Feasibility of the Mindfulness-Based Stress Reduction Intervention for Black Women Living with HIV

针对感染艾滋病毒的黑人女性进行正念减压干预的可行性

基本信息

批准号：
10213659
负责人：
Crystal LaShonda Chapman Lambert
金额：
$ 13.62万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-08-15 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10213659
关键词：
Accounting Adherence African American Area Attention Attenuated Awareness Behavior Behavior Therapy Breast Cancer survivor Caring Chronic Clinic Clinical Communities Conduct Clinical Trials Critiques Data Epidemic Evaluation Event Failure Female Focus Groups Future Gender Goals Group Interviews HIV HIV diagnosis Health Health behavior outcomes Informal Social Control Interpersonal Violence Intervention Interview K-Series Research Career Programs Lead Length Life Logistics Manuals Medical Mental Depression Mentors Mentorship Methods Mind Mind-Body Method Morbidity - disease rate Outcome Outpatients Participant Pilot Projects Process Publishing Quality of life Randomized Reporting Research Research Design Research Methodology Research Personnel Sampling Schedule Scientist Self Care Stress Stressful Event Suggestion Survivors Target Populations Testing Time Training Trauma Treatment Efficacy United States Viral Viral Load result Visit Woman Work acceptability and feasibility adherence rate antiretroviral therapy arm behavior test behavioral adherence black women care providers career career development comparison intervention coping data format data integration efficacy evaluation efficacy trial experience gender disparity high risk improved male marginalized population men mindfulness-based stress reduction mortality patient population physical symptom programs psychologic psychological distress psychological symptom racial and ethnic racial disparity recruit satisfaction standard of care stress management stress reduction symptom management therapy adherence therapy development treatment adherence treatment as usual visit adherence

项目摘要

Project Summary/Abstract The overall objective of this Mentored Research Scientist Career Development Award is to support and develop Dr. Chapman Lambert’s transition to an independent investigator in mind and body research with a focus on developing, integrating, and testing mind and body strategies to improve clinical, psychological, and physical outcomes among African American (AA) women living with HIV (WLWH). HIV viral load (VL) suppression among AA WLWH are suboptimal when compared to women of other racial and ethnic backgrounds. Two essential self- care behaviors for people living with HIV (PLWH) to achieve and sustain HIV VL suppression ad improve health outcomes and survival are adherence to antiretroviral therapy and scheduled medical visits. Medical visit adherence is suboptimal among women in general, but VL suppression rates among AA WLWH are suboptimal with AA WLWH being nearly 3 times more likely than White WLWH not to achieve viral suppression. One important factor associated with adherence behaviors is stressful life events including traumatic life events. Thus, there is a critical need to develop culturally appropriate interventions aimed reducing stress and improving adherence behaviors and VL suppression. Mindfulness-based stress reduction (MBSR), developed by Jon Kabat-Zinn, has the potential to reduced stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping as well as ART adherence in predominately white and male patient populations. We propose to culturally adapt the MSBR intervention for AA WLWH to reduce stress and enhance HIV self-care behaviors and VL suppression, which has the potential to attenuate prominent racial and gender disparities experienced by AA WLWH in the US. Specifically, we aim to 1) culturally adapt the MBSR intervention for AA WLWH using ADAPT-ITT; 2) pre-pilot the adapted intervention via an open non-randomized pilot study to further refine the culturally adapted intervention; and 3) conduct a 2-armed pilot test of the behavioral intervention compared to standard of care to assess the feasibility and acceptability the adapted MBSR intervention for AA WLWH. Findings from this study will provide an important first step in establishing my program of research as an independent investigator in stress-related morbidity and HIV treatment adherence. In addition, findings maybe applicable for other chronic conditions and marginalized populations living with and without HIV.

项目概要/摘要该导师研究科学家职业发展奖的总体目标是支持和发展查普曼·兰伯特博士转变为身心研究的独立研究者，重点关注开发、整合和测试身心策略，以改善临床、心理和身体非洲裔美国 (AA) 艾滋病毒感染者 (WLWH) 的 HIV 病毒载量 (VL) 抑制的结果。与其他种族和族裔背景的女性相比，AA WLWH 的表现并不理想。有两个基本的自我特征。 HIV 感染者 (PLWH) 的护理行为，以实现和维持 HIV VL 抑制并改善健康结果和生存是指坚持抗逆转录病毒治疗和定期就诊。一般而言，女性的依从性不佳，但 AA WLWH 的 VL 抑制率也不佳 AA WLWH 无法实现病毒抑制的可能性比 White WLWH 高出近 3 倍。与依从行为相关的重要因素是压力生活事件，包括创伤性生活事件。迫切需要制定适合文化的干预措施，旨在减轻压力并改善坚持行为和基于正念的减压 (MBSR)，由 Jon 开发。 Kabat-Zinn，有可能通过自我调节注意力和对压力的认识来减轻压力 MBSR 已被证明可以有效改善压力管理、心理困扰、身体和健康状况。主要是白人和男性的心理症状、生活质量、应对方式以及 ART 依从性我们建议在文化上调整 AA WLWH 的 MSBR 干预措施，以减轻压力和增强 HIV 自我护理行为和 VL 抑制，这有可能减弱显着的种族和具体来说，我们的目标是 1) 在文化上适应 MBSR。使用 ADAPT-ITT 对 AA WLWH 进行干预 2) 通过开放的非随机预试验调整干预措施；试点研究，进一步完善文化适应干预措施；3) 进行 2 组试点测试行为干预与护理标准进行比较，以评估适应的可行性和可接受性 AA WLWH 的 MBSR 干预措施将为建立我的研究迈出重要的第一步。作为压力相关发病率和艾滋病毒治疗依从性的独立调查员的研究计划。此外，研究结果可能适用于其他慢性病和患有慢性疾病的边缘人群没有艾滋病毒。