Identifying Factors to Improve Dental and Mental Health Care among People with HIV

确定改善艾滋病毒感染者牙科和心理保健的因素

基本信息

批准号：
10906440
负责人：
LARRY K BROWN
金额：
$ 77.35万
依托单位：
RHODE ISLAND HOSPITAL
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：
2023-09-22 至 2024-09-21
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10906440
关键词：
Acquired Immunodeficiency Syndrome Adherence Adoption Anxiety Behavior assessment Behavioral Boston Bruxism Candidiasis Caregiver Burden Caring Clinic Clinical Communicable Diseases Cross-Sectional Studies Data Dental Dental Care Dental Clinics Dental Hygiene Dental caries Dentists Discrimination Disease Drug Prescriptions Dysplasia Effectiveness Evaluation Focus Groups Food Fright HIV HIV/AIDS Health Health Care Costs Health Personnel Healthcare Hemorrhage Impairment Individual Interview Lead Leukoplakia Longitudinal Studies Maps Mental Depression Mental Health Services Mental disorders Methods Modeling Morbidity - disease rate Mucous Membrane Nature Oral Oral health Oral mucous membrane structure Outcome Participant Patients Periodontal Diseases Periodontitis Persons Pharmaceutical Preparations Provider Psychiatric therapeutic procedure Quality of life Recommendation Research Salivary Gland Diseases Social support Structure Substance Use Disorder Surveys Symptoms System Time Tooth Attrition Tooth Loss Ulcer Validation Viral Load result Work Xerostomia acceptability and feasibility barrier to care behavioral health care coordination care providers cost craving future implementation illicit drug use implementation intervention implementation strategy improved member mortality neglect oral condition oral lesion prevent programs prospective protective factors psychiatric symptom response screening social social stigma substance misuse substance use substance use treatment system-level barriers

项目摘要

Project Summary Identifying Factors to Improve Dental and Mental Health Care among People with HIV Impaired oral health and psychiatric disorders, including substance use, disproportionally impact people with HIV and AIDS (PWH). Conditions such as dental caries, salivary gland disease, ulcers, periodontitis, leukoplakia, and candidiasis are associated with HIV and can negatively impact quality of life. Depression, anxiety, substance use and other psychiatric disorders in PWH are also associated with more dental problems and unmet oral health needs. In addition, patient, provider, and system barriers interfere with the receipt of oral health care for PWH. HIV care, behavioral health care, and dental care are largely siloed, making it difficult for different health care clinics and different professionals to work together to provide coordinated care. There is great need to investigate further how individual and system-level barriers, behavioral health, and oral health intersect for PWH. In response to RFA-DE-23-002, this proposed project will conduct biannual assessments over two years of 400 PWH, from the Providence/Boston Center for AIDS Research HIV clinics, to identify modifiable individual and system-level barriers and facilitators for engagement and adherence in oral, HIV, and behavioral health care. Associations of longitudinal changes in oral, behavioral, and HIV symptoms and their relationships with barriers and facilitators will also be examined. In addition, in-depth interviews with 40 PWH from the longitudinal study, and 20 health care workers (from dental, behavioral, and HIV clinical settings) will provide further details on the nature of the barriers and facilitators to care, and suggest opportunities for improvement. Using this combined quantitative and qualitative data, strategies will be selected for clinic-based programs to improve oral and behavioral health care among PWH. Member checking, also known as participant validation, will examine the feasibility and acceptability of the selected strategies and actions through focus groups with 20 PWH from the longitudinal study and 10 health care workers from dental, behavioral, and HIV clinical settings. This will be one the largest, in-depth, prospective assessments to date of oral health among PWH that assesses behavioral health and other factors that directly influence oral health outcomes. These results will directly inform a research agenda beyond this study to improve oral and behavioral health among PWH.

项目概要确定改善艾滋病毒感染者牙科和心理保健的因素口腔健康受损和精神疾病，包括物质使用，不成比例影响艾滋病毒和艾滋病患者 (PWH)。龋齿、唾液腺等疾病疾病、溃疡、牙周炎、白斑和念珠菌病与 HIV 相关，并且可以对生活质量产生负面影响。抑郁、焦虑、药物滥用和其他精神疾病产后卫生保健中的疾病还与更多的牙齿问题和未得到满足的口腔健康需求有关。此外，患者、提供者和系统障碍也会干扰患者接受口腔保健服务。王后。艾滋病毒护理、行为健康护理和牙科护理在很大程度上是各自为政的，这使得不同的医疗保健诊所和不同的专业人员共同努力，提供协调一致的服务关心。非常需要进一步研究个人和系统层面的障碍如何行为健康和口腔健康对于感染者来说是交叉的。作为对 RFA-DE-23-002 的回应，这拟议的项目将在两年内对 400 名艾滋病患者进行一年两次的评估，普罗维登斯/波士顿艾滋病研究中心艾滋病毒诊所，以确定可修改的个人和参与和坚持口腔、艾滋病毒和行为方面的系统级障碍和促进因素卫生保健。口腔、行为和艾滋病毒症状的纵向变化与他们与障碍者和促进者的关系也将受到审查。此外，深入采访了纵向研究中的 40 名感染者和 20 名卫生保健工作者（来自牙科、行为和艾滋病毒临床环境）将提供有关障碍性质和协调员进行关怀，并提出改进的机会。使用这种组合定量和定性数据，将为基于临床的计划选择策略，以改善口腔和感染者行为卫生保健。成员检查，也称为参与者验证，将通过重点检查所选战略和行动的可行性和可接受性小组由来自纵向研究的 20 名 PWH 和来自牙科、行为和艾滋病毒临床环境。这将是规模最大、最深入、最具前瞻性的一次迄今为止对感染者口腔健康的评估，包括行为健康和其他方面的评估直接影响口腔健康结果的因素。这些结果将直接为研究提供信息本研究之外的议程旨在改善感染者口腔和行为健康。