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.

项目概要 在这个前所未有的社会疏远时期，调查人员和卫生系统必须了解 弱势患者面临的挑战并研究和制定新的策略，包括 远程医疗，提供研究参与和护理服务的连续性，从而降低风险 免疫功能低下的个体，包括艾滋病毒感染者（PLWH）。 为降低少数族裔艾滋病毒感染者的心血管风险做好组织准备”家长 赠款为黑人和拉丁裔 PLWH 提供治愈我们的心灵、思想和身体 (HHMB) 干预措施 有外伤史和心血管风险。该试验的目标是增加患者和患者的风险。 组织准备好应对从以下国家招募的 260 名黑人和拉丁裔 PLWH 的创伤和 CVD 风险 对于这些弱势患者，我们的团队有责任继续在南加州开设两个艾滋病毒诊所。 在冠状病毒（COVID-19）背景下提供干预措施，同时产生新知识 COVID-19 的爆发和病程不可预测，及其对健康和环境的影响。 为我们的弱势参与者提供的礼物，揭示了在进行健康方面的许多重要挑战 针对高风险、难以接触人群的行为研究。 未来的 HHMB 群体现在面临着额外的环境暴露风险，这些风险可能与其 HIV 状况相互作用 和心血管疾病风险，增加负面健康后果，造成包括死亡在内的严重后果。 因此，在文化上提供相关的计划以鼓励持续参与至关重要 最大限度地保留旨在降低健康风险并促进护理工作的研究。 有可能预防和控制慢性病，并降低发病率和过早死亡率，从而导致 改善整体健康状况，努力遵循当前的居家安全规定，减轻影响。 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 在不确定的时期，我们建议将我们的干预措施转换为虚拟平台。 参与者在 COVID-19 期间获得及时的服务，并根据特定因素促进健康 我们提出了两个补充目标： 通过集成混合方法设计实现：(1) 评估 HHMB 虚拟交付的影响 对临床结果的干预（例如，生活简单 7、抑郁、焦虑、创伤后应激）；以及 (2) 评估 COVID-19 对 HHMB 参与者不断变化的影响：a) 身体、心理和情绪健康 b) 日常生活，包括接触艾滋病毒、心血管疾病危险因素和其他慢性病； 医疗保健、所需的社会服务和其他社区资源；以及 c) 参与和满意度； HHMB 干预的交付形式（面对面与虚拟）。