A technology-based psychosocial intervention to support social engagement and well-being in adults aging with HIV

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Project Summary Older people with HIV (OPH) often live with significant mental health challenges such as social isolation, loneliness, and depression. Yet to date, there has been limited intervention research directed at psychosocial issues such as social isolation and loneliness among aging adults with HIV, especially long-term survivors, an area especially relevant given the COVID-19 pandemic and “stay in place” requirements. This proposed exploratory/development study addresses these issues and is responsive to NIH PAR-18-190 Multidisciplinary Studies of HIV and Aging. Consistent with OAR emphasis on improving outcomes through Cross-Cutting research to address HIV-associated comorbidities and complications, the study objectives are to develop and evaluate a technology-based psychosocial intervention program designed to: enhance social engagement and support, resource access and education; reduce loneliness; and improve well-being among older adults with HIV who are long-term survivors (diagnosed with HIV ≥ 20 years). The program, Connecting Older Positive People to Enhance Health and Resilience (COPPEhR), will build on the PRISM tablet platform [13] and the programs and services available at the Center for Special Studies (CSS) at Weill Cornell Medicine (WCM) (see preliminary studies). Phase 1 of the study will involve developing and tailoring the system for this understudied population, focus groups, and usability testing with a small sample of aging adults with HIV, and Phase 2 will involve a two-group pilot efficacy trial (akin to an NIH Stage 1b trial). The COPPEhR intervention will be compared to a tablet-only control condition (TCC). Sixty-eight adults aged 50+, stratified by age, with HIV who are long-term survivors (diagnosed with HIV ≥ 20 years) will be recruited and randomly assigned 1:1 to the COPPEhR or TCC conditions. The intervention duration will be six months. Outcomes will include measures of depression, loneliness, social support, changes in social network, quality of life, and indices of health. Assessments will be conducted at baseline and 3 & 6-months post-randomization. We will also assess the feasibility, usefulness, and usability of the COPPEhR system and collect real time data on system use. The specific aims of this developmental project are to: 1) Evaluate the feasibility, usefulness, and usability of a state-of-the art technology-based multicomponent COPPEhR intervention for aging adults with HIV; and, 2) Obtain preliminary information on the potential efficacy of the COPPEhR program in terms of enhancing social engagement, well-being, and resource access, and reducing loneliness among older adults with HIV. The overall goal of the research is to support the development of an efficacious technology-based intervention for OPH that can be evaluated in a larger scale trial and be delivered to diverse older adults in a variety of community and residential settings.