Health Promotion for Positives: A Randomized Trial with HIV Positive Black Men

描述（由申请人提供）：本申请是对RFA-MD-12-001，“NIMHD健康差异研究（R01）”的回应。感染艾滋病毒的非洲裔美国人的寿命更长，并且受到与40岁以上非洲裔美国人一般人群相同的慢性疾病的影响。可以肯定的是，总的来说，非裔美国男性患心血管疾病、高血压、糖尿病、肾脏疾病和癌症的比例高得不成比例，尤其是前列腺癌和结肠癌。然而，艾滋病毒感染与慢性病合并症的风险增加有关。艾滋病毒感染加剧了这种增加的风险，但在高活性抗逆转录病毒治疗（HAART）组合中使用的某些药物也加剧了这种风险。许多慢性疾病都有行为因素——风险受人们做什么和不做什么、饮食和运动量的影响。虽然已认识到艾滋病毒阳性个体患多种与行为相关的慢性病的高风险，但缺乏专门针对其需求的循证干预措施。因此，总体目标是降低风险

DESCRIPTION (provided by applicant): This application is in response to RFA-MD-12-001, "NIMHD Health Disparities Research (R01)." African American men who are infected with HIV are living longer and are being impacted by the same chronic diseases that affect the general population of African American men over 40. To be sure, African American men, in general, have disproportionately high rates of cardiovascular disease, hypertension, diabetes, kidney disease, and cancer, particularly prostate and colon cancer. However, HIV infection is associated with an increased risk for co-morbidity from chronic diseases. This increased risk is heightened by HIV infection, but also its treatment with certain agents used in highly active antiretroviral therapy (HAART) combinations. Many of these chronic illnesses have behavioral components-risk is influenced by what people do and do not do, their diet, and the amount of physical activity they get. Although the high risk for multiple behavior-linked chronic diseases among HIV-positive individuals has been recognized, there is a lack of evidence-based intervention specifically tailored to their needs. Hence, the broad objective is to reduce the risk of chronic diseases among HIV positive African American men. The Specific Aims are to test the efficacy of a theory- based, contextually appropriate health promotion intervention in inducing positive changes in behaviors linked to risk of chronic diseases among HIV positive African American men age 40 years or older and to identify the theoretical variables that mediate its efficacy. The study will utilize a randomized controlled trial. The participants willbe 384 African American HIV positive men age 40 or older who are receiving HAART for HIV. The men will be randomized to a theory-based contextually appropriate health promotion intervention that involves three, 3-hour weekly intervention sessions or an attention-control group. The health promotion intervention will be an adaptation of an intervention based on social cognitive theory integrated with formative research and found to be efficacious in increasing adherence to 5-a-Day diet and physical activity guidelines and prostate cancer screening guidelines in the applicants' preliminary studies. Data will be collected at baseline, immediately post, 3, 6 and 12 months post intervention, which will permit assessment of the short- term and long-term effects of the intervention and whether the intervention's efficacy varies over time. Audio computer-assisted self-interviewing will be used to assess self-reported adherence to physical activity guidelines, 5-a-Day fruit and vegetable guidelines, prostate screening guidelines, and colon cancer screening guidelines and theoretical mediators of behavior change. Objective outcomes will include health-related fitness (6-minute walk test, 1-minute push-up test, 1-minute sit-up test, sit-and-reach test), physiological variables (blood pressure, body mass index, waist circumference, and waist-hip ratio), and prostate and colon cancer screening based on medical record review.