Health Literacy and Management of Cardiovascular Risk among HIV-Infected Adults

艾滋病毒感染者成人的健康素养和心血管风险管理

• 批准号: 8263300
• 负责人: Michelle Floris-Moore
• 金额: $ 7.6万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-08 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8263300
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Adoption; Adult; Affect; Age; Anti-Retroviral Agents; Behavioral Model; Belief; Cardiovascular Diseases; Caring; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cessation of life; Chronic Disease; Clinical; Cohort Studies; Coronary heart disease; Cross-Sectional Studies; Data; Developed Countries; Development; Diagnosis; Disease; Elderly; Environment; Event; Exercise; Food; General Population; HIV; HIV Infections; HIV diagnosis; Health behavior; Healthcare; High Prevalence; Individual; Institute of Medicine (U.S.); Institutes; Intervention; Knowledge; Life; Life Expectancy; Low income; Measures; Medicine; Methods; Minority Groups; Outcome; Participant; Patients; Perception; Persons; Pharmaceutical Preparations; Play; Population; Population Study; Populations at Risk; Provider; Qualitative Methods; Recruitment Activity; Reporting; Research; Research Methodology; Risk; Risk Factors; Risk Management; Risk Reduction; Risk Reduction Behavior; Role; Self Efficacy; Self Management; Time; Vulnerable Populations; aged; antiretroviral therapy; cardiovascular disorder risk; cardiovascular risk factor; cohort; contextual factors; health belief; health literacy; heart disease risk; improved; patient oriented; peer; skills; therapy development

DESCRIPTION (provided by applicant): Increased survival among HIV-infected persons in the era of effective combination antiretroviral therapy and growing rates of new HIV diagnoses among older adults have resulted in growing numbers of older people living with HIV disease. At the same time, cardiovascular disease (CVD) has emerged as a major contributor to non-AIDS related illness and death among HIV-infected patients. Cumulative evidence suggests that HIV infection itself, as well as the antiretroviral medications used in its treatment, may contribute t increased CVD risk. In order to adequately manage their CVD risk as well as HIV disease, patients need to be able to correctly interpret the information provided to them about risk, a task that requires considerable skill in both health literacy and numeracy. Inadequate health literacy is a major barrier to effective health care in the U.S. and has been highlighted by the Institute o Medicine as a national priority. Poor health literacy is particularly prevalent among low-income and minority groups, groups that are over-represented in the HIV-infected population, and studies of health literacy among people living with HIV infection have reported inadequate or marginal health literacy in 25 - 30% of HIV-infected adults. Existing data offer evidence that low health literacy is associated with less knowledge about HIV and, in the general population both low health literacy and low numeracy have been associated with poorer control of major CVD risk factors. Relationships between literacy and health outcomes may be modified by patients' health beliefs. The beliefs that people living with HIV have about the benefits of CVD risk reduction are likely to be affected by their views on how HIV disease has affected their life expectancy. Growing evidence suggests that people diagnosed with HIV infection in industrialized countries during the current era of combination antiretroviral therapy have a life-expectancy approaching that of their uninfected peers. Recent data show non-AIDS clinical events to be a more frequent cause of death than AIDS-related illness among HIV-infected populations in this era, with CVD being among the leading causes of non-AIDS-related death. Although these data have been widely disseminated among HIV care providers, it is likely that many people living with HIV remain unaware of these findings. Additionally, beyond individual-level factors, contextual factors often affect the ability of at-risk populations to follow measure to modify CVD risk. This study will use a mixed methods approach to examine the roles that health literacy and numeracy, contextual factors, patients' perception of their life expectancy in the setting of HIV disease, and perceptions about facilitators and barriers to CVD risk management, play in cardiovascular risk among HIV-infected adults. The data collected in this study will inform our development of an intervention for improving the management of CVD risk in this vulnerable population. PUBLIC HEALTH RELEVANCE: As advances in antiretroviral treatment of HIV disease have led to increased survival among people living with HIV, cardiovascular disease (CVD) has emerged as a major contributor to non-AIDS related illness and death among HIV-infected patients. This study will examine the roles that health literacy and numeracy, patients' perception of their life expectancy in the setting of HIV disease, contextual factors, and perceptions about facilitators and barriers to CVD risk management play in cardiovascular risk among HIV-infected adults. The data collected in this study will inform our development of an intervention for improving the management of CVD risk in this vulnerable population.

描述（由申请人提供）：在有效组合抗逆转录病毒疗法的时代，艾滋病毒感染者之间的生存率增加，而老年人的新艾滋病毒诊断发生率不断提高，导致越来越多的老年人患有艾滋病毒疾病的老年人。同时，心血管疾病（CVD）已成为与HIV感染患者相关疾病和死亡的主要贡献者。累积证据表明，艾滋病毒感染本身以及治疗中使用的抗逆转录病毒药物可能会增加CVD风险。为了充分管理其CVD风险和HIV疾病，患者需要能够正确解释提供给他们风险的信息，任务 这在健康素养和算术方面都需要相当大的技能。 健康素养不足是美国有效医疗保健的主要障碍，并被研究所O医学作为国家优先事项。在低收入和少数群体中，健康素养尤其普遍存在，在艾滋病毒感染人群中代表过多的群体，艾滋病毒感染患者对健康素养的研究报告据报道，在25-30％的艾滋病毒感染的成年人中，患有HIV感染的人不足或边际健康素养。现有数据提供了证据表明，低健康素养与对艾滋病毒的了解较少有关，在普通人群中，健康素养和低计算能力都与对主要CVD危险因素的控制较差有关。 识字与健康结果之间的关系可能会通过患者的健康信念来改变。对艾滋病毒感染者对CVD风险降低的好处的信念可能受到他们对艾滋病毒疾病如何影响其预期寿命的看法。越来越多的证据表明，在当前组合抗逆转录病毒疗法时代，工业化国家被诊断出患有艾滋病毒感染的人具有终身预期，接近其未感染的同龄人。最近的数据表明，非AIDS临床事件比该时代的HIV感染人群中与艾滋病相关疾病的死亡原因更为频繁，而CVD是与非AID相关死亡的主要原因之一。尽管这些数据已在艾滋病毒护理提供者中广泛传播，但许多感染艾滋病毒的人可能仍然没有意识到这些发现。此外，除了个人级别的因素之外，上下文因素通常会影响处于危险人群遵循措施修改CVD风险的能力。 这项研究将使用一种混合方法来检验健康素养和算术，情境因素，患者对艾滋病毒疾病的预期寿命的看法以及对CVD风险管理的促进者和障碍的看法，在艾滋病毒感染的成年人中发挥心血管风险。这项研究中收集的数据将为我们开发一种干预措施，以改善该脆弱人群中CVD风险的管理。 公共卫生相关性：随着抗逆转录病毒治疗的艾滋病毒疾病的进展导致艾滋病毒患者的生存增加，心血管疾病（CVD）已成为与非AID相关疾病和死亡的HIV患者的主要贡献者。这项研究将研究健康素养和算术，患者对艾滋病毒疾病的预期寿命的看法，情境因素以及对促进因子的看法以及CVD风险管理在艾滋病毒感染的成年人中对CVD风险管理的障碍。这项研究中收集的数据将为我们开发一种干预措施，以改善该脆弱人群中CVD风险的管理。