Community-based Self-management of HIV and Chronic Disease

基于社区的艾滋病毒和慢性病自我管理

• 批准号: 7283440
• 负责人: SHERYL L CATZ
• 金额: $ 58.7万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7283440
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adopted; Age; Aging; American; Anti-Retroviral Agents; Arthritis; Attention; Behavior; Books; Characteristics; Chronic; Chronic Disease; Chronic Hepatitis C; Chronically Ill; Communities; Complex; Condition; Consultations; Counseling; Development; Diabetes Mellitus; Disease Management; Disease Progression; Education; Elderly; Enrollment; Evidence based intervention; HIV; Health; Heart Diseases; Hypertension; Intervention; Intervention Studies; Life; Literature; Lung diseases; Medical; Mental Depression; Mental Health; Modeling; Motivation; NIH Program Announcements; Numbers; Outcome Measure; Participant; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Physical Function; Population; Problem Solving; Protocols documentation; Quality of life; Randomized; Randomized Controlled Trials; Range; Readiness; Recruitment Activity; Research; Research Personnel; Resources; Self Efficacy; Self Management; Services; Site; Social Functioning; Social isolation; Stigmata; Stress; Telephone; Testing; Training; Transportation; Upper arm; Work; age group; aged; aging population; base; chronic pain; comparison group; coping; cost; desire; disability; follow-up; health related quality of life; improved; medication compliance; member; programs; response; self help; skills; skills training; social stigma; symptom management; treatment program

DESCRIPTION (provided by applicant): A growing number of Americans living with HIV/ AIDS are aged 50 or older. The majority of HIV+ older persons must manage multiple chronic health conditions, which increases the challenge of self-managing their health. However, little work has addressed this issue. Pilot research showed this population desires assistance with HIV management and adherence, chronic disease management, and quality of life. Prior research has also shown telephone counseling to be acceptable, feasible, and efficacious in improving coping among older HIV+ persons. We are therefore seeking to test the efficacy of an individualized telephone counseling intervention focused on HIV treatment adherence and chronic disease self- management. A telephone format has potential to increase access to self-management support services among older adults who may be isolated or in poor health. Primary aims are to conduct a randomized controlled trial with 450 persons recruited from community-based AIDS Service Organizations (ASOs) who are aged 50+ years and living with HIV/AIDS and other chronic conditions. We will evaluate the efficacy of an experimental 10-session individually-tailored telephone counseling intervention, as compared to a 10- session attention-matched didactic telephone group comparison arm, and an information-matched book only control arm. Primary outcome measures are HIV treatment adherence and health-related quality of life at baseline, 6, 9, and 12-month follow-ups. Secondary aims are to evaluate between group differences in: (a) overall chronic disease treatment adherence; (b) problem-solving skills, self-efficacy, and readiness to change; and (c) perceived stress and depression. Development of an individualized intervention to enhance HIV-specific and general chronic illness self-management skills and motivation among persons aged 50 and older living with HIV/AIDS and other comorbid chronic conditions will help to address the broad needs of this population. Our proposed intervention and recruitment plan capitalizes on the strengths of existing community-based organizations, and in the long-term may have the potential to help build their capacity to serve older persons with HIV. The proposed intervention model and format could also be generalizable to other populations of persons with multiple chronic conditions..

描述（由申请人提供）：越来越多的艾滋病毒/艾滋病的美国人年龄在50岁或以上。大多数艾滋病毒+老年人必须管理多种慢性健康状况，这增加了自我管理健康的挑战。但是，很少的工作解决了这个问题。试点研究表明，该人群希望在艾滋病毒管理和依从性，慢性疾病管理和生活质量方面提供帮助。先前的研究还表明，电话咨询是可以接受，可行和有效的，可改善老年艾滋病毒+人的应对。因此，我们正在寻求测试针对HIV治疗依从性和慢性病自我管理的个性化电话咨询干预措施的功效。电话格式有可能增加可能孤立或健康状况不佳的老年人获得自我管理支持服务的潜力。主要目的是对从50岁以上的社区艾滋病服务组织（ASO）招募的450人进行随机对照试验，并患有艾滋病毒/艾滋病和其他慢性病。与10次会话匹配的教学教学组比较组以及仅通过信息匹配的书籍控制部门相比，我们将评估实验性10条单独限制的电话咨询干预的实验性10次课程的疗效。主要结果指标是基线，6、9和12个月的随访时HIV治疗依从性和与健康相关的生活质量。次要目的是评估以下方面的群体差异：（a）总体慢性疾病治疗依从性； （b）解决问题的技能，自我效能和愿意改变； （c）感知的压力和抑郁。开发个性化干预措施，以增强艾滋病毒/艾滋病和其他合并症的50岁及以上生活的人的艾滋病毒特异性和一般慢性疾病自我管理能力和动力，将有助于满足该人群的广泛需求。我们提议的干预和招聘计划利用了现有社区组织的优势，从长远来看，我们可能有可能帮助建立为艾滋病毒的老年人服务的能力。拟议的干预模型和格式也可以推广到具有多种慢性病的其他人群。