Influence of Food Insecurity on Adherence

粮食不安全对依从性的影响

基本信息

批准号：
8603060
负责人：
SETH C KALICHMAN
金额：
$ 32万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-15 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8603060
关键词：
18 year old AIDS/HIV problem Address Adherence Advertisements Advocate Alcohol consumption Alcohol or Other Drugs use Alcoholism Anti-Retroviral Agents Attention Behavior Therapy Behavior monitoring Case Management Case Manager Cities Collaborations Communities Consent Consultations Counseling Data Collection Development Evaluation Feedback Focus Groups Food Food Access HIV HIV Infections HIV Seropositivity Health Health Services Health Services Accessibility Hunger Individual Individual Differences Intervention Intervention Studies Interview Life Malnutrition Mediating Mental Depression Methods Monitor Moods Outcome Participant Patients Pharmaceutical Preparations Population Poverty Procedures Protocols documentation Provider Randomized Recruitment Activity Regimen Reporting Request for Proposals Research Research Personnel Research Proposals Resources Sampling Site Social Work Social support Source Staging Stress Stress and Coping Substance abuse problem Surveys System Testing Text Time United States Woman addiction antiretroviral therapy base clinical care coping design drinking experience follow-up health disparity improved inner city innovation instrument intervention effect medication compliance meetings men novel nutrition prevent public health relevance research and development skills social standard of care substance abuse treatment theories therapy adherence therapy design therapy development treatment adherence urban area

项目摘要

DESCRIPTION (provided by applicant): This research proposal requests 3 years of support to conduct developmental intervention studies to design and field test a theory-based intervention to address food insecurity and improve antiretroviral therapy (ART) adherence among men and women living with HIV infection. Food insecurity is prevalent among people living with HIV in US inner-cities, with as many as 43% not having sufficient food and experiencing intermittent hunger. Food insecurity has demonstrated direct associations with ART adherence including predicting non-adherence over and above other factors including depression, social support, and alcohol use. Food insecurity is particularly problematic in relation to substance abuse given competing survival needs and the dire combined health consequences of alcoholism, addiction and malnutrition. Guided by the Conservation of Resources Theory of Stress and Coping, we will conduct 3 stages of intervention development research: (1) initial interviews and focus groups with people living with HIV who take ART, use substances, and experience food insecurity. Based on information gained from rapid formative studies, this first stage of research will be used to develop a theory-based intervention to address accessing food and sustaining ART adherence; (2) Test the feasibility of the newly developed food insecurity and adherence intervention with a small sample of HIV positive men and women who are taking ART, use substances, and experience food insecurity. Stage 2 will also finalize and pilot test all assessment instruments and protocols for data collection; and (3) Conduct a randomized field test to determine the potential efficacy of the food insecurity and ART adherence intervention. Participants in the field test will be randomly assigned to either receive the newly developed intervention or a time matched attention comparison condition. Following a 6- month follow-up period, we will test for differences between groups on ART adherence, food access, nutrition, and coping resource outcomes. The intervention development will include pilot testing daily food, mood, and substance use behaviors monitored by interactive text-message surveys. We will also examine the intervention effects on mediating theoretical constructs derived by Conservation of Resources Theory. Our developmental research will also examine the feasibility and acceptability of conducting the intervention in face-to-face intervention sessions. The proposed intervention research will therefore develop new strategies for use with people living with HIV who are taking ART under adverse conditions with multiple competing needs.

描述（由申请人提供）：本研究提案需要 3 年的支持来进行发育干预研究，以设计和现场测试基于理论的干预措施，以解决粮食不安全问题并提高艾滋病毒感染者的抗逆转录病毒治疗 (ART) 依从性。在美国内城区的艾滋病毒感染者中，粮食不安全现象普遍存在，多达 43% 的人没有足够的食物并经历间歇性饥饿。事实证明，粮食不安全与抗逆转录病毒疗法的依从性直接相关，包括预测不依从性以及其他因素（包括抑郁、社会支持和饮酒）。鉴于相互竞争的生存需求以及酗酒、成瘾和营养不良对健康造成的可怕综合后果，粮食不安全与药物滥用相关的问题尤其严重。在压力和应对的资源保护理论的指导下，我们将进行三个阶段的干预发展研究：（1）对接受抗逆转录病毒治疗、使用药物和经历粮食不安全的艾滋病毒感染者进行初步访谈和焦点小组。根据快速形成性研究获得的信息，第一阶段的研究将用于制定基于理论的干预措施，以解决获取食物和维持抗逆转录病毒治疗的依从性问题； (2) 使用一小部分正在接受抗逆转录病毒治疗、使用药物和经历粮食不安全的艾滋病毒阳性男性和女性样本，测试新开发的粮食不安全和依从性干预措施的可行性。第二阶段还将最终确定并试点测试所有评估工具和数据收集协议； (3) 进行随机现场测试，以确定粮食不安全和 ART 依从性干预措施的潜在功效。现场测试的参与者将被随机分配接受新开发的干预措施或时间匹配的注意力比较条件。经过 6 个月的随访期后，我们将测试各组之间在 ART 依从性、食物获取、营养和应对资源结果方面的差异。干预措施的开发将包括通过交互式短信调查监测日常食物、情绪和物质使用行为的试点测试。我们还将研究对资源保护理论衍生的中介理论构建的干预效果。我们的发展研究还将检验面对面干预会议中进行干预的可行性和可接受性。因此，拟议的干预研究将制定新的策略，供在具有多种相互竞争需求的不利条件下接受抗逆转录病毒治疗的艾滋病毒感染者使用。