Mindfulness and Behavior Change to Reduce Cardiovascular Disease Risk in Older People with HIV

正念和行为改变可降低老年艾滋病毒感染者的心血管疾病风险

• 批准号: 10762220
• 负责人: Jacklyn Donna Foley
• 金额: $ 19.59万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-05 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10762220
• 关键词: Acute myocardial infarction; Address; Affect; Alcohol consumption; Alcohols; Amaze; Atherosclerosis; Automobile Driving; Behavior Therapy; Behavioral; Behavioral Mechanisms; Behavioral Medicine; Behavioral Sciences; Benchmarking; Biological; Biological Markers; Blood Pressure; Breathing; Cardiology; Cardiovascular Diseases; Cardiovascular system; Cellular Phone; Chronic; Clinical; Clinical Trials; Communicable Diseases; Disease; Dose; Education; Elderly; Elements; Environment; Exercise; Feedback; Foundations; Functional disorder; General Hospitals; General Population; Goals; HIV; HIV/AIDS; Health; Health behavior; Heart; Heart failure; Immune; Immune response; Inflammation; Inflammatory; Informal Social Control; Institution; Integrative Medicine; Interdisciplinary Study; Intervention; Interview; Ischemic Stroke; Language; Licensing; Link; Longevity; Massachusetts; Mediating; Mental disorders; Mentors; Mentorship; Methods; Mind; Modality; Modeling; Movement; National Heart, Lung, and Blood Institute; Patient Self-Report; Personal Satisfaction; Persons; Phase; Protocols documentation; Psychologist; Psychology; Publications; Publishing; Qualitative Methods; Randomized, Controlled Trials; Research; Research Design; Research Infrastructure; Research Personnel; Research Priority; Risk; Risk Behaviors; Risk Reduction; Sampling; Self Efficacy; Stress; Structure; Symptoms; Text; Text Messaging; Tobacco smoking behavior; Training; Training Programs; Unhealthy Diet; United States; Woman; Work; acceptability and feasibility; aged; behavior change; cardiovascular disorder risk; comorbidity; diabetes prevention program; eHealth; effective intervention; efficacy trial; endothelial dysfunction; evidence base; experience; health management; impaired glucose tolerance; improved; innovation; interest; intervention refinement; medical schools; meetings; mindfulness; mindfulness intervention; mindfulness-based stress reduction; mobile computing; multidisciplinary; novel; physical inactivity; pilot test; programs; psychologic; psychological distress; skills; substance use; systemic inflammatory response; text messaging intervention; therapy development; treatment as usual; trial design; uptake

