Brief Acceptance and Commitment Therapy for HIV-Infected At-Risk Drinkers Administrative Supplement

针对艾滋病毒感染高危饮酒者的简短接受和承诺治疗行政补充

• 批准号: 10289729
• 负责人: STEPHEN A MAISTO
• 金额: $ 22.99万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-03-15 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10289729
• 关键词: AIDS prevention; Address; Adherence; Administrative Supplement; Adrenal Glands; Affect; Aftercare; Alcohol consumption; Appointment; Behavioral; Biological Markers; Blood; COVID-19; COVID-19 pandemic; Caring; Clinical Trials; Collection; Continuity of Patient Care; Data; Data Collection; Enrollment; Failure; Feeling; Focus Groups; Funding; General Population; Goals; HIV; HIV therapy; Hair; Human Resources; Human Subject Research; Hydrocortisone; Hypothalamic structure; Infrastructure; Intervention; Interview; Manuals; Measures; Mental Depression; Mental Health; National Institute on Alcohol Abuse and Alcoholism; New York; Outcome; Participant; Patient Self-Report; Pharmaceutical Preparations; Pituitary Gland; Population; Procedures; Protocols documentation; Reporting; Risk; Salivary; Schedule; Spottings; Stress; Supervision; Techniques; Telephone; Therapeutic Intervention; Thinking; Time; Training; Treatment Efficacy; Treatment outcome; United States; Universities; Viral; Visit; acceptability and feasibility; alcohol intervention; anxiety treatment; base; behavioral health; binge drinking; brief alcohol intervention; care providers; chronic pain; comorbidity; comparative effectiveness trial; coping; coronavirus disease; design; drinking; evidence base; experience; follow-up; improved; innovation; interest; meetings; mindfulness; mortality risk; novel; pandemic disease; preventive intervention; psychological symptom; recruit; reduced alcohol use; response; saliva sample; sexual risk behavior; skills; smoking cessation; stress management; substance use; success; transmission process; trial comparing

Abstract The COVID-19 pandemic has had a significant impact on the mental health and alcohol use of the United States (US) general population, and has disproportionately affected people living with HIV (PLWH). Alcohol consumption and stress are both critical factors in HIV treatment that, if unaddressed, can significantly contribute to onward transmission and poor treatment-related outcomes. Alcohol interventions for PLWH in the US have shown mixed results. One hypothesized reason for this limited success is the failure of these interventions to address the multiple overlapping problems (e.g., co-morbid mental health conditions, stress, behavioral health needs) of PLWH who are hazardous drinkers. Innovative alcohol intervention strategies that can have an impact on these multiple behavioral health needs, in a format that can be feasibly delivered in the context of HIV care, are needed, especially in the context of the COVID-19 pandemic. Brief Acceptance and Commitment Therapy (ACT) is a promising intervention for HIV-infected hazardous drinkers. ACT is a transdiagnostic treatment that uses mindfulness skills and values-guided behavioral action plans to impact a broad array of psychological symptoms. ACT has shown efficacy for treatment of anxiety, depression, chronic pain, and substance use, and is thus a promising approach for PLWH who are hazardous drinkers and coping with additional stress related to the COVID-19 pandemic. We are proposing to expand our ongoing, NIAAA- funded (R34AA026246), pilot RCT of a telephone-delivered ACT intervention for PLWH by applying for an administrative supplement in response to the Notice of Special Interest on Stress Management in Relation to COVID-19 (NOT-AT-20-011). The overall objective of this application is to use the infrastructure of our ongoing pilot RCT (NCT0397406) to collect preliminary data on the level of stress experienced by PLWH during the COVID-19 pandemic, and to determine if participants in the RCT find the stress management techniques in our ACT intervention useful and applicable for the management of COVID-related stress. The specific aims are as follows: Aim 1: Incorporate objective and self-reported measures of stress into the pilot RCT. We will accomplish this aim by: adding general and pandemic-specific self-report measures of stress, and self- collected samples of salivary cortisol to all study visits, including a newly added 12-month follow-up. Aim 2: Determine the feasibility and acceptability of ACT as a telephone-based stress management intervention for PLWH during the COVID-19 pandemic. We will accomplish this aim by modifying our treatment manuals to incorporate COVID-19 related stress, and examining stress-related RCT outcomes by treatment condition. This administrative supplement will provide important information on COVID-related stress among PLWH, and provide data on the feasibility and potential efficacy of telephone-delivered ACT for stress management.

摘要 COVID-19大流行对美国人的心理健康和酒精使用产生了重大影响， 美国的一般人口，并不成比例地影响艾滋病毒感染者（PLWH）。醇 消费和压力都是艾滋病毒治疗中的关键因素，如果不解决，可能会严重影响 有助于进一步传播和不良的治疗相关结果。对艾滋病毒携带者的酒精干预 美国的结果喜忧参半。这种有限成功的一个假设原因是这些失败 解决多重重叠问题的干预措施（例如，共病的心理健康状况，压力， 行为健康需要）的PLWH谁是危险的饮酒者。创新的酒精干预战略， 可以对这些多种行为健康需求产生影响，其形式可以在 在艾滋病毒护理的背景下，特别是在COVID-19大流行的背景下，简短的接受和 承诺疗法（ACT）是一种很有前途的干预艾滋病毒感染的危险饮酒者。行为是一 transdiagnosis治疗，使用正念技能和价值观指导的行为行动计划，以影响一个 一系列的心理症状ACT已显示出治疗焦虑、抑郁、慢性 疼痛和物质使用，因此是一个有前途的方法PLWH谁是危险的饮酒者和应对 新冠肺炎疫情带来额外压力。我们建议扩大我们正在进行的，NIAAA- 资助（R34 AA 026246），试点随机对照试验的电话交付的ACT干预PLWH通过申请 回应有关压力管理的特别关注通知的行政补充文件 COVID-19（NOT-AT-20-011）。此应用程序的总体目标是使用我们正在进行的基础设施 试点随机对照试验（NCT 0397406），以收集PLWH在 COVID-19大流行，并确定随机对照试验的参与者是否在我们的 ACT干预对COVID相关压力的管理有用且适用。具体目标如下： 目标1：将客观和自我报告的压力测量纳入试点RCT。我们将 实现这一目标的方法是：增加一般和特定流行病的自我报告压力措施， 收集所有研究访视的唾液皮质醇样本，包括新增加的12个月随访。目标二： 确定ACT作为电话压力管理干预的可行性和可接受性， 于2019冠状病毒病大流行期间的感染者及病毒携带者。我们将通过修改我们的治疗手册来实现这一目标， 纳入COVID-19相关压力，并按治疗条件检查压力相关RCT结果。这 行政补充将提供艾滋病毒感染者与新冠病毒相关压力的重要信息， 提供数据的可行性和潜在的有效性电话交付的ACT压力管理。

项目成果

Development of a Telephone-Delivered Acceptance and Commitment Therapy Intervention for People Living with HIV who are Hazardous Drinkers.

• DOI: 10.1007/s10461-022-03649-x
• 发表时间: 2022-09
• 期刊: AIDS and behavior
• 影响因子: 4.4
• 作者: Woolf-King SE;Firkey M;Foley JD;Bricker J;Hahn JA;Asiago-Reddy E;Wikier J;Moskal D;Sheinfil AZ;Ramos J;Maisto SA
• 通讯作者: Maisto SA