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

积极健康促进：艾滋病毒阳性黑人男性的随机试验

• 批准号: 8281766
• 负责人: JOHN BARTON JEMMOTT
• 金额: $ 41.12万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-03-21 至 2016-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8281766
• 关键词: AIDS prevention; AIDS-Related Opportunistic Infections; Adherence; Affect; African American; Age; Aging; Anti-Retroviral Agents; Applications Grants; Attention; Behavior; Behavioral; Blood Pressure; Body mass index; Budgets; Cardiovascular Diseases; Centers for Disease Control and Prevention (U.S.); Chronic; Chronic Disease; Colon Carcinoma; Comorbidity; Complement; Computer Assisted; Control Groups; Couples; Data; Diabetes Mellitus; Diet; Evidence based intervention; Expectancy; Future; General Population; Guidelines; HIV; HIV Infections; HIV Seropositivity; Health; Health Promotion; Health behavior; Highly Active Antiretroviral Therapy; Hour; Hypertension; Individual; Intervention; Interview; Kidney Diseases; Life; Link; Long-Term Effects; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Mediating; Mediator of activation protein; Medical Records; Morbidity - disease rate; Outcome; Participant; Patient Self-Report; Persons; Physical Fitness; Physical activity; Physiological; Prevention; Prostate; Randomized; Randomized Controlled Trials; Research; Risk; Screening for Prostate Cancer; Screening procedure; Self Efficacy; Testing; Time; Treatment Efficacy; United States; Vulnerable Populations; Waist-Hip Ratio; Walking; base; behavior change; comparative efficacy; design; effective therapy; efficacy testing; empowered; experience; fitness; fruits and vegetables; health disparity; high risk; innovation; interest; man; men; mortality; post intervention; primary outcome; randomized trial; response; sex; social cognitive theory; successful intervention; theories; waist circumference

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.

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寿命更长，并受到影响40岁以上非洲裔美国人的慢性疾病的影响。 可以肯定的是，非洲裔美国人的心血管疾病、高血压、糖尿病、肾脏疾病和癌症，特别是前列腺癌和结肠癌的发病率高得不成比例。 然而，艾滋病毒感染与慢性病并发症的风险增加有关。 这种增加的风险因艾滋病毒感染而增加，但也因其与高效抗逆转录病毒疗法（HAART）组合中使用的某些药物的治疗而增加。 许多慢性病都有行为因素风险受到人们做什么和不做什么、饮食和身体活动量的影响。 虽然艾滋病毒抗体阳性者罹患多种与行为有关的慢性病的风险很高，但缺乏专门针对他们需求的循证干预措施。因此，总体目标是降低风险 艾滋病毒阳性的非裔美国人中的慢性疾病。 具体目的是测试基于理论的、适合背景的健康促进干预措施在诱导40岁或40岁以上的HIV阳性非洲裔美国男性中与慢性病风险相关的行为发生积极变化方面的有效性，并确定介导其有效性的理论变量。 本研究将采用随机对照试验。 参与者将是384名年龄在40岁或40岁以上的非洲裔美国人HIV阳性男性，他们正在接受HAART治疗HIV。 这些男性将被随机分配到一个基于理论的环境适当的健康促进干预，包括三个，每周3小时的干预会议或注意力控制组。 健康促进干预措施将是基于社会认知理论的干预措施的改编，与形成性研究相结合，并在申请人的初步研究中发现其在增加对每日5次饮食和体力活动指南以及前列腺癌筛查指南的依从性方面有效。 将在基线、干预后即刻、干预后3个月、6个月和12个月收集数据，这将允许评估干预的短期和长期效果以及干预的功效是否随时间变化。 将使用音频计算机辅助自我访谈来评估自我报告的对体力活动指南、每日5次水果和蔬菜指南、前列腺筛查指南和结肠癌筛查指南的依从性以及行为改变的理论介导因素。 客观结果将包括健康相关的健身（6分钟步行试验、1分钟俯卧撑试验、1分钟仰卧起坐试验、坐位体前屈试验）、生理变量（血压、体重指数、腰围和腰臀比）以及基于病历审查的前列腺和结肠癌筛查。