PROJECT SUMMARY In this K23 proposal, I outline a comprehensive five-year training program that will prepare me for the transition to an independent, R01 level investigator capable of developing novel, feasible, and scalable integrative behavioral interventions to reduce psychological and cardiovascular disease (CVD) risk in older people with HIV (OPWH). To achieve this goal, my training objectives are to: 1.) develop expertise in mindfulness and behavior change for CVD risk reduction; 2.) gain experience in randomized controlled trial (RCT) design and implementation among OPWH; and 3.) develop proficiency in inflammation biomarker research to better my understanding of the HIV-CVD pathophysiology. In this application, I propose a significant and innovative research strategy, an amazing interdisciplinary mentorship team, and comprehensive didactic plan to support these goals. Background: OPWH are disproportionately impacted by CVD attributable to chronic HIV immune dysregulation and resulting inflammation. Systemic inflammation is exacerbated by psychological distress via activating the immune response and driving proinflammatory CVD risk behaviors. There is promising evidence to suggest that mindfulness could be an effective intervention to reduce psychological distress and support behaviorally- and inflammatory-mediated CVD risk reduction. Specific Aims and Research Design: I propose to refine and synthesize mindfulness and behavior change content from evidence-based protocols (mindfulness-based stress reduction and diabetes prevention program) to develop and pilot test a new text message-enhanced intervention called “One Mind One Heart” (OM-OH) using feedback from semi-structured interviews with OPWH in psychological distress (N=20), and my multidisciplinary mentorship team (Aim 1). Next, I will explore, via an open pilot (N=5) with exit interviews and pre-post self-report assessments, the initial acceptability of OM-OH and further refine OM-OH as needed (Aim 2). Finally, I will conduct a pilot randomized controlled trial (RCT; N=50) to a.) evaluate benchmarks of feasibility and acceptability of study methods and refined OM-OH compared to enhanced usual care, and b.) investigate potential for effects on psychological distress, inflammation, and behavioral CVD risk (Aim 3). Findings will provide the foundation for an R01 application to conduct an efficacy trial of OM-OH to reduce inflammatory-mediated CVD risk among OPWH. Training and Mentorship: My training plan will be led by my co-primary mentors Drs. Conall O’Cleirigh and Gloria Yeh, both renowned researchers focused on intervention development and clinical trials for HIV and cardiovascular disease, respectively. I will also be supported by a.) a team of expert co-mentors and collaborators, b.) a rich institutional environment at Massachusetts General Hospital and Harvard Medical School, and c.) targeted coursework, scientific meetings, seminars, and planned publications. Relevance to NHLBI: This K23 is in line with the published research priorities of the NHLBI HIV/AIDS program to address HIV-related cardiovascular comorbidities.

项目摘要 在此K23提案中，我概述了一项全面的五年培训计划，该计划将使我为过渡做好准备 对于独立的R01级研究者，能够开发新颖，可行和可扩展的整合 降低心理和心血管疾病（CVD）风险的行为干预措施 艾滋病毒（OPWH）。为了实现这一目标，我的培训目标是：1。）在正念和 CVD风险降低的行为改变； 2.）在随机对照试验（RCT）设计和 OPWH之间的实施； 3.）炎症生物标志物研究的发展水平，以改善我 了解HIV-CVD病理生理学。在此应用程序中，我提出了一个重要而创新的 研究策略，一个了不起的跨学科思想团队以及支持的全面教学计划 这些目标。背景：OPWH受到可归因于慢性HIV免疫的CVD的不成比例的影响 失调和导致的感染。心理困扰通过 激活免疫响应和驱动促炎CVD风险行为。有希望的证据 暗示正念可能是减少心理困扰和支持的有效干预措施 行为和炎症介导的CVD风险降低。具体目的和研究设计：我提出 完善和综合正念和行为从基于证据的协议中更改内容 （基于正念的压力减轻和预防糖尿病计划）开发和试点测试新文本 消息增强的干预措施称为“一颗心脏一颗心”（OM-OH），使用半结构化的反馈 在心理困扰（n = 20）和我的多学科心态团队（AIM 1）中对OPWH的访谈。 下一 OM-OH的可接受性，并根据需要进一步完善OM-OH（AIM 2）。最后，我将进行一个随机的飞行员 对照试验（RCT; n = 50）至a。）评估研究方法的可行性和可接受性的基准 与增强的通常护理相比，精致的OM-OH和b。）调查对心理影响的潜力 困扰，炎症和行为CVD风险（AIM 3）。调查结果将为R01提供基础 应用OM-OH进行效率试验以减少OPWH中炎症介导的CVD风险。 培训和指导：我的培训计划将由我的联合主要导师DRS领导。 Conall O'Clairigh和 格洛里亚·耶（Gloria Yeh）都是著名的研究人员，专注于干预开发和艾滋病毒和临床试验 心血管疾病分别。我还将得到a的支持。 合作者，b。）马萨诸塞州综合医院和哈佛医学的丰富机构环境 学校和c。）针对的课程，科学会议，半手级和计划的出版物。与 NHLBI：此K23符合NHLBI HIV/AIDS计划的已发表的研究优先事项 与HIV相关的心血管合并症。