In this mixed-methods study, guided by stress appraisal and burnout models, we will identify structural and intrapersonal sources of medical provider burnout and possible actions to reduce burnout. In addition, guided by positive mental health frameworks, we will identify areas of meaning, purpose and enjoyment and possible actions to promote those.
This multi-site study tests the efficacy of Epic Allies, a mobile phone application (app) that utilizes game mechanics and social networking features to improve engagement in care, anti-retroviral therapy (ART) uptake, ART adherence and viral suppression rates among HIV+ young men who have sex with men (YMSM).
The Analytic Core (AC) provides expertise and systems for the conduct of qualitative studies, randomized controlled trials (RCT), and economic studies to support the aims of the iTech and its research and pilot studies, interactions within the Adolescent Trials Network, and with National Institute of Child Health and Human Development.
Despite worldwide efforts to promote HIV counseling and testing, rates of testing in Tanzania remain low. This study uses a Discrete Choice Experiment, a survey method increasingly used by health economists for the design of patient-centered health care options, to identify HIV testing preferences among two high-risk populations and evaluate, in a pragmatic randomized controlled trial (RCT), the effect of a preference-based HIV counseling and testing intervention on testing uptake in the Kilimanjaro region.
The specific objectives of our project are to: a) identify interventions that are objectively associated with reduced short and long term opioid-utilization and significantly fewer adverse effects; b) adapt effective interventions from 'successful' VAMCs to other VAMCs where there is objective room for improvement in care; and finally, c) assess the effectiveness of these innovative plans via on-going surveillance for preoperative opioid related adverse events and prolonged use of opioids throughout the VHA.
Alcohol use among patients with hepatitis C can speed progression to liver failure and liver cancer. The Center has partnered with the Duke, UNC, and Durham VA Liver Clinics to conduct and test, using a randomized controlled trial, the impact of an integrated model of alcohol treatment. The integrated model includes brief alcohol counseling from the patient's hepatologist; co-locating addictions therapists in the liver clinic; and individual and group therapy that emphasizes the interplay between alcohol and liver health. The integrated model is compared against brief alcohol counseling from the patient's hepatologist and referral to outside alcohol treatment. The Center will conduct a cost effectiveness analysis of the integrated treatment, as well.