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.

项目概要/摘要 社会联系对于人类福祉至关重要，而人们缺乏这些联系（社会孤立） 或者那些认为自己缺乏这些联系（孤独）的人对慢性病的自我管理能力较低 疾病，更有可能患有药物滥用障碍和抑郁症，并且有更高的风险 过早死亡。艾滋病毒感染者报告了巨大的孤独负担和其他指标 社交联系受损；这些受损的社会关系与艾滋病毒依从性降低有关 和生活质量。 COVID-19 限制和 失去家人、朋友和社区给社会关系问题带来了紧迫性，特别是对于 弱势群体，例如艾滋病毒感染者。 COVID-19 也引发了越来越多的呼吁 实施的干预措施侧重于社会联系，这反过来又凸显了严重缺乏 该领域的有效干预措施植根于社会联系之间关系的证据差距 和不同人群的健康结果，了解不同人群的独特和协同影响 随着时间的推移，社会联系在概念上不同的维度对健康的影响以及可修改的联系途径 这些与健康结果的联系。应用纵向、混合方法和社区参与 MACS/WIHS 是一项具有全国代表性且特征明确的 HIV 队列研究框架 联合队列研究 (MWCCS)，该项目旨在：（目标 1）描述纵向和多维特征 新冠病毒时代之前和期间的社会联系模式，并识别社会、行为和 这些模式的基因组预测因子； （目标 2）识别社会联系模式和 HIV 结果，包括通过物质使用障碍和抑郁症确定机制途径， （目标 3）评估社会关系和社会关系之间关系的多层次中介和调节因素 时间相关的结果，包括地区层面的贫困和人口社会地理指标 密度。这项工作利用了 MWCCS 的广泛平台，包括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、将用于构建的全基因组数据 多基因风险评分、每年更新的地理编码数据以及物质使用的诊断评估 疾病和抑郁症（N=2000）。为此，我们将每年增加一系列社交联系措施， 包括在选定的 MWCCS 站点的社交和情感孤独、社交隔离和社交融合 （N=735），加上嵌套的纵向定性访谈（N=40）。这种多维、纵向 多层次分析将显着扩展该领域的先前研究，该项目的发现可以 用于确定可行的目标，以支持在这一重要领域设计有效的干预措施 和高优先级人群。