Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV

加强患者和组织为降低少数族裔艾滋病毒感染者的心血管风险做好准备

• 批准号: 10408469
• 负责人: ARLEEN F. BROWN
• 金额: $ 48.67万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408469
• 关键词: 2019-nCoV; Address; Adherence; Affective; African American; Anxiety; COVID-19; COVID-19 pandemic; California; Cardiovascular Diseases; Caring; Cessation of life; Chronic; Chronic Disease; Clinic; Clinical; Cognitive; Communication Research; Communities; Coronavirus; County; Emotional; Environmental Exposure; Face; Family; Financial Hardship; Friends; Future; Goals; HIV; HIV risk; Health; Health Personnel; Health Promotion; Health behavior; Health system; Heart; Home; Immunocompromised Host; Individual; Intervention; Knowledge; Latinx; Learning; Life; Los Angeles; Mental Depression; Methods; Mind; Mind-Body Intervention; Minority Groups; Morbidity - disease rate; Outcome; Participant; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Policies; Population; Premature Mortality; Procedures; Psyche structure; Qualitative Methods; Recording of previous events; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Risk Reduction; Self Care; Services; Social Distance; Social Work; Social isolation; Social support; Stress; Time; Trauma; Trauma patient; Uncertainty; Universities; Visual; Well in self; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; care delivery; design; ethnic minority population; experience; food insecurity; healing; health care availability; health care service utilization; high risk; improved; literacy; negative affect; novel; organizational readiness; pandemic disease; parent grant; post-traumatic stress; prevent; psychoeducation; psychological distress; psychosocial; public health emergency; recruit; satisfaction; skills; stressor; telehealth; virtual; virtual delivery; virtual platform

Project Summary During this unprecedented time of social distancing, investigators and health systems must understand the challenges faced by vulnerable patients and research participants and develop new strategies, including telehealth, to provide continuity of research engagement and care delivery that reduce risks for immunocompromised individuals, including people living with HIV (PLWH). The “Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV” parent grant provides the Healing our Hearts, Minds, and Bodies (HHMB) intervention to Black and Latinx PLWH who have both trauma histories and cardiovascular risks. The goal of the trial is to increase patient and organizational readiness to address trauma and CVD risk among 260 Black and Latinx PLWH recruited from two HIV clinics in Southern California. For these vulnerable patients, it is incumbent upon our team to continue delivering the intervention while generating new knowledge in the context of the coronavirus (COVID-19) pandemic. The unpredictable onset and course of COVID-19, and the health and environmental effects that it presents for our vulnerable participants, have uncovered many important challenges in conducting health behavior research in high-risk, hard-to-reach populations. Current HHMB participants and those recruited for future HHMB groups now face additional environmental exposure risks that can interact with their HIV status and CVD risks, increasing negative health consequences, with severe ramifications that include death. Therefore, it is critical to provide culturally relevant programming that will encourage sustained engagement and maximize retention in research designed to reduce health risks as well as facilitate care. Retention efforts are likely to prevent and control chronic disease, and reduce morbidity and premature mortality, leading to improved overall health and wellness. In an effort to follow current safer-at-home mandates, mitigate environmental exposures, and provide continued health promotion, social support, and interaction during these uncertain times, we propose to convert our intervention to a virtual platform. This conversion will enable participants to receive services that are timely during COVID-19 and promote health on factors specific to the parent grant (i.e., cardiovascular health, HIV, and trauma). We propose two supplemental aims that will be achieved in an integrated mixed methods design: (1) to evaluate the impact of virtual delivery of the HHMB intervention on clinical outcomes (e.g., Life’s Simple 7, depression, anxiety, post-traumatic stress); and (2) to evaluate the evolving impact of COVID-19 on HHMB participants’: a) physical, mental, and emotional well- being and self-care for HIV, CVD risk factors, and other chronic conditions; b) daily lives, including their access to health care, needed social services, and other community resources; and c) engagement in and satisfaction with the delivery format (in person vs. virtual) of the HHMB intervention.

项目摘要 在这个空前的社会疏远时期，调查人员和卫生系统必须了解 脆弱的患者和研究参与者面临的挑战，并制定了新策略，包括 远程医疗，提供研究参与和护理的连续性，以降低风险 免疫功能低下的人，包括患有艾滋病毒（PLWH）的人。 “增强患者和 艾滋病毒的少数民族患者的心血管风险降低的组织准备 格兰特（Grant 具有创伤历史和心血管风险。试验的目的是增加患者和 从招募的260个黑色和拉丁语PLWH中应对创伤和CVD风险的组织准备就绪 南加州的两个艾滋病毒诊所。对于这些脆弱的患者，我们的团队有责任继续 在冠状病毒（Covid-19）中产生新知识的同时提供干预措施（COVID-19） 大流行。 COVID-19的不可预测的发病和过程，以及健康和环境的影响 为我们脆弱的参与者提供礼物，发现了进行健康的许多重要挑战 高风险，难以触及的人群的行为研究。当前的HHMB参与者和招募的参与者 现在未来的HHMB小组现在面临可能与艾滋病毒状况相互作用的其他环境暴露风险 和CVD的风险，增加了负面的健康后果，并具有包括死亡在内的严重影响。 因此，提供与文化相关的节目以鼓励持续参与至关重要 并最大化旨在降低健康风险和准备护理的研究中的保留率。保留工作 可能会预防和控制慢性疾病，并降低发病率和过早死亡率，导致 改善了整体健康和健康。在遵循当前安全的授权中，减轻 环境暴露，并在此期间提供持续的健康促进，社会支持和互动 不确定的时间，我们建议将干预转换为虚拟平台。这种转换将启用 参与者接受及时在Covid-19期间及时的服务，并根据特定的因素促进健康 家长赠款（即心血管健康，艾滋病毒和创伤）。我们提出了两个补充目标 在集成的混合方法设计中实现：（1）评估HHMB虚拟递送的影响 干预临床结果（例如，生活的简单7，抑郁，动画，创伤后压力）； （2）到 评估Covid-19对HHMB参与者的不断发展的影响：a）身体，心理和情感良好 艾滋病毒，CVD风险因素和其他慢性病的存在和自我保健； b）日常生活，包括他们的访问 进行医疗保健，需要社会服务和其他社区资源； c）参与和满意 使用HHMB干预的交付格式（亲自与虚拟）。