Developing an intervention to promote API women's sexual and mental health

制定干预措施以促进 API 女性的性健康和心理健康

• 批准号: 8708978
• 负责人: Hyeouk Chris Hahm
• 金额: $ 24.48万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-08-01 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8708978
• 关键词: AIDS/HIV problem; Address; Adherence; Adverse event; Affect; Age; Alcohol or Other Drugs use; Area; Asians; Biometry; Boston; Child; Communities; Control Groups; Critiques; Data; Diagnosis; Dropout; Eligibility Determination; Enrollment; Epidemiologic Studies; Ethnic group; Evidence based intervention; Exhibits; Feedback; Feeling suicidal; Focus Groups; Foundations; Funding; Future; Gender; Group Psychotherapy; Growth; HIV; HIV Infections; HIV risk; HIV/STD; Health; Healthy People 2010; Heterosexuals; Hispanics; Human immunodeficiency virus test; Immigrant; Incidence; Individual; Intervention; Knowledge; Lead; Link; Manuals; Measures; Mediation; Mental Depression; Mental Health; Mental disorders; Mental health promotion; Modeling; National Institute of Mental Health; Outcome; Pacific Island Americans; Participant; Population; Post-Traumatic Stress Disorders; Prevalence; Preventive Medicine; Protocols documentation; Psychiatry; Psychology; Public Health; Qualitative Methods; Race; Randomized; Randomized Clinical Trials; Recording of previous events; Recruitment Activity; Reporting; Research; Research Project Grants; Research Support; Risk; Risk Behaviors; Risk Reduction; Safety; Secure; Self Efficacy; Self Mutilation; Severities; Sexual Health; Social Work; Strategic Planning; Suicide; Suicide attempt; Symptoms; Technology; Testing; Text; Translating; Trauma; United States National Institutes of Health; University Health Services; Violence; Voice; Waiting Lists; Woman; Women' s Health; Work; accomplished suicide; arm; base; design; efficacy testing; empowerment; experience; follow-up; group intervention; holistic approach; improved; innovation; intimate partner violence; meetings; post intervention; pregnant; premature; primary outcome; public health relevance; racial and ethnic; resilience; safer sex; satisfaction; secondary outcome; sex; social; suicide rate; transmission process

DESCRIPTION (provided by applicant): Our objective for this R34 is to systematically modify the existing evidence-based intervention, "Seeking Safety" (SS), by integrating a gender-specific HIV intervention (Project FIO) and critical cultural components for Asian-Pacific Islander (API) women who report a history of violent traumatic experience or a diagnosis of Post-Traumatic Stress Disorder (PTSD). This proposal is significant because it aims to reduce two public health problems among API women: 1) the rapidly rising incidence of HIV/STIs, and 2) the highest rates of completed suicide between the ages 15 to 24 among all racial groups of women. A preliminary study based on a K01 identified a strong association between lifetime sexual and physical trauma and health risk behaviors in API women. Specifically, those who experienced trauma had elevated risks of suicidality, substance use, and HIV risk behaviors. To date, no specific intervention that integrates sexual and mental health promotion has been tested for the APIs population, despite it is the fastest growing in the US. The most commonly applied, empirically-supported intervention for women who have experienced trauma is SS.1 However, the intervention should be culturally appropriate and grounded in "the real world" of API women affected by trauma. Thus, we will develop new protocols, which incorporate SS, Project FIO (Future is Ours), API women's unique experiences and voices, and feedback from intervention experts and an API Community Advisory Board (CAB) (Aim 1). We propose to test the feasibility and safety of a pilot randomized clinical trial (RCT) using a two- armed design (with an intervention group of 36, and a wait-list control group of 36) (Aim 2). We will launch AWARE (Asian Women's Action for Resilience and Empowerment) to screen at least 400 women in the greater Boston area and recruit a total of 72 women who meet the criteria for PTSD and traumatic history. The 10-week intervention will be given group psychotherapy along with secure daily mobile text messages ("AWARE Stories"). Adherence to group psychotherapy, utilization/satisfaction of secure mobile messages, and safety (suicidality and intimate partner violence) will be tested as feasibility outcomes. We also aim to test the efficacy of AWARE (Aim 3). We will measure HIV-related outcomes (primary outcomes) and psychiatric symptoms and substance use (secondary outcomes) at baseline, week 10, and 3 months to determine effect sizes for outcomes of the adapted intervention. This integrative, holistic approach is innovative in multiple ways: (1) the study will be the first pilot RCT study to target traumatized API women, (2) it incorporates a culturally appropriate intervention to be widely available, acceptable, and feasible, (3) it is designed to reduce HIV risk behavior, and (4) it tests the feasibility of a moble technology. The proposed research project responds to multiple priorities of NIH, NIMH, and Healthy People 2010. In the future, the findings can be translated into a larger RCT. It is our aim that these efforts will ultimately lead to the reduction of HIV transmission, suicidality, and psychiatric symptoms among API women.

描述（由申请人提供）：我们的R34的目标是通过整合特定性别的HIV干预措施（项目FIO）和亚洲太平洋岛民的关键文化组成部分来系统地修改现有的基于证据的干预“寻求安全”（SS）（SS） （API）报告了暴力创伤经历或创伤后应激障碍（PTSD）史的妇女。该提案很重要，因为它旨在减少API妇女中的两个公共卫生问题：1）艾滋病毒/性传播疾病的发病率迅速上升，以及2）在所有种族妇女种族群体中，在15至24岁之间的自杀率最高。一项基于K01的初步研究确定了API妇女的终身性和身体创伤与健康风险行为之间的密切关联。具体而言，那些经历过创伤的人的自杀，药物使用和艾滋病毒风险行为的风险升高。迄今为止，尽管它是美国增长最快的人群，但还没有针对API人群进行了对性和心理健康促进的整合的具体干预措施。对经历创伤的妇女，最常用的经验支持的干预措施是SS.1但是，这种干预措施应在文化上适当，并扎根于受创伤影响的API妇女的“现实世界”中。因此，我们将开发新的协议，其中包含SS，Project FIO（未来是我们的），API女性的独特经验和声音，以及干预专家和API社区顾问委员会（CAB）的反馈（AIM 1）。我们建议使用两种武装设计（36例干预组和36的候补名单组）测试试验随机临床试验（RCT）的可行性和安全性（AIM 2）。我们将启动意识到（亚洲妇女的韧性和赋权行动），以筛查大波士顿地区至少400名妇女，并招募72名妇女符合PTSD和创伤历史标准。为期10周的干预措施将接受团体心理治疗以及安全的每日移动短信（“意识故事”）。遵守组心理治疗，安全移动消息的利用/满意度以及安全性（自杀和亲密伴侣暴力）将被视为可行性结果。我们还旨在测试Aware的功效（AIM 3）。我们将在基线，第10周和3个月测量与HIV相关的结果（主要结果）以及精神症状和药物使用（次要结果），以确定适应性干预措施的结果。这种综合性的整体方法以多种方式具有创新性：（1）该研究将是针对受创伤的API妇女的第一项试点RCT研究，（2）它结合了一种具有文化上适当的干预措施，以广泛可用，可接受和可行，（3）它旨在降低HIV风险行为，并（4）测试Moble技术的可行性。拟议的研究项目对NIH，NIMH和Healthy People 2010的多个优先事项做出了回应。将来，这些发现可以转化为更大的RCT。这是我们的目标 这些努力最终将导致API妇女的艾滋病毒传播，自杀和精神病症状的减少。