BEHAVIORAL INTERVENTIONS FOR WOMEN WITH HIV/AIDS - NY

针对女性艾滋病毒/艾滋病患者的行为干预 - 纽约州

• 批准号: 6702285
• 负责人: Jonathan N. Tobin
• 金额: $ 64.5万
• 依托单位: CLINICAL DIRECTORS NETWORK, INC.
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-03-01 至 2006-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6702285
• 关键词: HIV infections; behavioral /social science research tag; body physical activity; cognitive behavior therapy; comorbidity; depression; diet; female; functional ability; health behavior; human subject; human therapy evaluation; nutrition related tag; patient oriented research; safe sex /sex abstinence; substance abuse related disorder; therapy compliance; women' s health

The principal objective of this proposed multisite clinical trial is to continue efforts to develop the most effective combination of behavioral interventions to optimize the health status of the most neglected and understudied population affected by the AIDS epidemic in this country: poor women of color living with HIV/AIDS. Findings from the current study with this population affirm the utility of cognitive-behavioral stress management training combined with expressive-supportive therapy (CBSM+) in reducing distress (depression, ,anxiety) and denial, while improving social support, self-efficacy, coping skills and quality of life. The proposed study will extend these findings in seeking to determine whether exposure to CBSM+ can significantly improve the ability of the participants to take advantage of a health behavior change program encouraging the adoption and maintenance of healthier lifestyle behaviors (high levels of medication adherence, appropriate nutritional intake and physical activity, safer sexual practices and reduced substance use/abuse) essential for optimal health in the context of living with HIV/AIDS. A corollary objective will be to determine whether the proposed intervention program will be beneficial to less-acculturated segments of the affected population (i.e., non-English speaking women with HIV/AIDS) by establishing culturally- and linguistically-sensitive versions of the program in Spanish and Creole. To accomplish these objectives, the proposed Phase III multisite clinical trial described in two linked interactive research project grant applications (Miami- S. Weiss, P.I.; New York/New Jersey- J. Tobin, P.I.) will randomize 450 ethically diverse women living with HIV/AIDS in the three major epicenters for women (Miami:n=180; New York:n=180; New Jersey:n=90) into a group CBSM+ Condition and an individual psychoeducational comparison condition (Phase I). Following Phase I, participants will be randomized by group or cohort into a group `Healthier Lifestyles' skills training program or an individual health educational control condition (Phase II) devoted to improving medication adherence, nutrition, physical activity, safer sex and substance use reduction. Follow-up assessments will be carried out at 6, 12, and 24 months after treatment.

这项拟议的多点临床试验的主要目标是继续努力开发最有效的行为干预组合，以优化受艾滋病疫情影响的最被忽视和最未被研究的人群的健康状况：感染艾滋病毒/艾滋病的贫穷有色人种妇女。目前对这一人群的研究结果证实了认知行为压力管理训练与表达支持疗法(CBSM+)相结合在减少痛苦(抑郁、焦虑)和否认方面的效用，同时提高社会支持、自我效能、应对技能和生活质量。这项拟议的研究将扩展这些发现，以寻求确定接触CBSM+是否可以显著提高参与者利用健康行为改变计划的能力，该计划鼓励采用和保持更健康的生活方式行为(高水平的服药依从性、适当的营养摄入和体育活动、更安全的性行为和减少药物使用/滥用)，这些行为对于艾滋病毒/艾滋病患者的最佳健康至关重要。一个必然的目标将是确定拟议的干预计划是否将通过建立西班牙语和克里奥尔语对文化和语言敏感的计划版本，对受影响人口中文化适应程度较低的部分(即感染艾滋病毒/艾滋病的非英语妇女)有利。为了实现这些目标，拟议的第三阶段多站点临床试验在两个相互关联的互动研究项目拨款申请中描述(迈阿密-S·韦斯，P.I.；纽约/新泽西-J.托宾，P.I.)将在三个主要的妇女中心(迈阿密：N=180；纽约：N=180；新泽西：N=90)将450名不同种族的艾滋病毒/艾滋病患者随机分为CBSM+组和个人心理教育比较组(第一阶段)。在第一阶段之后，参与者将按小组或队列被随机分成一组，参加一组“更健康的生活方式”技能培训计划或个人健康教育控制条件(第二阶段)，致力于改善服药依从性、营养、身体活动、安全性行为和减少药物使用。在治疗后6个月、12个月和24个月进行随访评估。