Women focused Encounters for Resilience, Independence, Strength and Eudaimonia (WE RISE)

以女性为中心的韧性、独立、力量和幸福的邂逅 (WE RISE)

• 批准号: 10744678
• 负责人: Maile Ann Young Karris
• 金额: $ 77.25万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10744678
• 关键词: Abstinence; Accelerometer; Acquired Immunodeficiency Syndrome; Address; Adherence; Anxiety; Behavior Therapy; Caring; Collection; Communities; Complement; Diagnostic; Diagnostic Factor; Economics; Education; Effectiveness; Epidemic; Evaluation; Exclusion; Exercise; Exercise Therapy; Exploration, Preparation, Implementation, and Sustainment; Feedback; Focus Groups; Gender; Goals; HIV; HIV/AIDS; Health; Health Services Accessibility; Hybrids; Individual; Intervention; Interview; Loneliness; Maintenance; Measures; Mediator; Meditation; Mental Depression; Methods; Modification; Moods; Morbidity - disease rate; Neighborhoods; Outcome; Participant; Periodicals; Persons; Pharmaceutical Preparations; Phase; Preparation; Process; Provider; Randomized; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Reduce health disparities; Reporting; Research; Resources; Risk; Self Efficacy; Site; Social support; Time; Training; Trauma; Violence; Viral; Visit; Withdrawal; Woman; antiretroviral therapy; barrier to care; behavior change; community organizations; coping mechanism; education access; effectiveness evaluation; effectiveness research; efficacious intervention; empowerment; experience; flexibility; girls; health care availability; health disparity; hybrid type 1 study; implementation framework; implementation process; implementation strategy; improved; intervention effect; men; mindfulness; outcome disparities; peer; peer support; psychologic; racism; resilience; social; social disparities; social stigma; standard of care; substance use; substance use treatment; sustainability framework; syndemic; therapy adherence; trauma symptom; violence against women; women of color

Project Abstract Women represent the majority of people living with HIV in the world. Yet the underrepresentation of women in HIV research persists despite them experiencing greater societal/social disparities of health (SSDoH) including HIV care access and poorer HIV outcomes when compared to men. The coming together of substance (ab)use, violence against women and girls (trauma), and AIDS/HIV (known as SAVA) in the context of SSDOH contributes to excess HIV associated morbidity in women living with and at risk for HIV. This proposal aims to improve HIV outcomes in women living with HIV (WLWH) by evaluating the effectiveness and implementation of a combination intervention addressing substance use, trauma, and HIV. We will employ a randomized Type1 Hybrid study evaluating the effectiveness of acceptance and commitment therapy, exercise, and social support delivered by peer navigators. Implementation strategies that carry the potential to address SSDoH (economic insecurity, limited healthcare access, limited community) that WLWH experience and may enhance sustainability and dissemination will be evaluated. Community-based organizations in four Ending the HIV Epidemic jurisdictions will employ the intervention for a total of 48 weeks per site. The first 24 weeks (research effectiveness) will include a randomized study of 40 WLWH and will evaluate the impact on HIV (ART adherence, % continuous viral suppression), substance use (days and amount of use), trauma (trauma symptoms) and factors common to all three conditions (mood, social disconnection) over time. Weeks 24-48 will include a research implementation phase guided by the Exploration, Preparation, Implementation and Sustainment (EPIS) framework evaluating local barriers, facilitators, change in implementation strategies selected to address structural/social disparities of health and intervention adaptations using the the Framework for Recording Adaptations and Modifications-Enhanced (FRAME). The following aims will guide evaluation of our intervention referred to as women focused encounters for resilience, independence, strength and eudaimonia (WE RISE). Aim 1: Evaluate short (week 8) and longer term (weeks 12, 24) effectiveness of WE RISE on HIV (↑ ART adherence, ↑ % of participants with continuous viral suppression), trauma (↓ trauma symptoms), substance use (↓ days of substance use) and transdiagnostic factors such as mood (↓depression, ↓anxiety) and social connectedness. Aim 2: Document the WE RISE implementation process by characterizing reach, effectiveness, adoption, implementation and maintenance (RE-AIM) by site for 24 weeks. Aim 3: At completion of 24 and 48 weeks, transcreate alternate or additional implementation strategies that address local barriers and leverage facilitators to optimize the effectiveness, maintenance and broader dissemination of WE RISE and document site-specific adaptations FRAME.

项目摘要 妇女代表了世界上大多数艾滋病毒的人。然而，妇女的人数不足 艾滋病毒研究一直是他们经历更大的社会/社会健康差异（SSDOH），包括 与男性相比，艾滋病毒护理的访问和较差的艾滋病毒结局。基板的聚在一起 （AB）在SSDOH的背景下使用，对妇女和女孩的暴力（创伤）以及艾滋病/艾滋病毒（称为萨瓦） 在患有艾滋病毒和艾滋病毒风险的妇女中导致艾滋病毒过度相关的艾滋病毒相关的发病率。该建议旨在 通过评估有效性和实施，改善艾滋病毒（WLWH）妇女的艾滋病毒结局 涉及物质使用，创伤和艾滋病毒的组合干预措施。 我们将采用一项随机类型的混合研究，以评估接受和承诺的有效性 同伴导航员提供的治疗，运动和社会支持。实施策略 解决SSDOH的潜力（经济不安全，有限的医疗保健访问，有限的社区）WLWH 经验并可能会提高可持续性和传播。基于社区 四个结束艾滋病毒流行司法管辖区的组织将总共采用干预措施48周 每个站点。最初的24周（研究效果）将包括40 wlwh的随机研究，并将 评估对艾滋病毒（艺术依从性，连续病毒抑制％），药物使用的影响（天和 使用量），创伤（创伤符号）和所有三个条件共同的因素（情绪，社交 断开连接）随着时间的流逝。第24-48周将包括一个研究实施阶段 探索，准备，实施和维持（EPIS）框架评估当地障碍， 促进者，选择解决健康的结构/社会分布的实施策略的变化和 使用该框架记录改编和修改增强的框架进行调整 （框架）。以下目的将指导对我们的干预措施的评估，称为妇女的重点 遇到韧性，独立性，力量和艾达米尼亚（Eudaimonia）（我们崛起）。 目标1：评估短期（第8周）和长期（第12、24周）我们在艾滋病毒上的有效性（↑ART 依从性，↑百分比有连续病毒的参与者），创伤（↓创伤症状），物质使用 （↓药物使用天数）和跨诊断因素，例如情绪（↓抑郁，↓焦虑）和社交 连接。 目标2：通过表征覆盖范围，有效性，采用， 通过现场实施和维护（RE-AIM）24周。 目标3：在完成24周和48周后，转换替代或其他实施策略 应对当地障碍并利用促进者来优化效力，维护和更广泛的 我们上升和记录特定地点适应框架的传播。