The DC Cohort: A Longitudinal Population-Based Cohort Study of People Living with HIV in Washington, DC

华盛顿特区队列：对华盛顿特区艾滋病毒感染者进行的一项基于人群的纵向队列研究

• 批准号: 10625851
• 负责人: Amanda Derryck Castel
• 金额: $ 478.41万
• 依托单位: GEORGE WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10625851
• 关键词: Achievement; Acquired Immunodeficiency Syndrome; Address; Area; Basic Science; Capital; Caring; Cessation of life; Cities; Clinic; Clinical; Cohort Studies; Collection; Communities; Computerized Medical Record; Continuity of Patient Care; Data; Data Collection; Data Linkages; Data Sources; Databases; Effectiveness; Electronic Health Record; Enrollment; Epidemic; Epidemiology; Feedback; Framingham Heart Study; Funding; Future; Geography; Goals; HIV; HIV diagnosis; Health; Health Resources; High Prevalence; Infrastructure; Intervention; Intervention Studies; Knowledge; Laboratories; Learning; Link; Longitudinal cohort; Longitudinal cohort study; Medical; Molecular Epidemiology; Monitor; National Institute of Allergy and Infectious Disease; Newly Diagnosed; Outcome; Participant; Patient Outcomes Assessments; Performance; Persons; Pharmacy facility; Population; Positioning Attribute; Prevalence; Prevention; Productivity; Provider; Public Health; Quality of Care; Reduce health disparities; Research; Research Personnel; Research Proposals; Resources; Risk; Services; Social Behavior; Testing; Therapeutic; Thinking; Time; United States National Institutes of Health; Viral; Washington; Work; age group; care outcomes; clinical research site; cohort; community engagement; comorbidity; dashboard; data repository; data visualization; efficacy evaluation; epidemiology study; health disparity; implementation science; improved; novel; novel therapeutics; population based; response; tool; transmission process; urban area

Project Abstract Washington, DC has approximately 13,000 people living with HIV (PLWH) and is one of the HIV “hotspots” in the US that collectively contribute to 50% of new HIV diagnoses. As we strive to end the HIV epidemic, the ability to characterize persons who are newly diagnosed with HIV, effectively direct treatment efforts for HIV and its co-occurring conditions, and use novel prevention tools to avert further transmissions, are of critical importance. The DC Cohort, a longitudinal cohort study of over 10,000 PLWH receiving care at 15 clinical sites in DC, is uniquely positioned to help end the HIV epidemic. The Cohort was launched in 2011 with the goal of bending the trajectory of the HIV epidemic in DC by improving the quality of care. The Cohort engages academic and community-based clinics, links to DC Health Department (DOH) databases, and provides near real-time performance feedback to clinics on HIV outcomes using a data visualization Clinical Dashboard. All of this is achieved through automated data extraction and harmonization of electronic medical records data from varied clinical settings and all age groups. The Cohort provides a representative, population-level and scientifically productive research resource that does not exist in most urban high prevalence cities. Building off the Cohort’s infrastructure and achievements, we will expand this robust population-level data repository to comprehensively and longitudinally track outcomes among PLWH in a high prevalence city. We will incorporate new data sources into the Cohort including administrative, service, pharmacy, additional co-morbidity and patient-reported outcomes data. Access to multi-level data will enhance the monitoring of HIV and co- morbidities outcomes. Next, we propose to use the Cohort to monitor the impact and effectiveness of Ending the HIV Epidemic (EHE) initiatives in DC and contribute lessons learned to national EHE efforts. The Dashboard will monitor key EHE indicators: retention in care; viral suppression (VS); availability, initiation and efficacy of new ARV therapeutics; and reductions in health disparities. With this tool, local HIV providers and the DC DOH can support those at greatest risk for suboptimal outcomes. Finally, we will use the Cohort to develop pioneering interventions to improve the quality of care among PLWH. We will partner with the DC Center for AIDS Research, local and national HIV investigators, and community stakeholders to identify and develop clinical, epidemiologic, socio-behavioral, basic science, and implementation science interventions to improve care. We will use the Cohort infrastructure to identify potential participants and clinical sites for these studies in support of NIH-funded and other research proposals. The goals of the Cohort align with OAR, NIAID, and EHE priorities which focus on reducing health disparities, achieving VS, monitoring quality of care, and improving the management of HIV-related clinical outcomes. The DC Cohort is an unparalleled clinical, research, and public health resource which enables us to monitor care in a high prevalence city. Lessons learned will produce generalizable knowledge that can be applied in other urban hotspots across the US.

项目摘要 华盛顿特区有大约13,000人患有艾滋病毒（PLWH），是艾滋病毒的“热点”之一 美国共同贡献了50％的新HIV诊断。当我们努力结束艾滋病毒流行时， 能够表征新诊断为艾滋病毒的人，有效地直接为艾滋病毒治疗 及其同时发生的条件，并使用新颖的预防工具避免进一步的传输，至关重要 重要性。 DC队列，一项对10,000多个PLWH的纵向队列研究，在15个临床部位接受护理 在DC中，独特的位置可以帮助结束HIV流行。该队列于2011年成立，目的是 通过提高护理质量，弯曲DC中HIV流行的轨迹。队列参与 基于学术和社区的诊所，链接到DC卫生部（DOH）数据库，并提供附近 使用数据可视化临床仪表板对诊所的实时绩效反馈。所有人 这是通过自动数据提取和对电子医疗记录数据的协调来实现的 各种各样的临床环境和所有年龄组。该队列提供了代表，人口级和 在大多数城市高流行城市中不存在的科学生产研究资源。建造 该队列的基础架构和成就，我们将将这个强大的人口级数据存储库扩展到 在高流行城市中，全面和纵向跟踪PLWH的结果。我们将合并 新的数据源到该队列中，包括行政，服务，药房，额外的合并症和 患者报告的结果数据。访问多层次数据将增强艾滋病毒和共同的监测 病毒结果。接下来，我们建议使用该队列来监控结束的影响和有效性 DC中的艾滋病毒流行（EHE）倡议为国家的努力做出了贡献。 仪表板将监控密钥指标：保留护理；病毒抑制（VS）；可用性，启动和 新ARV疗法的功效；和降低健康差异。使用此工具，本地艾滋病毒提供者和 DC DOH可以支持那些最大风险的人。最后，我们将使用该队列 制定开拓性干预措施，以提高PLWH的护理质量。我们将与DC合作 艾滋病研究中心，地方和国家艾滋病毒研究者以及社区利益相关者识别和 开发临床，流行病学，社会行为，基础科学和实施科学干预措施 改善护理。我们将使用队列基础设施来确定这些潜在的参与者和临床站点 支持NIH资助和其他研究建议的研究。队列的目标与桨，尼亚德（Niaid）保持一致 以及重点是降低健康差异，实现VS，监视护理质量以及 改善与HIV相关的临床结果的管理。 DC队列是无与伦比的临床 研究和公共卫生资源，使我们能够监视高流行城市的护理。教训 学到的将产生可推广的知识，这些知识可用于美国其他城市热点。