Hopkins Center to Promote resilience in persons and families living with multiple chronic conditions (the PROMOTE Center)

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Project Summary Racial and ethnic minority and socioeconomically disadvantaged women (hereafter vulnerable women) are at great risk of Covid-19 infection in their roles as family caregivers and low-wage, essential workers. Further, they face an increased risk of poor health outcomes associated with infection given the disproportionate burden of multiple chronic conditions (e.g., heart disease, depression, chronic pain) and limited access to health care and supportive services. This supplement’s (NOT-AT-20-010) purpose is to strengthen the resilience of vulnerable women living with multiple chronic conditions in the context of Covid-19. Resilience is the process of adapting well in the face of adversity, trauma, tragedy or significant sources of stress such as living with multiple chronic conditions, limited financial resources, isolation from supportive people and health services and relationship conflict. To strengthen resilience, our team will modify and integrate two well- established, evidence based digital interventions. The myPlan web-based app platform is a free, confidential and secure platform that is available nationally and has reached 50,000 users. Women use the app to assess their health and safety priorities and design tailored health and safety plans that links via chat/phone directly to community programs. We will leverage the myPlan platform to integrate content (videos with expert instructions) from the evidence-based Common Elements Treatment Approach (CETA). CETA is an effective transdiagnostic behavioral change approach that builds individual skills (e.g., cognitive reframing, communication, behavioral activation, adherence to health program) to improve self-directed management of multiple chronic conditions. We will modify and integrate CETA skills building videos with expert instructions into the myPlan web-based platform (myPlan +CETA) using human centered design with end users and then examine the feasibility and acceptability of the integrated digital intervention to reach and engage vulnerable women living with multiple chronic conditions in this time of crisis. The feasibility and acceptability of the intervention will be examined with adult vulnerable women using secure on-line surveys to examine changes in proximal outcomes (e.g. adherence to health program, resilience, behavioral activation, safety behaviors) and distal outcomes (e.g., physical and mental health functioning) over 6 months.