Social connections, risk for COVID-era psychiatric and substance use disorders, and HIV control

社会关系、新冠病毒时代精神疾病和物质使用障碍的风险以及艾滋病毒控制

• 批准号: 10374557
• 负责人: Jacquelyn Leigh Meyers
• 金额: $ 68.95万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10374557
• 关键词: Address; Adherence; African American; Age; Area; Black race; Buffers; COVID-19; Cessation of life; Chronic Disease; Clinical; Cohort Studies; Communities; Consensus; Coupled; Data; Data Collection; Diagnostic; Dimensions; Disease; Education; Educational Background; Emotional; Ethnic Origin; Ethnic group; Evaluation; Family; Friends; Gender; Geography; Goals; HIV; HIV Infections; Health; Human; Impairment; Income; Insurance Coverage; Intervention; Interview; Knowledge; Laboratories; Link; Literature; Loneliness; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Meta-Analysis; Methods; Modeling; Neighborhoods; Outcome; Pathway interactions; Pattern; Perception; Personal Satisfaction; Persons; Plant Roots; Population; Population Density; Population Heterogeneity; Poverty; Premature Mortality; Prevention; Public Health; Quality of life; Race; Recording of previous events; Reporting; Research; Risk; Science; Self Management; Site; Social Interaction; Social isolation; Standardization; Strategic Planning; Substance Use Disorder; Substance abuse problem; Surveys; Time; United States National Institutes of Health; Update; Viral Load result; Vulnerable Populations; Woman; Work; behavioral genomics; biopsychosocial; coronavirus disease; design; effective intervention; genome-wide; genomic predictors; high risk; implementation intervention; indexing; lens; longitudinal analysis; longitudinal design; medication compliance; mortality; multilevel analysis; polygenic risk score; primary outcome; racial and ethnic; secondary outcome; social; social integration; social relationships; socioeconomics; stressor

PROJECT SUMMARY / ABSTRACT Social connections are critical to human well-being, and people lacking in these connections (social isolation) or who perceive that they are lacking these connections (loneliness) have lower self-management of chronic disease, are more likely to suffer from substance abuse disorders and depression, and are at higher risk for premature mortality. People living with HIV report a significant burden of loneliness and other indicators of impaired social connectedness; these impaired social connections have been linked to reduced HIV adherence and quality of life. The significant strain imposed on social relationships by COVID-19 restrictions and by losses of family, friends, and community has brought urgency to the issue of social connections, particularly for vulnerable populations such as those living with HIV infection. COVID-19 has also brought increased calls for implementation of interventions focused on social connections, which in turn has highlighted a critical lack of effective interventions in this area, rooted in evidence gaps regarding relationships between social connection and health outcomes in diverse populations, in understanding of the unique and synergistic influences of conceptually distinct dimensions of social connection on health over time, and on modifiable pathways linking these connections to health outcomes. Applying a longitudinal, mixed-methods, and community-engaged framework within a nationally-representative and well-characterized HIV cohort study, the MACS/WIHS Combined Cohort Study (MWCCS), this project aims to: (Aim 1) characterize longitudinal and multidimensional patterns of social connection both prior to and during the COVID-era, and identify social, behavioral and genomic predictors of these patterns; (Aim 2) identify relationships between patterns of social connection and HIV outcomes, including identification of mechanistic pathways via substance use disorders and depression, and (Aim 3) assess multilevel mediators and moderators of relationships between social connection and temporally associated outcomes including area-level socio-geographic indicators of poverty and population density. This work utilizes the extensive platform of the MWCCS, including annual laboratory evaluation of HIV disease indices, validated medication adherence measures, genome-wide data that will be utilized to construct polygenic risk scores, annually updated geocoded data, and diagnostic assessments of substance use disorders and depression (N=2000). To this, we will add an annual battery of social connection measures, including social and emotional loneliness, social isolation, and social integration at selected MWCCS sites (N=735), coupled with nested, longitudinal qualitative interviews (N=40). This multidimensional, longitudinal and multilevel analysis will significantly extend previous research in this area, and findings from this project can be utilized to identify actionable targets to support the design of effective interventions in this important area and high priority population.

项目摘要 /摘要 社会联系对于人类的福祉至关重要，缺乏这些联系的人（社会隔离） 或者认为他们缺乏这些联系（孤独）的人的自我管理较低 疾病，更有可能患有药物滥用障碍和抑郁症，并且面临更高的风险 过早死亡。患有艾滋病毒的人报告了孤独的重大负担和其他指标 社会联系受损；这些受损的社交联系与降低的艾滋病毒依从性有关 和生活质量。 COVID-19限制对社会关系造成的重大压力以及 家庭，朋友和社区的损失使社会联系问题紧迫，尤其是针对 弱势群体，例如患有艾滋病毒感染的人。 Covid-19还带来了更多的电话 采用着针对社会联系的干预措施的实施，这反过来强调了严重缺乏 在这一领域的有效干预措施，植根于有关社会联系之间关系的证据差距 以及不同人群中的健康成果，了解 从概念上讲，随着时间的流逝，社会联系在健康方面的不同方面以及可修改的途径链接 这些与健康成果的联系。应用纵向，混合方法和社区参与 在全国代表性且表征良好的HIV队列研究中，Mac/WIHS中的框架 组合研究（MWCC），该项目的目的是：（目标1）表征纵向和多维 社会联系的模式在covid-er时代之前和期间都 这些模式的基因组预测指标； （目标2）确定社会联系模式与 HIV结果，包括通过药物使用障碍和抑郁症鉴定机械途径， （目标3）评估社会联系与 时间相关的结果，包括贫困和人口的地区级社会地理指标 密度。这项工作利用了MWCC的广泛平台，包括对艾滋病毒的年度实验室评估 疾病指数，经过验证的药物依从性测量，全基因组的数据将用于构建 多基因风险评分，每年更新的地理编码数据以及对药物使用的诊断评估 疾病和抑郁（n = 2000）。为此，我们将添加一年一度的社交连接措施， 包括社会和情感的孤独感，社会隔离以及选定的MWCC网站的社会融合 （n = 735），再加上嵌套的纵向定性访谈（n = 40）。这个多维的纵向 多级分析将大大扩展该领域的先前研究，并且该项目的发现可以 被用来确定可操作的目标，以支持在这一重要领域的有效干预措施的设计 和高优先人口。