Brief Acceptance and Commitment Therapy for HIV-Infected At-Risk Drinkers Administrative Supplement

针对艾滋病毒感染高危饮酒者的简短接受和承诺治疗行政补充

• 批准号: 10289729
• 负责人: STEPHEN A MAISTO
• 金额: $ 22.99万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10289729
• 关键词: AIDS prevention; Address; Adherence; Administrative Supplement; Adrenal Glands; Affect; Aftercare; Alcohol consumption; Appointment; Behavioral; Biological Markers; Blood; COVID-19; COVID-19 pandemic; Caring; Clinical Trials; Collection; Continuity of Patient Care; Data; Data Collection; Enrollment; Failure; Feeling; Focus Groups; Funding; General Population; Goals; HIV; HIV therapy; Hair; Human Resources; Human Subject Research; Hydrocortisone; Hypothalamic structure; Infrastructure; Intervention; Interview; Manuals; Measures; Mental Depression; Mental Health; National Institute on Alcohol Abuse and Alcoholism; New York; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Pituitary Gland; Population; Procedures; Protocols documentation; Reporting; Risk; Salivary; Schedule; Spottings; Stress; Supervision; Techniques; Telephone; Therapeutic Intervention; Thinking; Time; Training; Treatment Efficacy; Treatment outcome; United States; Universities; Viral; Visit; acceptability and feasibility; alcohol intervention; anxiety treatment; base; behavioral health; binge drinking; brief alcohol intervention; care providers; chronic pain; comorbidity; comparative effectiveness trial; coping; coronavirus disease; design; drinking; evidence base; experience; follow-up; improved; innovation; interest; meetings; mindfulness; mortality risk; novel; pandemic disease; preventive intervention; psychological symptom; recruit; reduced alcohol use; response; saliva sample; sexual risk behavior; skills; smoking cessation; stress management; substance use; success; transmission process; trial comparing

Abstract The COVID-19 pandemic has had a significant impact on the mental health and alcohol use of the United States (US) general population, and has disproportionately affected people living with HIV (PLWH). Alcohol consumption and stress are both critical factors in HIV treatment that, if unaddressed, can significantly contribute to onward transmission and poor treatment-related outcomes. Alcohol interventions for PLWH in the US have shown mixed results. One hypothesized reason for this limited success is the failure of these interventions to address the multiple overlapping problems (e.g., co-morbid mental health conditions, stress, behavioral health needs) of PLWH who are hazardous drinkers. Innovative alcohol intervention strategies that can have an impact on these multiple behavioral health needs, in a format that can be feasibly delivered in the context of HIV care, are needed, especially in the context of the COVID-19 pandemic. Brief Acceptance and Commitment Therapy (ACT) is a promising intervention for HIV-infected hazardous drinkers. ACT is a transdiagnostic treatment that uses mindfulness skills and values-guided behavioral action plans to impact a broad array of psychological symptoms. ACT has shown efficacy for treatment of anxiety, depression, chronic pain, and substance use, and is thus a promising approach for PLWH who are hazardous drinkers and coping with additional stress related to the COVID-19 pandemic. We are proposing to expand our ongoing, NIAAA- funded (R34AA026246), pilot RCT of a telephone-delivered ACT intervention for PLWH by applying for an administrative supplement in response to the Notice of Special Interest on Stress Management in Relation to COVID-19 (NOT-AT-20-011). The overall objective of this application is to use the infrastructure of our ongoing pilot RCT (NCT0397406) to collect preliminary data on the level of stress experienced by PLWH during the COVID-19 pandemic, and to determine if participants in the RCT find the stress management techniques in our ACT intervention useful and applicable for the management of COVID-related stress. The specific aims are as follows: Aim 1: Incorporate objective and self-reported measures of stress into the pilot RCT. We will accomplish this aim by: adding general and pandemic-specific self-report measures of stress, and self- collected samples of salivary cortisol to all study visits, including a newly added 12-month follow-up. Aim 2: Determine the feasibility and acceptability of ACT as a telephone-based stress management intervention for PLWH during the COVID-19 pandemic. We will accomplish this aim by modifying our treatment manuals to incorporate COVID-19 related stress, and examining stress-related RCT outcomes by treatment condition. This administrative supplement will provide important information on COVID-related stress among PLWH, and provide data on the feasibility and potential efficacy of telephone-delivered ACT for stress management.

抽象的 COVID-19 大流行对美国人的心理健康和饮酒产生了重大影响 州（美国）一般人口，并且对艾滋病毒感染者（PLWH）产生了不成比例的影响。酒精 消费和压力都是艾滋病毒治疗中的关键因素，如果不加以解决，可能会显着 导致进一步传播和不良的治疗相关结果。对艾滋病病毒感染者的酒精干预 美国的结果好坏参半。造成这种有限成功的一个假设原因是这些方法的失败 解决多重重叠问题的干预措施（例如共病心理健康状况、压力、 危险饮酒者的艾滋病病毒感染者的行为健康需求）。创新的酒精干预策略 可以对这些多种行为健康需求产生影响，以一种可以在 需要在艾滋病毒护理的背景下，特别是在 COVID-19 大流行的背景下。简短的接受和 承诺疗法（ACT）对于感染艾滋病毒的危险饮酒者来说是一种很有前途的干预措施。 ACT 是一个 跨诊断治疗，利用正念技能和价值观引导的行为行动计划来影响 广泛的心理症状。 ACT 已显示出治疗焦虑、抑郁、慢性病的功效。 因此，对于酗酒者和应对危险的艾滋病病毒感染者来说，这是一种很有前途的方法 与 COVID-19 大流行相关的额外压力。我们提议扩大我们正在进行的 NIAAA- 资助（R34AA026246），通过申请对 PLWH 进行电话提供的 ACT 干预试点随机对照试验 针对与以下方面有关的压力管理特别关注通知的行政补充 COVID-19（非 AT-20-011）。该应用程序的总体目标是使用我们正在进行的基础设施 试点随机对照试验（NCT0397406）收集关于感染者在感染期间所经历的压力水平的初步数据 COVID-19 大流行，并确定 RCT 参与者是否在我们的研究中找到了压力管理技术 ACT 干预对于管理与新冠病毒相关的压力很有用且适用。具体目标如下 目标 1：将客观和自我报告的压力测量纳入试点随机对照试验。我们将 通过以下方式实现这一目标：添加一般和针对大流行病的压力自我报告措施，以及自我报告措施。 在所有研究访问中收集唾液皮质醇样本，包括新增加的 12 个月随访。目标 2： 确定 ACT 作为基于电话的压力管理干预措施的可行性和可接受性 COVID-19 大流行期间的 PLWH。我们将通过修改我们的治疗手册来实现这一目标 纳入与 COVID-19 相关的压力，并按治疗条件检查与压力相关的 RCT 结果。这 行政补充文件将提供有关 PLWH 中与新冠病毒相关的压力的重要信息，以及 提供有关电话传递 ACT 压力管理的可行性和潜在功效的数据。

项目成果

Development of a Telephone-Delivered Acceptance and Commitment Therapy Intervention for People Living with HIV who are Hazardous Drinkers.

• DOI: 10.1007/s10461-022-03649-x
• 发表时间: 2022-09
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Woolf-King SE;Firkey M;Foley JD;Bricker J;Hahn JA;Asiago-Reddy E;Wikier J;Moskal D;Sheinfil AZ;Ramos J;Maisto SA
• 通讯作者: Maisto SA