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美国青少年向成人HIV护理的过渡:干预试点试验的实施经验教训

Transitioning Adolescents to Adult HIV Care in the United States: Implementation Lessons from the Intervention Pilot Trial.

作者信息

Tanner Amanda E, Mertus Sulianie, Jibriel Mohammed Sheikh Eldin, Urquhart Rakira, Phillips Keenan, Dowshen Nadia, Dutta Srija, Goldstein Madeleine H, Lee Susan, Knowles Kayla, Darien Kaja, Rulison Kelly L, Madden Julia, Hussen Sophia A

机构信息

Department of Public Health Education, University of North Carolina Greensboro, 437 Coleman, Greensboro, NC 27402, USA.

Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA 19146, USA.

出版信息

Trop Med Infect Dis. 2024 Dec 3;9(12):297. doi: 10.3390/tropicalmed9120297.

Abstract

Although every youth in pediatric/adolescent HIV care will need to transition to adult-oriented care, there are no existing evidence-based interventions to optimize health through this process. Healthcare transition poses a persistent challenge to the health of youth living with HIV, which may result in gaps in care engagement, medication adherence, and viral suppression. Our process evaluation of , a multilevel mobile health (mHealth) intervention, included iterative interviews with youth, providers, and Transition Champions. These data, along with team meeting notes, highlight the important role the intervention plays in addressing healthcare transition-related challenges, positioning it to fill a critical gap for both youth and providers. It also highlights important individual (e.g., competing priorities of youth and providers), clinical (e.g., electronic health record integration), and contextual (e.g., clinical policies during COVID-19 pandemic) challenges to intervention reach and implementation. More work is needed to refine interventions to support care continuity for youth living with HIV as they transition to adult-oriented care.

摘要

尽管儿科/青少年HIV护理中的每一位青年都需要过渡到以成人为主的护理,但目前尚无基于证据的干预措施来在此过程中优化健康状况。医疗保健过渡对感染HIV的青年的健康构成了持续挑战,这可能导致在护理参与、药物依从性和病毒抑制方面出现差距。我们对一项多层次移动健康(mHealth)干预措施的过程评估,包括对青年、提供者和过渡倡导者的反复访谈。这些数据,连同团队会议记录,凸显了该干预措施在应对与医疗保健过渡相关挑战方面所起的重要作用,使其能够填补青年和提供者之间的关键空白。它还凸显了影响干预措施覆盖范围和实施的重要个体(例如,青年和提供者相互冲突的优先事项)、临床(例如,电子健康记录整合)和背景(例如,COVID-19大流行期间的临床政策)挑战。需要开展更多工作来完善干预措施,以支持感染HIV的青年在过渡到以成人为主的护理时的护理连续性。

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Health-care transition from adolescent to adult services for young people with HIV.青少年到成人的艾滋病患者医疗保健服务过渡。
Lancet Child Adolesc Health. 2018 Mar;2(3):214-222. doi: 10.1016/S2352-4642(18)30005-1. Epub 2018 Jan 6.

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