CASE STUDY ABSTRACT,
OBJECTIVES & DESIGN
CASE STUDY ABSTRACT
The Center for
Adherence Support Evaluation
at the New York Academy of Medicine
Project Title: Center for Adherence Support Evaluation (CASE) A technical support center for SPNS Adherence Evaluation Grantees
Grantee: The New York Academy of Medicine
Contact Information: 1216 Fifth Avenue; New York, NY 10029 rfinkelstein@nyam.org
Principal Investigator: Ruth Finkelstein, Sc.D.
The New York Academy of Medicine (NYAM), currently conducting a cross-site evaluation often HIV treatment adherence support programs in New York, proposes to apply these skills to form the Center for Adherence Support Evaluation (CASE). Veterans of the New York project, the CASE team has an understanding of the technical challenges of adherence support evaluation and a command of the methodology essential to its success. CASE team members combine expertise in outcomes evaluation, health services research, and epidemiology with first hand knowledge of program development in HIV/AIDS care. The team also has extensive experience working to remove barriers to health care access for vulnerable populations, providing technical assistance to community groups, and translating research into findings of national policy significance.
The CASE project will enhance SPNS adherence evaluation grantees' (AEGs) ability to answer the basic question of what kind of adherence support works best for whom, at what cost. Given new understanding of the speed with which HIV mutates, and the old problem that those patients most in need of adherence support are precisely those that have been systematically understudied and underserved, the project is critical.
CASE will support the AEGs to evaluate adherence support programs, helping each to enhance to enhance their study design, data collection systems and analysis. AEG evaluations will be strengthened by technical assistance from a team of experts, including David Vlahov, Ph.D., Jeannette Ickovics, Ph.D., and Wafaa El-Sadr, MD, MPH. Each AEG will receive a written assessment of the strengths and weaknesses of their evaluation plan, an individualized technical assistance plan for improvement, and state-of -the art bibliographic information updated regularly by NYAM's medical library. In addition, CASE proposes to work with the group to determine a uniform minimum data set for evaluation across sites. Using the greater statistical power and stronger conclusions afforded by such cross-site analysis, the CASE project will provide evidence about how to best to support adherence, particularly for populations often overlooked, including mothers with children, substance abusers, the mentally ill, people of color and people with language barriers.
Coordination and communication is essential to CASE's success. In addition to conference calls, site visits and joint meetings, CASE will establish a dedicated website which will include regularly updated, searchable bibliographic information on adherence evaluation, and data collection instruments. The website will link CASE participants to the largest private medical library in the country, as well as provide a portal for electronic data submission, a forum for communication and an additional medium to publicize CASE findings.
CASE will help HAB and AEGs advance a national consensus on best practices to support adherence. Findings will be disseminated in a variety of forms, including a training curriculum on adherence support; a draft "best practices" document; articles in peer-reviewed journals; presentations at conferences; briefing documents for legislators, the media and funders; and a strategic plan for future research. NYAM's national reputation will give added weight to the findings of the project, whose basic inquiry-whether and how the most vulnerable are able to realize the promise of new HIV treatments-will shape the next era of the HIV epidemic in this country.
CASE
The
New York Academy of Medicine
1216 Fifth Avenue
New York, NY 10029
(212) 822-7237
Mail to: ebehar@nyam.org