Traditional Healers as Adherence Partners for PLHIV in Rural Mozambique

传统治疗师是莫桑比克农村地区艾滋病毒感染者的依从伙伴

基本信息

批准号：
9070781
负责人：
Carolyn Audet
金额：
$ 16.4万
依托单位：
VANDERBILT UNIVERSITY MEDICAL CENTER
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-06-01 至 2019-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9070781
关键词：
AIDS/HIV problem Address Adherence Adult Adverse effects Advocate Africa South of the Sahara Appointment Attitude Award Behavior Belief Caring Centers for Disease Control and Prevention (U.S.)Chronic Disease Clinic Clinical Collaborations Communities Community Health Counseling Country Coupled Crowding Development Diagnosis Disclosure Disease Effectiveness Enrollment Ensure Experimental Designs Faculty Family Fellowship Focus Groups Food Fostering Friends Fright Funding Future Goals Grant HIV HIV Infections HIV Seropositivity Health Health Personnel Health Services Health care facility Health system Healthcare Healthcare Systems Herb-Drug Interactions Institution Intervention Interview K-Series Research Career Programs Knowledge Language Leadership Life Link Malaria Measures Medical Mentored Research Scientist Development Award Mentors Michigan Modeling Mozambique NIH Program Announcements National Institute of Mental Health Nurses Outcome Patient Preferences Patient-Focused Outcomes Patients Perception Persons Pharmaceutical Preparations Pharmacy facility Physicians Policies Population Positioning Attribute Pregnant Women Prevalence Prevention Provider Province Public Health Quality of Care Recruitment Activity Reporting Research Research Personnel Research Training Rural Rural Community Scientist Self Care Self Efficacy Series Services Site Surveys System Testing Time Traditional Birth Attendants Traditional Medicine Training Training Programs Transportation Trust Tuberculosis Universities Viral Load result Visit Work antiretroviral therapy arm career clinical research site compliance behavior design field study follow-up gender-based violence global health improved innovation interest intervention effect medically underserved member men novel post intervention preference professor programs role model skills social stigma stem success therapy adherence treatment adherence tuberculosis treatment uptake willingness

项目摘要

DESCRIPTION (provided by applicant): This career award application seeks to foster the development of Dr. Audet's career as an independent global health researcher. With the support from an NIMH K01 award, Dr. Audet plans to develop a harmonized health system linking complementary and allopathic providers to improve HIV outcomes in countries in under- resourced countries. Dr. Audet's goals are to improve and formalize relationships between allopathic and alternative providers to improve adherence among patients with HIV disease, with a geographic focus in Mozambique. High rates of HIV infection in central Mozambique (12.5%) coupled with high rates of loss to follow up among patients (50%) have resulted in a public health crisis. Major barriers to HIV treatment adherence have been fear of disclosure/ stigma, patient misunderstanding/ not believing their diagnosis, poor perceived treatment at the health facility and patient preference for traditional medicine. Healers are ideally positioned to support patient adherence by: (1) maintaining confidentiality and/or assisting with partner disclosure; (2) explaining HIV using local languages and in local cultural context; (3) advocating for their health at clinical sites; and (4) ensuring patients do not abandon care for traditional medicines. The applicant, Dr. Carolyn Audet, an Assistant Professor at Vanderbilt University, has been in the forefront of Mozambique's attempt to engage healers in a culturally appropriate manner. Her interest in working with healers to improve patient health outcomes has led to the development of National level Ministry of Health referral forms, as healers are `task shifting' int community health agents. In collaboration with the Ministry of Health, she has field-tested referral forms and training programs, establishing that healers can effectively partner with the Ministry. She is also the PI of two grants: a CDC-funded grant to improve clinical delivery of positive prevention messages among clinicians in rural Mozambique and a ViiV Health Care grant to engage men and traditional birth attendants to improve uptake of ART among HIV infected pregnant women. Responsive to NIMH's K01 program announcement, Dr. Audet seeks `protected time' for pursuing a career as an independent scientist. She will engage in additional training in the design and implementation of health messaging interventions to address culturally entrenched beliefs and behaviors at Vanderbilt University and University of Michigan (with her co-primary Mentor Dr. Amico). Dr. Audet aims to provide on-site research leadership to current funded initiatives coupled with ongoing research training and capacity building efforts at the collaborating institutions, with whom her partnerships will focus on developing a sustainable, practical, and effective relationship between traditional healers and the health care system.

描述（由应用程序提供）：本职业奖申请旨在促进Audet博士作为独立全球健康研究员的职业发展。在NIMH K01奖的支持下，Audet博士计划开发一个协调的卫生系统，将完善和同种疗法提供者联系起来，以改善资源不足国家 /地区的艾滋病毒成果。 Audet博士的目标是改善同种疗法和替代提供者之间的关系，以提高艾滋病毒疾病患者的依从性，并在莫桑比克的地理重点。莫桑比克中部（12.5％）的艾滋病毒感染发生率高，加上患者的损失率很高（50％）导致了公共卫生危机。艾滋病毒治疗依从性的主要障碍是害怕披露/污名，患者误解/不相信他们的诊断，在医疗机构的诊断不良以及患者对传统医学的偏爱。理想情况下，治疗师可以通过以下位置支持患者的依从性：（1）保持机密性和/或协助伴侣披露；（2）使用当地语言和当地文化背景来解释艾滋病毒；（3）提倡在临床部位健康；（4）确保患者不要放弃对传统药物的照顾。申请人，范德比尔特大学的助理教授卡罗琳·奥特（Carolyn Audet）博士一直处于莫桑比克（Mozambique）的最前沿，试图以文化上适当的方式聘请头盔。她对使用头盔的兴趣改善患者的健康成果，这导致了国家一级卫生部推荐形式的发展，因为头盔是“任务转移” INT社区卫生代理商。她与卫生部合作，已经进行了现场测试的推荐表格和培训计划，确定头盔可以有效与该部合作。她也是两项赠款的PI：由CDC资助的赠款，旨在改善莫桑比克农村临床医生在临床医生中提供积极的预防信息和VIIV医疗保健赠款，以吸引男性和传统的亲生服务员，以改善艾滋病毒感染的孕妇对艺术的吸收。 Audet博士对NIMH的K01计划公告做出了回应，为从事独立科学家的职业寻求“受保护的时间”。她将在设计和实施健康消息干预措施的设计和实施方面进行其他培训，以解决范德比尔特大学和密歇根大学（与她的联合主要导师Amico博士）的文化信念和行为。 Audet博士旨在为现有资金的计划提供现场研究领导，以及正在进行的研究培训和能力建设在合作机构的能力努力，她的合作伙伴关系将专注于建立传统治疗者与医疗保健系统之间的可持续，实用和有效的关系。