Adaptation and Pilot Testing a Behavioral Physical Activity Intervention with Peer Support for Women with HIV and Co-Occurring Hypertension

对患有艾滋病毒和并发高血压的女性进行同伴支持的行为体力活动干预的适应和试点测试

基本信息

批准号：
10672227
负责人：
Kaylee Burnham Crockett
金额：
$ 13.26万
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：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2026-07-31
项目状态：
未结题

项目摘要

PROJECT SUMMARY Hypertension is the most common comorbidity with HIV affecting over two thirds of women with HIV over forty years of age. Hypertension is a prominent risk factor for cardiovascular disease (CVD) that is modifiable through lifestyle behavior changes such as physical activity. On average, women with HIV engage in low levels of physical activity particularly if they reside in the southeastern United States where CVD risk is substantial. There are gaps in knowledge regarding the integration of lifestyle medicine approaches in HIV primary care. Further, under-representation and low engagement are significant barriers to existing behavioral physical activity interventions for women with HIV. The goal of the proposed Mentored Patient-Oriented Research Career Development Award (K23) is to provide the essential training and professional scaffolding critical for Dr. Crockett's career transition to independent clinical scientist focused on preventing and addressing cardiovascular comorbidities in underserved populations. To achieve this goal Dr. Crockett will pursue formal training in hypertension and cardiovascular health outcomes, advanced mixed methods research, adaptation of behavioral health interventions, and intervention science. These training aims will be accomplished through the wealth of institutional resources at the University of Alabama at Birmingham; close mentorship from experts; formal training through courses and intensive workshops; attendance at local, national, and international meetings; and professional development activities. This training will be applied to a research project that aims to: (1) elucidate the barriers and facilitators to daily physical activity behavior among women with HIV and hypertension using a social cognitive theory framework; (2) systematically adapt a prescriptive physical activity intervention with peer support for women with HIV and hypertension; and (3) conduct a pilot clinical trial of the adapted intervention to evaluate its acceptability, feasibility, and preliminary impact on systolic and diastolic blood pressure. The research aims will be accomplished by conducting a mixed methods assessment of daily physical activity behavior through objective measurement with accelerometers and experience sampling with 30 women with HIV and hypertension; using an evidence-based intervention adaptation framework (the “ADAPT-ITT model”) with input from key stakeholders (i.e., women with HIV, healthcare workers) in focus groups, expert consultations, and integration of the existing literature; and a randomized pilot intervention trial with 50 women with HIV and hypertension. Results of the proposed study will form the foundation for an NIH R01 application to evaluate the adapted intervention in a larger scale randomized controlled trial. The complimentary training and research goals will ensure Dr. Crockett's transition to independent clinical investigator and contribute to reducing the burden of CVD while improving quality of life among women with HIV.

项目概要高血压是艾滋病毒最常见的合并症，影响超过三分之二的四十岁以上感染艾滋病毒的女性高血压是可改变的心血管疾病 (CVD) 的一个重要危险因素。平均而言，感染艾滋病毒的女性的活动水平较低。尤其是如果他们居住在美国东南部，那里的 CVD 风险很高。关于将生活方式医学方法纳入艾滋病毒初级保健的知识存在差距。此外，代表性不足和参与度低是现有行为物理的重大障碍。拟议的以患者为导向的研究的目标。职业发展奖（K23）旨在为博士提供至关重要的基本培训和专业支架。克罗克特的职业转型为独立临床科学家，重点关注预防和解决问题为了实现这一目标，克罗克特博士将追求正式的治疗。高血压和心血管健康结果培训、先进的混合方法研究、适应这些培训目标将通过以下方式实现：行为健康干预和干预科学。阿拉巴马大学伯明翰分校丰富的机构资源；来自专家的密切指导；通过课程和强化讲习班进行正式培训；参加当地、国家和国际的培训；该培训将应用于旨在实现目标的研究项目。 (1) 阐明感染艾滋病毒和艾滋病毒的女性日常体力活动行为的障碍和促进因素使用社会认知理论框架来治疗高血压；（2）系统地调整规定的身体活动；对患有艾滋病毒和高血压的女性进行同伴支持干预；(3) 开展试点临床试验调整干预措施以评估其可接受性、可行性以及对收缩压和舒张压的初步影响研究目标将通过对日常血压进行混合方法评估来实现。通过加速度计客观测量和经验采样来测量身体活动行为 30 名患有艾滋病毒和高血压的女性使用基于证据的干预适应框架（ “ADAPT-ITT 模型”）重点关注关键利益相关者（即感染艾滋病毒的妇女、医护人员）的意见小组、专家咨询以及现有文献的整合；以及随机试点干预试验；这项研究的结果将构成 NIH 的基础，该研究涉及 50 名患有艾滋病毒和高血压的女性。 R01 应用程序在更大规模的随机对照试验中评估适应性干预措施。免费的培训和研究目标将确保克罗克特博士过渡到独立临床研究者，致力于减轻 CVD 负担，同时提高患有 CVD 的女性的生活质量艾滋病病毒。