical Research Cognition Communicable Diseases Comprehensive Health Care Continuity of Patient Care Data Dedications Development Plans Diagnosis Early Diagnosis Elderly Evaluation Exhibits Frequencies Future General Population Geriatric Assessment Geriatrics Goals HIV Health Home Impaired cognition Impairment Individual Intervention Investigation Leadership Literature Logic Medical Medicine Memory Loss Mentorship Methodology Methods Modeling Outcome Pathway interactions Patient Preferences Patient Selection Patient-Focused Outcomes Patients Penetration Persons Physical Function Physical Performance Population Premature aging syndrome Process Proctor framework Protocols documentation Provider Quality of life Recommendation Reporting Research Research Infrastructure Research Methodology Research Personnel Risk Screening procedure Site Standardization Structure Syndrome Training Universities Vulnerable Populations Work aged antiretroviral therapy barrier to care care systems career career development clinical care cognitive function cohort comorbidity contextual factors design disability evidence base experience follow-up functional disability healthy aging implementation evaluation implementation measures implementation outcomes implementation research implementation science implementation strategy improved outcome medical schools medical specialties meetings mortality peer programs promote resilience response satisfaction scale up screening skills social social health determinants user centered design

Academic achievement Address Adopted Adoption Age Aging Brain Caring Clinic Clinical Clinical Investigator Clinical Research Cognition Communicable Diseases Comprehensive Health Care Continuity of Patient Care Data Dedications Development Plans Diagnosis Early Diagnosis Elderly Evaluation Exhibits Frequencies Future General Population Geriatric Assessment Geriatrics Goals HIV Health Home Impaired cognition Impairment Individual Intervention Investigation Leadership Literature Logic Medical Medicine Memory Loss Mentorship Methodology Methods Modeling Outcome Pathway interactions Patient Preferences Patient Selection Patient-Focused Outcomes Patients Penetration Persons Physical Function Physical Performance Population Premature aging syndrome Process Proctor framework Protocols documentation Provider Quality of life Recommendation Reporting Research Research Infrastructure Research Methodology Research Personnel Risk Screening procedure Site Standardization Structure Syndrome Training Universities Vulnerable Populations Work aged antiretroviral therapy barrier to care care systems career career development clinical care cognitive function cohort comorbidity contextual factors design disability evidence base experience follow-up functional disability healthy aging implementation evaluation implementation measures implementation outcomes implementation research implementation science implementation strategy improved outcome medical schools medical specialties meetings mortality peer programs promote resilience response satisfaction scale up screening skills social social health determinants user centered design

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项目摘要

PROJECT SUMMARY AND ABSTRACT Older persons with HIV (PWH) experience more comorbidities and are at increased risk for geriatric syndromes at relatively younger ages than their peers without HIV. However, identification and management of geriatric syndromes in PWH remains a clinical challenge in HIV care. The frequency of geriatrics assessment as part of routine HIV care for older PWH has not been reported. Furthermore, no studies to date have rigorously evaluated implementation of such assessments integrated in clinics dedicated to the care of PWH (HIV clinics). To address this gap in clinical care, we will use implementation research and user-centered design to implement and evaluate an HIV clinic-based screening intervention for 2 key geriatric syndromes in this population, cognitive and physical function impairment. The Northwestern Medicine Infectious Disease Center (NM-IDC) provides care annually to over 1,500 PWH, approximately half of whom are aged 50 years old or older. NM-IDC clinic staff will be trained to administer evidence-based screening assessments of cognitive and physical function and will be educated on appropriate follow-up care for all PWH aged 50 years old or older who receive continuity care in the clinic. Specifically, we aim to: 1) utilize user-centered design to select implementation strategies for the screening intervention and process with key stakeholders, 2) evaluate the implementation outcomes of the screening and care pathway protocol for physical function impairment and memory loss among older PWH, and 3) identify contextual factors associated with variability in implementation outcomes among patients, providers, and other clinic staff. With co-mentorship from an interdisciplinary team of researchers, Mary Clare Masters, MD/MSCI, seeks to build upon her previous clinical research experience at the intersection of HIV and aging. Dr. Masters will receive training in implementation science, qualitative and mixed research methods, participatory research with a focus on inclusion of vulnerable populations (particularly older adults who have cognitive or physical function impairment) and addressing social determinants of health, and advanced leadership skills. Her long-term research goal is to become an independent investigator focused on implementing scalable and sustainable interventions to reduce functional and cognitive impairment and promote resilience among older PWH. The integrated research infrastructure at the Northwestern University Feinberg School of Medicine will facilitate achievement of her academic goals. Future research directions include evaluating this intervention’s impact on clinical outcomes and retention in appropriate care and its scale-up to additional sites. These data are essential to inform the most appropriate strategies for sustaining and expanding HIV geriatric programs in the future.

项目摘要和摘要艾滋病毒（PWH）的老年人经历更多的合并症，并且患有老年综合征的风险增加比没有艾滋病毒的同龄人相对年轻。但是，老年病的识别和管理 PWH中的综合征仍然是HIV护理中的临床挑战。老年医学评估的频率作为尚未报告常规的艾滋病毒护理对较老的PWH。此外，迄今为止尚未进行严格评估专门用于PWH（HIV诊所）的诊所中集成的此类评估。解决在临床护理中，我们将使用实施研究和以用户为中心的设计来实施和评估该人群中2种关键老年综合症的基于HIV诊所的筛查干预措施和身体功能障碍。西北医学传染病中心（NM-IDC）提供每年要照顾1,500多个PWH，大约一半的50岁或以上。 NM-IDC诊所员工将接受培训，以管理认知和身体机能的循证筛查评估，将接受有关获得连续性的所有50岁或50岁以上的PWH的适当后续护理教育在诊所的护理。具体而言，我们的目的是：1）利用以用户为中心的设计选择实施策略与关键利益相关者的筛查干预和过程，2）评估筛查和护理途径方案，用于较旧的PWH中的身体功能障碍和记忆力损失，以及 3）确定与患者，提供者，提供者之间实施结果变异性相关的上下文因素和其他诊所工作人员。在研究人员跨学科团队玛丽·克莱尔大师赛的统治下 MD/MSCI，试图以她以前在艾滋病毒和衰老的交叉路口为基础的临床研究经验。 Masters博士将接受实施科学，定性和混合研究方法的培训，参与研究侧重于包含脆弱人群的研究（部分具有认知或具有认知能力的老年人身体功能障碍）并针对健康的社会决定者和先进的领导技能。她长期研究目标是成为一名专注于实施可扩展性和的独立研究者可持续的干预措施，以减少功能和认知障碍并促进年龄较大的韧性 PWH。西北大学Feinberg医学院的综合研究基础设施将有助于实现她的学术目标。未来的研究指示包括评估此干预措施对临床结果的影响和在适当护理中的保留及其对其他站点的扩大。这些数据是为维持和扩大艾滋病毒老年计划的最合适策略提供信息至关重要未来。