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

针对感染艾滋病毒的黑人女性进行正念减压干预的可行性

• 批准号: 10454380
• 负责人: Crystal LaShonda Chapman Lambert
• 金额: $ 13.58万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-08-15 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10454380
• 关键词: Accounting; Adherence; African American; Area; Attention; Attenuated; Awareness; Behavior; Behavior Therapy; Breast Cancer survivor; Caring; Chronic; Clinic; Clinical; Communities; Conduct Clinical Trials; Critiques; Data; Epidemic; Evaluation; Event; Failure; Female; Focus Groups; Future; Gender; Goals; Group Interviews; HIV; HIV diagnosis; Health; Health behavior outcomes; Informal Social Control; Interpersonal Violence; Intervention; Interview; K-Series Research Career Programs; Lead; Length; Life; Logistics; Manuals; Medical; Mental Depression; Mentors; Mentorship; Methods; Mind; Mind-Body Method; Morbidity - disease rate; Outcome; Outpatients; Participant; Persons; Pilot Projects; Process; Publishing; Quality of life; Randomized; Reporting; Research; Research Design; Research Methodology; Research Personnel; Sampling; Schedule; Scientist; Self Care; Stress; Stressful Event; Suggestion; Survivors; Target Populations; Testing; Time; Training; Trauma; Treatment Efficacy; United States; Viral; Viral Load result; Visit; Woman; Work; acceptability and feasibility; adherence rate; antiretroviral therapy; arm; behavioral adherence; black women; care providers; career; career development; comparison intervention; coping; data format; data integration; efficacy evaluation; efficacy trial; experience; gender disparity; high risk; improved; male; marginalized population; men; mindfulness-based stress reduction; mortality; patient population; physical symptom; pilot test; programs; psychologic; psychological distress; psychological symptom; racial and ethnic; racial disparity; recruit; satisfaction; standard of care; stress management; stress reduction; symptom management; therapy adherence; therapy development; treatment adherence; treatment as usual; visit adherence

Project Summary/Abstract The overall objective of this Mentored Research Scientist Career Development Award is to support and develop Dr. Chapman Lambert’s transition to an independent investigator in mind and body research with a focus on developing, integrating, and testing mind and body strategies to improve clinical, psychological, and physical outcomes among African American (AA) women living with HIV (WLWH). HIV viral load (VL) suppression among AA WLWH are suboptimal when compared to women of other racial and ethnic backgrounds. Two essential self- care behaviors for people living with HIV (PLWH) to achieve and sustain HIV VL suppression ad improve health outcomes and survival are adherence to antiretroviral therapy and scheduled medical visits. Medical visit adherence is suboptimal among women in general, but VL suppression rates among AA WLWH are suboptimal with AA WLWH being nearly 3 times more likely than White WLWH not to achieve viral suppression. One important factor associated with adherence behaviors is stressful life events including traumatic life events. Thus, there is a critical need to develop culturally appropriate interventions aimed reducing stress and improving adherence behaviors and VL suppression. Mindfulness-based stress reduction (MBSR), developed by Jon Kabat-Zinn, has the potential to reduced stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping as well as ART adherence in predominately white and male patient populations. We propose to culturally adapt the MSBR intervention for AA WLWH to reduce stress and enhance HIV self-care behaviors and VL suppression, which has the potential to attenuate prominent racial and gender disparities experienced by AA WLWH in the US. Specifically, we aim to 1) culturally adapt the MBSR intervention for AA WLWH using ADAPT-ITT; 2) pre-pilot the adapted intervention via an open non-randomized pilot study to further refine the culturally adapted intervention; and 3) conduct a 2-armed pilot test of the behavioral intervention compared to standard of care to assess the feasibility and acceptability the adapted MBSR intervention for AA WLWH. Findings from this study will provide an important first step in establishing my program of research as an independent investigator in stress-related morbidity and HIV treatment adherence. In addition, findings maybe applicable for other chronic conditions and marginalized populations living with and without HIV.

项目总结/摘要 这个指导研究科学家职业发展奖的总体目标是支持和发展 博士查普曼兰伯特的过渡到一个独立的调查员在心灵和身体的研究，重点是 开发，整合和测试身心策略，以改善临床，心理和身体 非裔美国人（AA）感染艾滋病毒的妇女（WLWH）的结果。HIV病毒载量（VL）抑制 与其他种族和民族背景的女性相比，AA WLWH是次优的。两个基本的自我- 艾滋病毒感染者（PLWH）的护理行为，以实现和维持艾滋病毒VL抑制并改善健康 结果和生存率取决于是否坚持抗逆转录病毒治疗和定期就医。医学访视 一般来说，女性患者的依从性不佳，但AA WLWH患者的VL抑制率不佳 AA WLWH不实现病毒抑制的可能性比白色WLWH高近3倍。一 与依从行为相关的重要因素是压力性生活事件，包括创伤性生活事件。因此，在本发明中， 迫切需要制定文化上适当的干预措施，旨在减轻压力， 粘附行为和VL抑制。基于正念的压力减轻（MBSR），由乔恩开发 Kabat-Zinn，通过自我调节注意力和对压力的意识， 事件正念减压疗法已被证明在改善压力管理、心理困扰、身体和精神方面有效。 主要为白色和男性的心理症状、生活质量、应对方式以及ART依从性 患者人群。我们建议在文化上适应AA WLWH的MSBR干预，以减轻压力， 增强艾滋病毒自我护理行为和VL抑制，这有可能减轻突出的种族和 AA WLWH在美国经历的性别差异。具体来说，我们的目标是1）文化适应MBSR 使用ADAPT-ITT对AA WLWH进行干预; 2）通过开放式非随机化预试验适应性干预 试点研究，以进一步完善适应文化的干预措施;以及3）对 行为干预与标准治疗相比，以评估适应的可行性和可接受性 MBSR干预AA WLWH。这项研究的结果将为建立我的研究提供重要的第一步。 研究计划作为一个独立的调查员在压力相关的发病率和艾滋病毒治疗的依从性。在 此外，研究结果可能适用于其他慢性病和边缘化人群， 没有艾滋病毒。

项目成果

The Mediating Role of Social Support and Resilience Between HIV-Related Stigmas and Patient Activation Among Young Black Women Living With HIV in the Southern United States: A Cross-sectional Study.

美国南部感染艾滋病毒的年轻黑人女性中，社会支持和复原力在艾滋病毒相关耻辱与患者激活之间的中介作用：一项横断面研究。

• DOI: 10.1097/jnc.0000000000000312
• 发表时间: 2022
• 期刊: The Journal of the Association of Nurses in AIDS Care : JANAC
• 作者: ChapmanLambert,Crystal;Fazeli,PariyaL;Yigit,Ibrahim;Elopre,Latesha;King,Kiko;Kempf,Mirjam-Colette;Guthrie,Barbara;Mugavero,MichaelJ
• 通讯作者: Mugavero,MichaelJ