Feasibility of the Mindfulness-Based Stress Reduction Intervention for BlackWomen Living with HIV

针对感染艾滋病毒的黑人女性进行基于正念的减压干预的可行性

• 批准号: 10285078
• 负责人: Crystal LaShonda Chapman Lambert
• 金额: $ 13.62万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10285078
• 关键词: AIDS dementia; Address; Adherence; African American; Age; Aging; Alzheimer' s disease related dementia; Alzheimer' s disease risk; Attention; Attenuated; Award; Awareness; Biological Markers; Breast Cancer survivor; CD4 Lymphocyte Count; Chronic Disease; Clinical; Cognition; Cognitive; Data; Dementia; Educational Curriculum; Enrollment; Epidemic; Female; Female Breast Carcinoma; Focus Groups; Future; Gender; General Population; Goals; HIV; Health; Health behavior outcomes; Home; Impaired cognition; Informal Social Control; Interpersonal Violence; Intervention; Life Expectancy; Literature; Manuals; Medical; Mental Depression; Outcome; Parents; Participant; Population; Population Heterogeneity; Post-Traumatic Stress Disorders; Prevalence; Process; Protocols documentation; Public Health; Quality of life; Randomized; Recommendation; Reporting; Research; Risk; Risk Factors; Severities; Socioeconomic Status; Stress; Stressful Event; Surveys; Survivors; Target Populations; Testing; Therapeutic; Time; Training; Treatment Failure; Treatment outcome; Viral; Viral Load result; Visit; Woman; acceptability and feasibility; antiretroviral therapy; arm; base; career development; cognitive function; cohort; comparison intervention; coping; daily functioning; efficacy evaluation; efficacy testing; experience; follow-up; gender disparity; improved; improved outcome; male; medication compliance; mild cognitive impairment; mindfulness intervention; mindfulness-based stress reduction; mortality; patient population; physical symptom; psychologic; psychological distress; psychological symptom; psychosocial; racial disparity; recruit; research and development; satisfaction; stress management; stress reduction; symptom management; systematic review; therapy adherence; treatment adherence; usual care arm

Project Summary/Abstract People living with HIV (PLWH) are seven times more likely to have mild cognitive impairment (MCI) than people without HIV. Women living with HIV (WLWH), and more specifically African American (AA) WLWH, have evidenced poorer cognitive function when compared to their male counterparts living with HIV and women without HIV. Few studies have targeted this population in non-pharmacological strategies to mitigate cognitive impairment. The current proposed study will assess the feasibility and acceptability of mindfulness-based stress reduction (MBSR) in AA WLWH with MCI. MBSR has the potential to reduce stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving or stabilizing cognition, improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping in the general population, as well as ART adherence in PLWH. Yet, the studies have been conducted in predominately white and male patient populations. Thus, the research proposed here will begin to address these gaps by piloting the MBSR intervention for AA WLWH with MCI. This will be an important first step in developing and implementing MBSR protocols in AA WLWH with MCI. In our Supplement Aim we will conduct a two-arm randomized pilot test of the adapted intervention compared to a usual care control group among 30 AA WLWH (15/arm) to assess the feasibility and acceptability of the MBSR among WLWH with MCI. Feasibility will be assessed by our ability to (1) recruit, randomize, and retain participants and (2) deliver the intervention per the manual, as well as (3) participants adherence to home practices and assignments. Acceptability will be assessed via qualitative data (focus group input regarding participants’ satisfaction with the intervention and intent to continue using the practices), as well quantitative data (satisfaction survey). The ultimate goal of this research is to: 1) reduce racial and gender disparities in cognitive impairment and dementia prevalence, 2) inform next steps for efficacy testing and implementation of a group-based non-pharmacologic interventions targeting cognitive outcomes in diverse populations, and 3) impact clinical and public health recommendations for maintaining cognitive health in aging populations.

项目概要/摘要 艾滋病毒感染者 (PLWH) 患有轻度认知障碍 (MCI) 的可能性是未感染艾滋病毒的人的七倍。与感染艾滋病毒的男性和未感染艾滋病毒的女性相比，感染艾滋病毒的女性 (WLWH)，尤其是非裔美国人 (AA) WLWH 的认知功能较差。很少有研究针对这一人群采取非药物策略来减轻认知障碍。目前拟议的研究将评估基于正念的减压（MBSR）在 AA WLWH 和 MCI 中的可行性和可接受性。 MBSR 有可能通过自我调节对压力事件的注意力和意识来减轻压力。 MBSR 已被证明可以有效改善或稳定认知、改善压力管理、心理困扰、身体和心理症状、生活质量和一般人群的应对能力，以及艾滋病病毒感染者的抗逆转录病毒治疗依从性。然而，这些研究主要是在白人和男性患者群体中进行的。因此，本文提出的研究将通过针对 AA WLWH 和 MCI 试行 MBSR 干预来解决这些差距。这将是在 AA WLWH 和 MCI 中开发和实施 MBSR 协议的重要第一步。在我们的补充目标中，我们将在 30 名 AA WLWH（15 名/组）中对调整后的干预措施与常规护理对照组进行双臂随机试点测试，以评估 MBSR 在患有 MCI 的 WLWH 中的可行性和可接受性。可行性将根据我们的能力进行评估：(1) 招募、随机分组和留住参与者，(2) 按照手册提供干预，以及 (3) 参与者遵守家庭实践和作业。可接受性将通过定性数据（关于参与者对干预的满意度和继续使用实践的意图的焦点小组输入）以及定量数据（满意度调查）进行评估。这项研究的最终目标是：1）减少认知障碍和痴呆症患病率方面的种族和性别差异，2）为后续功效测试和实施针对不同人群认知结果的基于群体的非药物干预措施提供信息，3）影响维持老龄化人群认知健康的临床和公共卫生建议。