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

项目摘要 少数族裔和在社会经济上处于不利地位的妇女(下称弱势妇女) 他们作为家庭照顾者和低工资的基本工人，感染新冠肺炎的风险很大。此外， 他们面临着与感染相关的不良健康结局的风险增加，因为 多种慢性病(如心脏病、抑郁症、慢性疼痛)的负担和获得有限的机会 医疗保健和支持性服务。本附录(非-AT-20-010)的目的是加强 在新冠肺炎的背景下，患有多种慢性病的弱势妇女的复原力。韧性是 良好适应面对逆境、创伤、悲剧或重大压力来源的过程 生活在多种慢性病中，经济资源有限，与支持他们的人和健康隔绝 服务和关系冲突。为了增强韧性，我们团队将修改和整合两个很好的- 已建立的、基于证据的数字干预。MyPlan基于Web的应用程序平台是免费的、保密的 和安全的平台，在全国范围内可用，已达到50,000用户。女性使用这款应用来评估 他们的健康和安全优先事项，并设计量身定制的健康和安全计划，通过聊天/电话直接链接到 社区项目。我们将利用myPlan平台集成内容(视频和专家 说明)来自循证通用元素治疗方法(CETA)。CETA是一种有效的 建立个人技能的跨诊断行为改变方法(例如，认知重建， 沟通、行为激活、遵守健康计划)，以改善自我指导的管理 多种慢性病。我们将修改和整合CETA技能构建视频和专家指导 进入myPlan基于Web的平台(MyPlan CETA)，使用以人为本的最终用户设计，然后 审查综合数字干预的可行性和可接受性，以接触和接触弱势群体 在这个危机时期，患有多种慢性病的妇女。该方案的可行性和可接受性 将使用安全的在线调查对成年易受伤害妇女进行干预，以检查 近期结果(例如，坚持健康计划、恢复能力、行为激活、安全行为)和 超过6个月的远期结局(例如，身体和心理健康功能)。

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.