Adaptation and Pilot Testing a Behavioral Physical Activity Intervention with Peer Support for Women with HIV and Co-Occurring Hypertension

项目总结 高血压是与艾滋病毒最常见的共病，在40岁以上的艾滋病毒携带者中，超过三分之二的人受到影响 几年前。高血压是心血管疾病(CVD)的一个重要危险因素，是可以改变的 通过体力活动等生活方式行为的改变。平均而言，感染艾滋病毒的妇女参与程度较低。 特别是如果他们居住在美国东南部，那里的心血管疾病风险很大。 在将生活方式医学方法整合到艾滋病毒初级保健方面存在知识空白。 此外，代表性不足和参与度低是现有行为体检的重大障碍 对感染艾滋病毒妇女的活动干预。拟议的以患者为导向的导师研究的目标 职业发展奖(K23)是为博士提供必要的培训和专业的脚手架。 克罗基特的职业生涯转变为专注于预防和解决问题的独立临床科学家 服务不足人群的心血管合并症。为了实现这一目标，克罗基特博士将寻求正式 高血压和心血管健康结果方面的培训，高级混合方法研究，适应 行为健康干预和干预学。这些培训目标将通过 阿拉巴马大学伯明翰分校丰富的机构资源；专家的密切指导； 通过课程和强化讲习班进行正式培训；参加地方、国家和国际会议 会议；和专业发展活动。这种培训将应用于一个研究项目，目的是 目的：(1)阐明艾滋病毒携带者和妇女日常体育活动行为的障碍和促进者 高血压使用社会认知理论框架；(2)系统地适应规定的体力活动 对感染艾滋病毒和高血压的妇女进行同伴支持干预；以及。(3)进行一项试点临床试验。 适应性干预评估其可接受性、可行性及其对收缩和舒张期的初步影响 血压。研究目标将通过进行每日的混合方法评估来实现 通过使用加速度计进行客观测量和使用体验采样来实现身体活动行为 30名患有艾滋病毒和高血压的妇女；使用循证干预适应框架( “适应-ITT模式”)，重点关注关键利益攸关方(即，艾滋病毒携带者妇女、医护人员)的意见 分组、专家会诊和现有文献的整合；以及随机试点干预试验 与50名患有艾滋病毒和高血压的女性在一起。拟议的研究结果将为NIH的研究奠定基础 R01在更大规模的随机对照试验中评估适应性干预的应用。这个 免费的培训和研究目标将确保克罗基特博士过渡到独立临床 研究人员，并有助于减轻心血管疾病的负担，同时提高妇女的生活质量 爱滋病毒。

PROJECT SUMMARY Hypertension is the most common comorbidity with HIV affecting over two thirds of women with HIV over forty years of age. Hypertension is a prominent risk factor for cardiovascular disease (CVD) that is modifiable through lifestyle behavior changes such as physical activity. On average, women with HIV engage in low levels of physical activity particularly if they reside in the southeastern United States where CVD risk is substantial. There are gaps in knowledge regarding the integration of lifestyle medicine approaches in HIV primary care. Further, under-representation and low engagement are significant barriers to existing behavioral physical activity interventions for women with HIV. The goal of the proposed Mentored Patient-Oriented Research Career Development Award (K23) is to provide the essential training and professional scaffolding critical for Dr. Crockett's career transition to independent clinical scientist focused on preventing and addressing cardiovascular comorbidities in underserved populations. To achieve this goal Dr. Crockett will pursue formal training in hypertension and cardiovascular health outcomes, advanced mixed methods research, adaptation of behavioral health interventions, and intervention science. These training aims will be accomplished through the wealth of institutional resources at the University of Alabama at Birmingham; close mentorship from experts; formal training through courses and intensive workshops; attendance at local, national, and international meetings; and professional development activities. This training will be applied to a research project that aims to: (1) elucidate the barriers and facilitators to daily physical activity behavior among women with HIV and hypertension using a social cognitive theory framework; (2) systematically adapt a prescriptive physical activity intervention with peer support for women with HIV and hypertension; and (3) conduct a pilot clinical trial of the adapted intervention to evaluate its acceptability, feasibility, and preliminary impact on systolic and diastolic blood pressure. The research aims will be accomplished by conducting a mixed methods assessment of daily physical activity behavior through objective measurement with accelerometers and experience sampling with 30 women with HIV and hypertension; using an evidence-based intervention adaptation framework (the “ADAPT-ITT model”) with input from key stakeholders (i.e., women with HIV, healthcare workers) in focus groups, expert consultations, and integration of the existing literature; and a randomized pilot intervention trial with 50 women with HIV and hypertension. Results of the proposed study will form the foundation for an NIH R01 application to evaluate the adapted intervention in a larger scale randomized controlled trial. The complimentary training and research goals will ensure Dr. Crockett's transition to independent clinical investigator and contribute to reducing the burden of CVD while improving quality of life among women with HIV.