Developing Internet-Delivered, Mindfulness-based Intervention to Reduce HIV Risk and Promote Mental and Sexual Health among Young Adult MSM

制定基于互联网的正念干预措施，以降低艾滋病毒风险并促进年轻男男性接触者的心理和性健康

• 批准号: 10675151
• 负责人: Shufang Sun
• 金额: $ 16.84万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675151
• 关键词: AIDS prevention; Address; Affect; Age; Biological Markers; Bisexual; Clinical; Clinical Trials; Distress; Educational workshop; Epidemic; Focus Groups; Funding; Gays; General Population; HIV; HIV risk; Hair; Health Promotion; Human immunodeficiency virus test; Hydrocortisone; Internet; Intervention; K-Series Research Career Programs; Longevity; Mental Health; Mentors; Mentorship; Methods; Minority Groups; Modeling; National Center for Complementary and Integrative Health; Phase; Physiology; Population; Protocols documentation; Psyche structure; Public Health; Public Health Schools; Randomized; Reading; Research; Research Personnel; Risk; Scientist; Sexual Health; Sexual and Gender Minorities; Strategic Planning; Stress; Stress and Coping; Testing; The Sun; Training; United States National Institutes of Health; Universities; Waiting Lists; Work; acceptability and feasibility; base; behavioral health; behavioral health intervention; biopsychosocial; career; clinical development; disorder prevention; efficacious intervention; evidence base; experience; feasibility trial; health disparity; high risk; innovation; men who have sex with men; mindfulness; mindfulness intervention; mindfulness-based stress reduction; minority stress; population health; primary outcome; psychological distress; research and development; secondary outcome; sexual risk behavior; social stigma; stress reduction; syndemic; young adult; young men who have sex with men

PROJECT SUMMARY Young men who have sex with men (YMSM; age 18-24) are disproportionately burdened by HIV. Minority stress and its “downstream” effects in YMSM, including mental health issues, sexual risk behaviors, and suboptimal HIV testing, contribute to syndemic risks surrounding HIV. Mindfulness-based interventions (MBI), adapted for HIV prevention among YMSM and online-based delivery, could offer a transdiagnostic, innovative, and scalable method to address this public health issue. Consistent with NCCIH’s scientific priority in Disease Prevention and Health Promotion across Lifespan and NIH’s Strategic Plan to Advance Research on the Health of Sexual and Gender Minorities, the current project targets distressed, high HIV risk YMSM and aims to mobilize MBI for HIV prevention, to reduce minority stress and promote mental and HIV-related behavioral health. Specifically, this K23 will provide support for early phase, exploratory clinical trial by adapting mindfulness-based stress reduction (MBSR) and conducting a feasibility trial among YMSM. Candidate: Dr. Sun is a clinical scientist with a research background in HIV prevention and mental health concerning minority populations. In recent years, she has pursued clinical and research development in mindfulness. Building on her prior work, she is applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert in adapting and evaluating MBI to address HIV-related health disparities and an independent investigator capable of R01 funding. Mentoring: An excellent team of senior investigators serve as mentors on this proposal. Drs. Don Operario and Judson Brewer are co-primary mentors, who have complimentary expertise in HIV prevention for MSM and internet-based MBI for behavioral health. Three co-mentors bring expertise in internet-based HIV intervention with young adults (Dr. Larry Brown), mindfulness for population health (Dr. Eric Loucks), and stress physiology (Dr. Audrey Tyrka). Research: Guided by the ADAPT-ITT model, the proposed project aims to (1) adapt MBSR for distressed, high risk YMSM using focus groups with YMSM (n=30) and stakeholders (n=16), (2) refine the intervention protocol by administering adapted materials to distressed, high risk YMSM (n=18) via theatre testing, and (3) examine the feasibility and acceptability of the adapted iMBI for HIV prevention by randomizing 40 distressed, high-risk YMSM to the iMBI (n=20) and a waitlist condition (n=20). Primary outcomes are HIV testing and sexual risk behaviors. Secondary outcomes are stress biomarker (hair cortisol), psychological health, minority stress and coping. Trainings: Dr. Sun will receive tailored training in MBSR, intervention adaptation and implementation for YMSM, and a biopsychosocial-based understanding of stress through coursework, seminars, workshops, directed readings, and mentored research. Guided by an excellent mentorship team, these training and research experiences will establish the candidate’s career as an expert in HIV-related behavioral health through MBI. The candidate is institutionally supported by Brown University School of Public Health.

项目概要 与男性发生性行为的年轻男性（YMSM；年龄 18-24 岁）感染艾滋病毒的比例尤其高。 YMSM 中的压力及其“下游”影响，包括心理健康问题、性风险行为和 次优的 HIV 检测会导致基于正念的干预措施 (MBI) 的并发风险， 适合 YMSM 和在线交付中的艾滋病毒预防，可以提供跨诊断、创新、 解决这一公共卫生问题的可扩展方法符合 NCCIH 在疾病方面的科学优先事项。 整个生命周期的预防和健康促进以及 NIH 推进研究的战略计划 性和性别少数群体的健康，当前项目针对陷入困境、高艾滋病毒风险的 YMSM 和目标 动员 MBI 预防艾滋病毒，减少少数群体压力并促进与艾滋病毒相关的心理和行为 具体来说，该 K23 将通过调整为早期探索性临床试验提供支持。 基于正念的减压（MBSR）并在 YMSM 中进行可行性试验：博士。 孙先生是一名临床科学家，具有艾滋病毒预防和少数民族心理健康方面的研究背景 近年来，她致力于正念的临床和研究发展。 根据她之前的工作，她正在申请五年 K23 职业发展奖以获得培训、指导、 和研究经验，成为适应和评估 MBI 以解决艾滋病毒相关健康问题的专家 差异和能够获得 R01 资助的独立调查员：一支优秀的高级团队。 唐·奥帕里奥 (Don Operario) 博士和贾德森·布鲁尔 (Judson Brewer) 博士是该提案的共同导师。 导师，他们在 MSM 艾滋病毒预防和行为行为基于互联网的 MBI 方面拥有免费的专业知识 三位共同导师带来了针对年轻人的基于互联网的艾滋病毒干预方面的专业知识（拉里博士） Brown）、人口健康正念（Eric Loucks 博士）和压力生理学（Audrey Tyrka 博士）。 研究：在 ADAPT-ITT 模型的指导下，拟议项目旨在 (1) 使 MBSR 适应不良、高 使用 YMSM (n=30) 和利益相关者 (n=16) 焦点小组来风险 YMSM，(2) 完善干预方案 通过剧院测试向陷入困境的高风险 YMSM（n=18）施用改编材料，以及（3）检查 通过随机化 40 名陷入困境的高危人群，评估改良后的 iMBI 用于 HIV 预防的可行性和可接受性 YMSM 至 iMBI (n=20) 和候补名单条件 (n=20) 主要结果是 HIV 检测和性风险。 次要结果是生物标志物压力（头发皮质醇）、心理健康、少数群体压力和 应对培训：孙博士将接受有关MBSR、干预措施适应和实施的定制培训。 YMSM，以及通过课程作业、研讨会、讲习班对压力进行基于生物心理社会的理解， 在优秀的导师团队的指导下，进行定向阅读和指导研究。 研究经验将奠定候选人作为艾滋病毒相关行为健康专家的职业生涯 通过 MBI，候选人得到布朗大学公共卫生学院的机构支持。