Community-based Self-management of HIV and Chronic Disease

基于社区的艾滋病毒和慢性病自我管理

• 批准号: 7363666
• 负责人: SHERYL L CATZ
• 金额: $ 67.62万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-03-01 至 2012-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7363666
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; Adopted; Age; Aging; American; Anti-Retroviral Agents; Arthritis; Attention; Behavior; Books; Characteristics; Chronic; Chronic Disease; Chronic Hepatitis C; Chronically Ill; Communities; Complex; Condition; Consultations; Counseling; Development; Diabetes Mellitus; Disease Management; Disease Progression; Education; Elderly; Enrollment; Evidence based intervention; HIV; Health; Heart Diseases; Hypertension; Intervention; Intervention Studies; Life; Literature; Lung diseases; Medical; Mental Depression; Mental Health; Modeling; Motivation; NIH Program Announcements; Numbers; Outcome Measure; Participant; Personal Satisfaction; Persons; Pharmaceutical Preparations; Phase; Physical Function; Population; Problem Solving; Protocols documentation; Quality of life; Randomized; Randomized Controlled Trials; Range; Readiness; Recruitment Activity; Research; Research Personnel; Resources; Self Efficacy; Self Management; Services; Site; Social Functioning; Social isolation; Stigmata; Stress; Telephone; Testing; Training; Transportation; Upper arm; Work; age group; aged; aging population; base; chronic pain; comparison group; coping; cost; desire; disability; follow-up; health related quality of life; improved; medication compliance; member; programs; response; self help; skills; skills training; social stigma; symptom management; treatment program

DESCRIPTION (provided by applicant): A growing number of Americans living with HIV/ AIDS are aged 50 or older. The majority of HIV+ older persons must manage multiple chronic health conditions, which increases the challenge of self-managing their health. However, little work has addressed this issue. Pilot research showed this population desires assistance with HIV management and adherence, chronic disease management, and quality of life. Prior research has also shown telephone counseling to be acceptable, feasible, and efficacious in improving coping among older HIV+ persons. We are therefore seeking to test the efficacy of an individualized telephone counseling intervention focused on HIV treatment adherence and chronic disease self- management. A telephone format has potential to increase access to self-management support services among older adults who may be isolated or in poor health. Primary aims are to conduct a randomized controlled trial with 450 persons recruited from community-based AIDS Service Organizations (ASOs) who are aged 50+ years and living with HIV/AIDS and other chronic conditions. We will evaluate the efficacy of an experimental 10-session individually-tailored telephone counseling intervention, as compared to a 10- session attention-matched didactic telephone group comparison arm, and an information-matched book only control arm. Primary outcome measures are HIV treatment adherence and health-related quality of life at baseline, 6, 9, and 12-month follow-ups. Secondary aims are to evaluate between group differences in: (a) overall chronic disease treatment adherence; (b) problem-solving skills, self-efficacy, and readiness to change; and (c) perceived stress and depression. Development of an individualized intervention to enhance HIV-specific and general chronic illness self-management skills and motivation among persons aged 50 and older living with HIV/AIDS and other comorbid chronic conditions will help to address the broad needs of this population. Our proposed intervention and recruitment plan capitalizes on the strengths of existing community-based organizations, and in the long-term may have the potential to help build their capacity to serve older persons with HIV. The proposed intervention model and format could also be generalizable to other populations of persons with multiple chronic conditions..

描述（由申请人提供）：越来越多的美国艾滋病毒/艾滋病感染者年龄在50岁或以上。大多数艾滋病毒阳性老年人必须管理多种慢性健康状况，这增加了自我管理健康的挑战。然而，很少有工作涉及这一问题。试点研究表明，这一人群希望获得艾滋病毒管理和依从性、慢性病管理和生活质量方面的帮助。先前的研究也表明，电话咨询是可以接受的，可行的，有效地改善老年艾滋病毒阳性者的应对。因此，我们正在寻求测试的疗效，个性化的电话咨询干预，重点是艾滋病毒治疗的依从性和慢性病的自我管理。电话形式有可能增加可能被孤立或健康状况不佳的老年人获得自我管理支持服务的机会。主要目的是对450名来自社区艾滋病服务组织（ASO）的50岁以上艾滋病毒/艾滋病感染者和其他慢性病患者进行随机对照试验。我们将评估一个实验性的10个会话的个性化定制的电话咨询干预的有效性，相比10个会话的注意力匹配的说教电话组比较arm. Primary结局措施的控制arm. Primary图书匹配的注意力匹配的图书是艾滋病毒治疗的依从性和健康相关的生活质量在基线，6，9和12个月的后续行动。次要目的是评估组间差异：（a）总体慢性病治疗依从性;（B）解决问题的技能，自我效能和改变的准备;和（c）感知的压力和抑郁。制定个性化的干预措施，以提高50岁及以上艾滋病毒/艾滋病和其他慢性病共病患者的艾滋病毒特异性和一般慢性病自我管理技能和积极性，将有助于满足这一人群的广泛需求。我们提出的干预和招募计划利用了现有社区组织的优势，从长远来看，可能有潜力帮助这些组织建设为感染艾滋病毒的老年人服务的能力。拟议的干预模式和形式也可以推广到其他患有多种慢性病的人群。