Neuropsychological and cultural predictors of adherence

依从性的神经心理学和文化预测因素

• 批准号: 7231173
• 负责人: Reuben N Robbins
• 金额: $ 2.54万
• 依托单位: FORDHAM UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-25 至 2007-09-24
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7231173
• 关键词: AIDS therapy; HAART (highly active antiretroviral therapy); HIV infections; Hispanic Americans; attention; behavioral /social science research tag; caucasian American; clinical research; cognition disorders; culture; executive function; health disparity; health services research tag; human immunodeficiency virus 1; human subject; mental disorder prevention; microprocessor /microchip; neuropsychological tests; patient monitoring device; predoctoral investigator; psychological models; psychomotor function; racial /ethnic difference; short term memory; therapy compliance

DESCRIPTION (provided by applicant): HIV infection among the Hispanic community is disproportionate to the overall population of the United States (CDC, 2002). Hispanics account for 13% of the U.S. population, yet they account for 20% of reported AIDS cases in the U.S. (CDC, 2002). Hispanics have approximately four tunes the rate of new infections compared to non-Hispanic Whites, and the estimated number of Hispanics living with HIV/AIDS compared to non-Hispanic Whites is 25% to 12% (CDC, 2002). Numerous studies have identified the detrimental neurocognitive sequela and functional impact of HIV infection and research has shown that ethnic minorities are less likely to adhere to medical protocols. Highly active antiretroviral therapy (HAART) for HIV/AIDS has helped to inhibit the detrimental neurocognitive effects of HIV's involvement in the central nervous system. However, in order to benefit from HAART, individuals must be vigilant in their compliance. Studies have shown that individuals with neuropsychological (NP) impairment are less likely to adhere to their medication regimens. However, these studies have examined mostly African American populations, with no emphasis on cultural differences. With disproportionate rates of HIV infection among Hispanics, the high rate of new infections among Hispanics, and the risk of not adhering to medical protocols, this group is at particularly high risk for neurocognitive impairment and impaired functioning in everyday activities. The present study intends to extend the literature by examining the NP and cultural predictors of medication adherence in a sample of HIV+ Hispanic and demographically matched non-Hispanic white adults. The aims of the study are to: i) characterize HIV+ Hispanic adults' medication adherence rates using state of the art medication monitoring technology, and compare this groups' medication adherence rates to a demographically and medically matched sample non-Hispanic whites; 2) Determine the neuropsychological domains most predictive of medication adherence; and 3) Evaluate the role acculturation plays in medication adherence among HIV+ Hispanics. This study, if funded, has particular import on public health, as developing a clear understanding of Hispanics' medication taking behaviors can help develop tailored interventions targeting NP impairment and cultural issues for Hispanics and hopefully attenuate HIV's disproportionate impact on this community.

描述（由申请人提供）：西班牙裔社区中的艾滋病毒感染率与美国总人口不成比例（CDC，2002）。西班牙裔占美国人口的 13%，但他们却占美国报告的艾滋病病例的 20%（CDC，2002）。与非西班牙裔白人相比，西班牙裔新感染率大约高出四倍，预计感染艾滋病毒/艾滋病的西班牙裔人数与非西班牙裔白人相比为 25% 至 12%（CDC，2002 年）。大量研究已经确定了艾滋病毒感染的有害神经认知后遗症和功能影响，并且研究表明少数族裔不太可能遵守医疗方案。针对艾滋病毒/艾滋病的高效抗逆转录病毒疗法（HAART）有助于抑制艾滋病毒对中枢神经系统的有害神经认知影响。然而，为了从 HAART 中受益，个人必须警惕其依从性。研究表明，患有神经心理（NP）损伤的个体不太可能坚持他们的药物治疗方案。然而，这些研究主要考察的是非裔美国人，没有强调文化差异。由于西班牙裔的艾滋病毒感染率过高、新感染率很高，以及不遵守医疗方案的风险，该群体神经认知障碍和日常活动功能受损的风险特别高。本研究旨在通过检查 HIV+ 西班牙裔和人口匹配的非西班牙裔白人成年人样本中药物依从性的 NP 和文化预测因素来扩展文献。该研究的目的是：i) 使用最先进的药物监测技术描述 HIV+ 西班牙裔成年人的药物依从率，并将该群体的药物依从率与人口统计和医学上匹配的非西班牙裔白人样本进行比较； 2) 确定最能预测药物依从性的神经心理学领域； 3) 评估文化适应在 HIV+ 西班牙裔患者的药物依从性中所起的作用。这项研究如果获得资助，对公共卫生具有特别重要的意义，因为清楚地了解西班牙裔的用药行为有助于制定针对西班牙裔 NP 损伤和文化问题的定制干预措施，并有望减轻艾滋病毒对该社区的不成比例的影响。