Social connections, risk for COVID-era psychiatric and substance use disorders, and HIV control

社会关系、新冠病毒时代精神疾病和物质使用障碍的风险以及艾滋病毒控制

• 批准号: 10543792
• 负责人: Jacquelyn Leigh Meyers
• 金额: $ 65.9万
• 依托单位: SUNY DOWNSTATE MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2026-10-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10543792
• 关键词: Address; Adherence; African American; Age; Area; Black race; Buffers; COVID-19; Cessation of life; Chronic Disease; Clinical; Cohort Studies; Communities; Consensus; Coupled; Data; Data Collection; Diagnostic; Dimensions; Disease; Education; Educational Status; Emotional; Ethnic Origin; Ethnic Population; Evaluation; Family; Friends; Gender; Geography; Goals; HIV; HIV Infections; Health; Human; Impairment; Income; Insurance Coverage; Intervention; Interview; Knowledge; Laboratories; Link; Literature; Loneliness; Measures; Mediating; Mediator; Mental Depression; Mental Health; Meta-Analysis; Methods; Modeling; Neighborhoods; Outcome; Pathway interactions; Pattern; Perception; Personal Satisfaction; Persons; Population; Population Density; Population Heterogeneity; Poverty; Premature Mortality; Prevention; Public Health; Quality of life; Race; Recording of previous events; Reporting; Research; Risk; Science; Self Management; Site; Social Interaction; Social isolation; Standardization; Strategic Planning; Substance Use Disorder; Substance abuse problem; Surveys; Time; United States National Institutes of Health; Update; Viral Load result; Vulnerable Populations; Woman; Work; behavior prediction; biopsychosocial; coronavirus disease; design; dimensional analysis; effective intervention; genome-wide; genomic predictors; high risk; implementation intervention; indexing; lens; longitudinal analysis; longitudinal design; medication compliance; mortality; multilevel analysis; polygenic risk score; primary outcome; racial population; secondary outcome; social; social integration; social relationships; socioeconomics; stressor

PROJECT SUMMARY / ABSTRACT Social connections are critical to human well-being, and people lacking in these connections (social isolation) or who perceive that they are lacking these connections (loneliness) have lower self-management of chronic disease, are more likely to suffer from substance abuse disorders and depression, and are at higher risk for premature mortality. People living with HIV report a significant burden of loneliness and other indicators of impaired social connectedness; these impaired social connections have been linked to reduced HIV adherence and quality of life. The significant strain imposed on social relationships by COVID-19 restrictions and by losses of family, friends, and community has brought urgency to the issue of social connections, particularly for vulnerable populations such as those living with HIV infection. COVID-19 has also brought increased calls for implementation of interventions focused on social connections, which in turn has highlighted a critical lack of effective interventions in this area, rooted in evidence gaps regarding relationships between social connection and health outcomes in diverse populations, in understanding of the unique and synergistic influences of conceptually distinct dimensions of social connection on health over time, and on modifiable pathways linking these connections to health outcomes. Applying a longitudinal, mixed-methods, and community-engaged framework within a nationally-representative and well-characterized HIV cohort study, the MACS/WIHS Combined Cohort Study (MWCCS), this project aims to: (Aim 1) characterize longitudinal and multidimensional patterns of social connection both prior to and during the COVID-era, and identify social, behavioral and genomic predictors of these patterns; (Aim 2) identify relationships between patterns of social connection and HIV outcomes, including identification of mechanistic pathways via substance use disorders and depression, and (Aim 3) assess multilevel mediators and moderators of relationships between social connection and temporally associated outcomes including area-level socio-geographic indicators of poverty and population density. This work utilizes the extensive platform of the MWCCS, including annual laboratory evaluation of HIV disease indices, validated medication adherence measures, genome-wide data that will be utilized to construct polygenic risk scores, annually updated geocoded data, and diagnostic assessments of substance use disorders and depression (N=2000). To this, we will add an annual battery of social connection measures, including social and emotional loneliness, social isolation, and social integration at selected MWCCS sites (N=735), coupled with nested, longitudinal qualitative interviews (N=40). This multidimensional, longitudinal and multilevel analysis will significantly extend previous research in this area, and findings from this project can be utilized to identify actionable targets to support the design of effective interventions in this important area and high priority population.

项目摘要/摘要 社会关系对人类的福祉至关重要，而缺乏这些关系的人(社会孤立) 或者那些认为自己缺乏这些联系(孤独)的人对慢性病的自我管理能力较低 疾病，更有可能遭受物质滥用障碍和抑郁，并处于更高的风险 过早死亡。艾滋病毒携带者报告了严重的孤独负担和其他指标 社交联系受损；这些社交联系受损与HIV依从性降低有关 和生活质量。新冠肺炎限制和新冠肺炎限制给社会关系带来的巨大压力 家庭、朋友和社区的丧失给社会关系问题带来了紧迫性，特别是对 弱势群体，如艾滋病毒感染者。新冠肺炎也带来了更多的呼声 实施以社会关系为重点的干预措施，这反过来又突出了严重缺乏 这一领域的有效干预措施，根植于关于社会联系之间关系的证据差距 和不同人群的健康结果，以了解艾滋病的独特和协同影响 随着时间的推移，社会联系在概念上对健康的不同维度，以及在可修改的途径上的联系 这些与健康结果的联系。应用纵向、混合方法和社区参与 在具有全国代表性和特点良好的艾滋病毒队列研究框架内，MACS/WIHS 联合队列研究(MWCCS)，该项目旨在：(目标1)表征纵向和多维 在COVID时代之前和期间的社会联系模式，并确定社会、行为和 这些模式的基因组预测因子；(目标2)确定社会关系模式和 艾滋病毒结果，包括通过物质使用障碍和抑郁确定机制途径， 和(目标3)评估社会联系和社会联系之间关系的多层次调解人和调解人 与时间相关的成果，包括地区一级贫困和人口的社会地理指标 密度。这项工作利用了MWCCS的广泛平台，包括艾滋病毒的年度实验室评估 疾病指数、有效的药物依从性衡量标准、全基因组数据，将用于构建 多基因风险评分、每年更新的地理编码数据以及物质使用的诊断评估 精神障碍和抑郁(N=2000)。为此，我们将每年增加一系列社交联系措施， 包括社会和情感上的孤独感、社会孤立和社会融合 (n=735)，加上嵌套的纵向定性访谈(N=40)。这是多维的、纵向的 多水平分析将极大地扩展这一领域的先前研究，该项目的发现可以 用于确定可采取行动的目标，以支持在这一重要领域设计有效的干预措施 和高优先级人群。