Part Two: Project Grant -- An Adaptable Interdisciplinary Model for Chronic Health Care Management and Health Promotion
Children with AIDS are one of the world’s most vulnerable populations. They live in poverty and suffer from preventable or treatable oral disease, with high rates of dental caries and periodontal disease, compounded by immunodeficiency and malnutrition. They rarely receive oral health care due to expense, complexity, and a shortage of dentists willing (due to fear) or able (due to lack of training) to care for patients with HIV. Oral health care, when available, should be delivered in a context of comprehensive multi-disciplinary health care that includes HIV monitoring, treatment, and health promotion.
AIDS is the leading cause of childhood and adult death in Kenya. An oral health initiative will be created at the Nyumbani Home, an orphanage in Nairboi caring for 120 children with AIDS and providing outpatient care for over 3,000 HIV-infected children. A baseline needs assessment will be performed by CUMC faculty. Dental practitioners from the Kenya Dental School will receive on-site training to perform standardized oral examinations using an intraoral digital camera and a laptop computer, securely storing and forwarding images to CUMC for review and discussion. Training to support interdisciplinary collaborative HIV management will be provided. Subsequently, the oral health and HIV care program will be supported remotely through telehealth patient management videoconferences, continuing education seminars, and research support seminars. With faculty mentorship, an interprofessional team of students from CUMC will work with Kenyan students to evaluate the project process (year 1) and patient outcomes (years 2 and 3), assess health education and promotion modules, and study the effects of collaborative practice.
Our telehealth approach will be adapted to create two additional health initiatives: youth smoking cessation and cancer prevention (Beijing, China, year 2, in collaboration and diabetes (Amman, Jordan, year 3).
Additional Columbia Co-investigators: