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

项目摘要 高血压是艾滋病毒最常见的合并症，影响超过三分之二的40岁以上的艾滋病毒感染妇女 岁的高血压是心血管疾病（CVD）的主要危险因素， 通过生活方式的行为改变，如身体活动。平均而言，感染艾滋病毒的妇女 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纳入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物理的重大障碍， 对感染艾滋病毒的妇女采取干预措施。拟议的指导性患者导向研究的目标 职业发展奖（K23）旨在为博士提供必要的培训和专业支架。 克罗克特的职业生涯过渡到独立的临床科学家集中在预防和解决 心血管并发症在服务不足的人群。为了实现这一目标，克罗克特博士将寻求正式的 高血压和心血管健康结果培训，先进的混合方法研究， 行为健康干预和干预科学。这些培训目标将通过 在伯明翰的亚拉巴马大学拥有丰富的机构资源;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;和专业发展活动。该培训将应用于一个研究项目， 目的：（1）阐明HIV感染妇女日常体力活动行为的障碍和促进因素， 高血压使用社会认知理论框架;（2）系统地适应规定的身体活动 对感染艾滋病毒和高血压的妇女进行同伴支持的干预;以及（3）进行一项试验性临床试验， 适应性干预，以评估其可接受性，可行性和对收缩和舒张的初步影响， 血压.研究目的将通过进行日常的混合方法评估来实现。 通过加速度计的客观测量和 30名感染艾滋病毒和高血压的妇女;使用循证干预适应框架（ “ADAPT-ITT模型”），其中包括关键利益相关者的投入（即，感染艾滋病毒的妇女、保健工作者） 小组、专家咨询和现有文献的整合;以及随机试点干预试验 with 50 women妇女with HIV艾滋病毒and hypertension高血压.拟议研究的结果将为NIH奠定基础。 R 01应用于在较大规模随机对照试验中评价适应性干预。的 免费的培训和研究目标将确保克罗克特博士的过渡到独立的临床 研究人员，并有助于减少心血管疾病的负担，同时提高妇女的生活质量， 艾滋病。

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.