Testing the Efficacy and Mechanisms of an Adapted Resilience Building Intervention in People Aging with HIV

测试针对艾滋病毒感染者的适应能力建设干预措施的功效和机制

• 批准号: 10478381
• 负责人: Pariya Fazeli Wheeler
• 金额: $ 18.56万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10478381
• 关键词: Adverse effects; Affect; Affective; Age; Aging; Attention; Behavioral; Behavioral Model; Biological Markers; Buffers; CD4 Lymphocyte Count; Chronic Disease; Cognitive; Control Groups; Control Locus; Coping Skills; Data; Deep South; Development; Discrimination; Disease Management; Distal; Education; Educational Curriculum; Ego; Elderly; Failure; Feedback; Future; Goals; HIV; Health; Health Promotion; Hour; Individual; Intervention; Intervention Studies; Lead; Maintenance; Measurement; Measures; Mediating; Mental Health; Methods; Mission; Modeling; Older Population; Outcome; Outcome Measure; Participant; Pathway interactions; Personal Satisfaction; Personality; Persons; Pilot Projects; Population; Population Heterogeneity; Process; Program Acceptability; Quality of life; Randomized; Recovery; Reporting; Research; Resources; Sampling; Science; Self Administration; Self Efficacy; Severities; Social support; Stress; Stress and Coping; Stressful Event; Taxonomy; Testing; Time; Translations; Trauma; Treatment Efficacy; United States National Institutes of Health; Viral; Vulnerable Populations; Work; acceptability and feasibility; adverse childhood events; aged; allostatic load; biological adaptation to stress; cognitive function; coping; daily functioning; demographics; depressive symptoms; design; effectiveness implementation study; effectiveness implementation trial; efficacy evaluation; efficacy testing; emotion regulation; experience; feasibility testing; health management; improved; innovation; intervention effect; mindfulness meditation; multiphase optimization strategy; optimism; primary outcome; programs; protective factors; psychoeducation; psychoeducational; psychologic; resilience; response; social; social stigma; socioeconomic adversity; stress reactivity; stressor; symptomatology; therapy development; treatment response; visit adherence

PROJECT SUMMARY/ABSTRACT Despite evidence that: 1) older people living with HIV (PLHIV) experience a high burden of stress that is associated with myriad poorer outcomes, 2) psychological resilience may buffer the negative effects of stress in older PLHIV, and 3) older PLHIV may possess lower levels of this protective factor than seronegative counterparts, little work has examined strategies to bolster resilience in older PLHIV. In line with the mission of NIH and PAR-21-069, this R21 proposal, guided by preliminary studies, the Stage Model for Behavioral Intervention Development, and a strong research team, will advance the science on resilience interventions by including: 1) AN IMPORTANT UNDERSTUDIED POPULATION: older PLHIV in the Deep South; 2) A THEORY-DRIVEN RESILIENCE FRAMEWORK: Guided by The Transactional Model of Stress and Coping, the Protective Factor Model of Resilience, and the Broaden-and-Build Model, we operationalize resilience as a process whereby individuals with a set of malleable resilience resources for both appraising and responding to stress are better able to avoid prolonged (or any) disruptions in functioning. We will use a resilience curriculum that is theoretically grounded in these models and has been optimized with our pilot data; 3) RIGOROUS EXAMINATION OF EFFICACY AND MECHANISMS: We will test intervention efficacy on resilience resources and momentary stress responses using real-time methods (i.e., experience sampling method [ESM]). This RCT will randomize 100 older PLHIV aged 50+ to either an intervention condition or an attention-matched control condition. Our comprehensive battery will include proximal mechanistic measures, (i.e., ESM measurement of resilience resources and stress reactivity and recovery), and health (i.e., psychological functioning and HIV outcomes) measures. Our Primary Aims focus on intervention effects on: the use of resilience resources and whether such increases drive improved affective stress reactivity and recovery (Aim 1) and distal health outcomes at three months (Aim 2). Our exploratory aim will examine moderators of treatment response. Findings will identify intervention mechanisms and inform the development of potent and scalable interventions for building resilience in older PLHIV and other diverse populations of older adults.

项目概要/摘要 尽管有证据表明：1) 老年人艾滋病毒感染者 (PLHIV) 承受着沉重的压力， 与无数较差的结果相关，2）心理弹性可以缓冲压力的负面影响 在老年 PLHIV 中，以及 3) 老年 PLHIV 中这种保护因子的水平可能低于血清阴性者 与此相反，很少有人研究增强老年感染者艾滋病毒恢复能力的策略。符合 NIH 和 PAR-21-069 的任务，此 R21 提案以初步研究、阶段模型为指导 行为干预开发和强大的研究团队将推动复原力科学的发展 干预措施包括： 1) 重要的未被研究人群：深海中的老年艾滋病病毒感染者 南; 2) 理论驱动的复原力框架：以压力交互模型为指导 和应对、复原力的保护因素模型以及扩展和构建模型，我们将其付诸实施 复原力是一个过程，个人拥有一套可塑的复原力资源，用于评估和评估 应对压力能够更好地避免长期（或任何）功能中断。我们将使用一个 复原力课程在理论上以这些模型为基础，并根据我们的试点数据进行了优化； 3）严格检验效果和机制：我们将测试干预效果 使用实时方法（即经验采样 方法[ESM]）。该随机对照试验将 100 名 50 岁以上的老年艾滋病毒感染者随机分为干预组或随机组 注意力匹配控制条件。我们的综合电池将包括近端机械措施， （即弹性资源和压力反应性和恢复的 ESM 衡量）和健康（即 心理功能和艾滋病毒结果）措施。我们的主要目标侧重于以下方面的干预效果： 复原力资源的使用以及这种增加是否会改善情感压力反应性以及 恢复（目标 1）和三个月后的远端健康结果（目标 2）。我们的探索目标将检查 治疗反应的调节因素。调查结果将确定干预机制并告知 制定有效且可扩展的干预措施，以增强老年艾滋病毒感染者和其他感染者的抵御能力 不同的老年人群体。