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

项目总结/摘要 艾滋病毒感染者（PLWH）患轻度认知障碍（MCI）的可能性是未感染艾滋病毒者的七倍。女性艾滋病毒感染者（WLWH），更具体地说，非洲裔美国人（AA）WLWH，与男性艾滋病毒感染者和未感染艾滋病毒的女性相比，认知功能较差。很少有研究针对这一人群的非药物策略，以减轻认知障碍。目前提出的研究将评估正念减压（MBSR）在AA WLWH与MCI中的可行性和可接受性。正念减压疗法有潜力通过自我调节注意力和对压力事件的意识来减轻压力。正念减压疗法在改善或稳定认知、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以及PLWH的ART依从性方面表现出疗效。然而，这些研究主要在白色和男性患者人群中进行。因此，这里提出的研究将开始通过对患有MCI的AA WLWH进行MBSR干预来解决这些差距。这将是在具有MCI的AA WLWH中开发和实现MBSR协议的重要的第一步。在我们的补充目标中，我们将在30名AA WLWH（15/组）中进行一项适应性干预的双臂随机试验，与常规护理对照组进行比较，以评估MBSR在伴有MCI的WLWH中的可行性和可接受性。可行性将通过我们的以下能力进行评估：（1）招募、随机分配和保留受试者;（2）按照手册提供干预措施;以及（3）受试者遵守家庭实践和任务。可接受性将通过定性数据（关于参与者对干预措施的满意度和继续使用这些做法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。本研究的最终目标是：1）减少认知障碍和痴呆症患病率的种族和性别差异，2）为针对不同人群认知结果的基于组的非药物干预措施的疗效测试和实施提供信息，3）影响临床和公共卫生建议，以维持老年人群的认知健康。

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.