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，以降低年轻男男性接触者的艾滋病毒风险并促进心理和性健康

• 批准号: 10248557
• 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/10248557
• 关键词: AIDS prevention; Address; Adherence; Affect; Age; Anxiety; Benchmarking; Biological Markers; Bisexual; Clinical; Clinical Research; Clinical Trials; Communities; Counseling; Data; Development; Disclosure; Discrimination; Distress; Educational workshop; Epidemic; Evaluation; Feedback; Focus Groups; Foundations; Funding; Future; Gays; Grant; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV risk; Hair; Health; Health Promotion; Health Services; Health education; Home; Human immunodeficiency virus test; Hydrocortisone; Impulsivity; Individual; Internet; Intervention; K-Series Research Career Programs; Lead; Link; Longevity; Mental Depression; Mental Health; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methods; Mindfulness Training; Minority; Minority Groups; Modeling; Patient Self-Report; Persons; Phase; Physiological; Physiology; Population; Prevention strategy; Process; Production; Protocols documentation; Provider; Public Health; Public Health Schools; Randomized; Reading; Research; Research Personnel; Resources; Risk; Sampling; Scientist; Series; Sexual Health; Stigmatization; Stress; Stress and Coping; Testing; The Sun; Training; Underserved Population; Universities; Work; acceptability and feasibility; base; behavioral health; behavioral health intervention; biological adaptation to stress; biopsychosocial; career; clinical development; clinical efficacy; clinical trial implementation; condomless anal sex; coping; design; disorder prevention; efficacious intervention; efficacy study; emotion dysregulation; evidence base; experience; feasibility trial; health disparity; high risk; improved; innovation; men who have sex with men; mindfulness; mindfulness intervention; mindfulness-based stress reduction; minority health; population health; pre-exposure prophylaxis; preventive intervention; primary outcome; protocol development; psychological distress; psychological symptom; recruit; research and development; sample collection; service intervention; sexual risk behavior; social stigma; stress reduction; substance use; young adult; young men who have sex with men

PROJECT SUMMARY Young men who have sex with men (YMSM; age 18-34) 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 the syndemic risks surrounding HIV. Mindfulness-based interventions (MBIs), adapted for HIV prevention among YMSM and internet-based delivery to maximize reach and engagement, could offer an innovative and scalable method to address this public health issue. Consistent with NCCIH’s scientific priority in Disease Prevention and Health Promotion across Lifespan, the current project aims to develop an internet-delivered MBI for HIV prevention among distressed, high-risk YMSM. Specifically, this K23 will provide support for an 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 and marginalized communities. 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 internet-delivered MBI to address HIV-related health disparities and an independent investigator capable of R01 funding. Mentoring: A stellar team of senior investigators serve on the advisory panel. 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 and internet-delivery 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) and stakeholders (n=16) 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 Health Education condition (n=20). The study will examine recruitment and retention, intervention adherence (e.g., attendance, at-home practice), completion of assessment (HIV testing, sexual risk behaviors, hair sample collection, mental health, minority stress and coping), and acceptability of the intervention. Trainings: Dr. Sun will receive training in MBSR, intervention adaptation and implementation for YMSM and internet-delivery, 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 and iMBI for minority health. The candidate is institutionally supported by Brown University School of Public Health.

项目概要 与男性发生性关系的年轻男性（YMSM；年龄 18-34 岁）承受着 HIV 的不成比例的负担。少数群体压力及其对 YMSM 的“下游”影响，包括心理健康问题、性危险行为和次优的 HIV 检测，导致了这种综合症。基于正念的干预措施 (MBI) 适合 YMSM 中的艾滋病毒预防和基于互联网的传播，以最大限度地扩大覆盖面和参与度，可以提供一种创新且可扩展的方法来解决这一公共卫生问题。与 NCCIH 在整个生命周期疾病预防和健康促进方面的科学优先事项相一致，当前项目旨在开发一种互联网提供的 MBI，用于在陷入困境的高风险 YMSM 中预防艾滋病毒。具体来说，该 K23 将为早期探索性临床提供支持。通过采用基于正念的减压（MBSR）并在 YMSM 中进行可行性试验候选人：孙博士是一位临床科学家，具有少数群体和边缘人群的艾滋病毒预防和心理健康方面的研究背景。近年来，她在之前的工作基础上致力于正念的临床和研究发展，并正在申请为期五年的 K23 职业发展奖，以获得培训、指导和研究经验，以成为适应和适应的专家。评估互联网提供的 MBI，以解决与艾滋病毒相关的健康差异，并由一位能够提供 R01 资助的独立调查员：Don Operario 博士和 Judson Brewer 博士是顾问小组的杰出团队。他们在 MSM 艾滋病毒预防和基于互联网的行为健康 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（拉里·布朗博士）和人口健康正念（埃里克·劳克斯博士）方面的专业知识。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) 使用 YMSM 焦点小组将 MBSR 应用于痛苦、高风险的 YMSM 和互联网交付。 (n=30) 和利益相关者 (n=16)，(2) 通过剧场测试向陷入困境、高风险的 YMSM (n=18) 和利益相关者 (n=16) 提供改编材料，从而完善干预方案，以及 (3)通过将 40 名陷入困境的高风险 YMSM 随机分配到 iMBI (n=20) 和健康教育条件 (n=20)，检查改编后的 iMBI 用于 HIV 预防的可行性和可接受性。该研究将检查招募和健康教育条件。保留率、干预依从性（例如出勤、在家练习）、评估完成情况（艾滋病毒检测、性危险行为、头发样本采集、心理健康、少数群体压力和应对）以及干预的可接受性：孙博士。将通过课程作业、研讨会、讲习班、定向阅读和定向研究，接受 MBSR、YMSM 和互联网传递的干预适应和实施方面的培训，以及基于生物心理社会的压力理解。研究经验将奠定候选人作为艾滋病毒相关行为健康和少数民族健康 iMBI 专家的职业生涯。候选人得到布朗大学公共卫生学院的机构支持。