Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV

加强患者和组织为降低少数族裔艾滋病毒感染者的心血管风险做好准备

• 批准号: 10408469
• 负责人: ARLEEN F. BROWN
• 金额: $ 48.67万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10408469
• 关键词: 2019-nCoV; Address; Adherence; Affective; African American; Anxiety; COVID-19; COVID-19 pandemic; California; Cardiovascular Diseases; Caring; Cessation of life; Chronic; Chronic Disease; Clinic; Clinical; Cognitive; Communication Research; Communities; Coronavirus; County; Emotional; Environmental Exposure; Face; Family; Financial Hardship; Friends; Future; Goals; HIV; HIV risk; Health; Health Personnel; Health Promotion; Health behavior; Health system; Heart; Home; Immunocompromised Host; Individual; Intervention; Knowledge; Latinx; Learning; Life; Los Angeles; Mental Depression; Methods; Mind; Mind-Body Intervention; Minority Groups; Morbidity - disease rate; Outcome; Participant; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Policies; Population; Premature Mortality; Procedures; Psyche structure; Qualitative Methods; Recording of previous events; Research; Research Design; Research Personnel; Resources; Risk; Risk Factors; Risk Reduction; Self Care; Services; Social Distance; Social Work; Social isolation; Social support; Stress; Time; Trauma; Trauma patient; Uncertainty; Universities; Visual; Well in self; base; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; care delivery; design; ethnic minority population; experience; food insecurity; healing; health care availability; health care service utilization; high risk; improved; literacy; negative affect; novel; organizational readiness; pandemic disease; parent grant; post-traumatic stress; prevent; psychoeducation; psychological distress; psychosocial; public health emergency; recruit; satisfaction; skills; stressor; telehealth; virtual; virtual delivery; virtual platform

Project Summary During this unprecedented time of social distancing, investigators and health systems must understand the challenges faced by vulnerable patients and research participants and develop new strategies, including telehealth, to provide continuity of research engagement and care delivery that reduce risks for immunocompromised individuals, including people living with HIV (PLWH). The “Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV” parent grant provides the Healing our Hearts, Minds, and Bodies (HHMB) intervention to Black and Latinx PLWH who have both trauma histories and cardiovascular risks. The goal of the trial is to increase patient and organizational readiness to address trauma and CVD risk among 260 Black and Latinx PLWH recruited from two HIV clinics in Southern California. For these vulnerable patients, it is incumbent upon our team to continue delivering the intervention while generating new knowledge in the context of the coronavirus (COVID-19) pandemic. The unpredictable onset and course of COVID-19, and the health and environmental effects that it presents for our vulnerable participants, have uncovered many important challenges in conducting health behavior research in high-risk, hard-to-reach populations. Current HHMB participants and those recruited for future HHMB groups now face additional environmental exposure risks that can interact with their HIV status and CVD risks, increasing negative health consequences, with severe ramifications that include death. Therefore, it is critical to provide culturally relevant programming that will encourage sustained engagement and maximize retention in research designed to reduce health risks as well as facilitate care. Retention efforts are likely to prevent and control chronic disease, and reduce morbidity and premature mortality, leading to improved overall health and wellness. In an effort to follow current safer-at-home mandates, mitigate environmental exposures, and provide continued health promotion, social support, and interaction during these uncertain times, we propose to convert our intervention to a virtual platform. This conversion will enable participants to receive services that are timely during COVID-19 and promote health on factors specific to the parent grant (i.e., cardiovascular health, HIV, and trauma). We propose two supplemental aims that will be achieved in an integrated mixed methods design: (1) to evaluate the impact of virtual delivery of the HHMB intervention on clinical outcomes (e.g., Life’s Simple 7, depression, anxiety, post-traumatic stress); and (2) to evaluate the evolving impact of COVID-19 on HHMB participants’: a) physical, mental, and emotional well- being and self-care for HIV, CVD risk factors, and other chronic conditions; b) daily lives, including their access to health care, needed social services, and other community resources; and c) engagement in and satisfaction with the delivery format (in person vs. virtual) of the HHMB intervention.

项目摘要 在这个前所未有的社会距离时期，调查人员和卫生系统必须了解 弱势患者和研究参与者面临的挑战，并制定新的战略，包括 远程保健，以提供研究参与和护理提供的连续性， 免疫功能低下的人，包括艾滋病毒感染者（PLWH）。“增强患者和 减少少数民族艾滋病病毒感染者”父母“心血管风险的组织准备 赠款提供治疗我们的心，思想和身体（HHMB）干预黑人和拉丁裔PLWH谁 有创伤史和心血管风险试验的目的是增加患者和 组织准备，以解决创伤和心血管疾病的风险之间的260个黑人和拉丁裔PLWH招募从 南加州的两家艾滋病诊所。对于这些脆弱的患者，我们的团队有责任继续 提供干预措施，同时在冠状病毒（COVID-19）背景下产生新知识 流行病COVID-19的不可预测的发病和病程，以及它对健康和环境的影响， 为我们脆弱的参与者提供的礼物，揭示了在开展健康教育方面的许多重要挑战。 高风险、难以接触人群的行为研究。目前的HHMB参与者和那些招募 未来的HHMB群体现在面临着额外的环境暴露风险，这些风险可能与他们的艾滋病毒状况相互作用 和心血管疾病风险，增加了负面的健康后果，严重的分支，包括死亡。 因此，至关重要的是提供与文化相关的方案，以鼓励持续参与 并最大限度地保留在旨在减少健康风险以及促进护理的研究中。留用工作 有可能预防和控制慢性病，降低发病率和过早死亡率， 改善整体健康状况。为了遵循当前的国内安全任务， 环境暴露，并提供持续的健康促进，社会支持和互动，在这些 在不确定的时期，我们建议将我们的干预转变为一个虚拟平台。这种转换将使 参与者在COVID-19期间及时获得服务，并根据特定因素促进健康 父母补助金（即，心血管健康、艾滋病毒和创伤）。我们提出两个补充目标， 在综合混合方法设计中实现：（1）评估HHMB虚拟交付的影响 对临床结果的干预（例如，生活的简单7，抑郁症，焦虑症，创伤后压力）;以及（2） 评估COVID-19对HHMB参与者的不断变化的影响：a）身体，精神和情绪健康- 艾滋病毒、心血管疾病风险因素和其他慢性病的自我护理; B）日常生活，包括获得这些服务的途径 卫生保健，所需的社会服务和其他社区资源;以及c）参与和满意度 与HHMB干预的交付形式（亲自与虚拟）。