The Influence of HIV Disease Events/Stages on Smoking Attitudes and Behaviors

HIV 疾病事件/阶段对吸烟态度和行为的影响

• 批准号: 8270334
• 负责人: Damon J. Vidrine
• 金额: $ 28.07万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8270334
• 关键词: AIDS diagnosis; AIDS population; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adult; Attitude; Behavior; Cardiovascular Diseases; Caring; Categories; Cause of Death; Cessation of life; Chronic; Clinic; Cognition; Cognitive; Computers; Data; Data Collection; Development; Diagnosis; Disease; Disease Progression; Employee Strikes; Enrollment; Event; Expectancy; Foundations; Future; Goals; HIV; HIV Seropositivity; HIV diagnosis; Health; Health behavior; Highly Active Antiretroviral Therapy; Incidence; Individual; Intention; Intervention; Kaposi Sarcoma; Learning; Life; Life Expectancy; Link; Lung diseases; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Medical; Medical Indigency; Medical Records; Morbidity - disease rate; Motivation; Newly Diagnosed; Oral; Outcome; Participant; Patient Self-Report; Pattern; Persons; Population; Population Heterogeneity; Prevention; Progressive Disease; Questionnaires; Recruitment Activity; Reporting; Research; Research Design; Research Personnel; Resources; Risk; Risk Behaviors; Smoker; Smoking; Smoking Behavior; Smoking Cessation Intervention; Social Controls; Stable Disease; Staging; Target Populations; Telephone; Texas; Time; Time Study; Treatment Failure; Withholding Treatment; abstracting; adverse outcome; attributable mortality; base; cancer risk; cigarette smoking; critical period; design; effective intervention; follow-up; improved; inner city; interest; low socioeconomic status; mortality; psychologic; public health priorities; racial and ethnic disparities; response; risk perception; smoking cessation; smoking prevalence; standard care

Abstract: While mortality attributable to AIDS-related diseases has decreased dramatically in the highly active antiretroviral therapy (HAART) era, the proportion of deaths attributable to other diseases (e.g., cardiovascular disease, pulmonary disease, and cancer) has markedly increased. Thus, efforts to reduce morbidity and mortality attributable to these non-AIDS defining diseases represent an important public health priority. One approach to improve health outcomes for this population is to target health-risk behaviors, such as cigarette smoking. Existing evidence indicates that smoking prevalence is significantly elevated among persons living with HIV/AIDS. In addition, smoking is associated with numerous HIV-related adverse outcomes. Despite these findings, few efforts have been made to deliver cessation treatment to this population. Also lacking are efforts to explore the relationship between HIV disease events/stages and smoking. Thus, the overarching goal of this project is to prospectively explore the relationship between HIV disease events/stages, perceived impact of HIV, attitudes about smoking, and smoking behaviors. HIV disease events/stages (e.g., time of HIV diagnosis, progressive disease, and stable disease) will be evaluated as potential teachable moments for smoking cessation. Specifically, we will identify and recruit newly HIV-diagnosed smokers from a large, inner city HIV/AIDS care center serving a racially/ethnically diverse, medically indigent population. Participants will complete a computer-administered assessment designed to measure perceived impact of HIV, attitudes about smoking, and current smoking behavior at the time of study enrollment. In addition to traditional self-report measures, certain variables (e.g., perceived impact of HIV) will be assessed using "implicit" cognitive psychological measures, as considerable evidence suggests that both explicit and implicit measures yield unique information that predicts outcome. Participants will be followed for one year and asked to complete follow-up computer- administered assessments at three-month intervals. In addition to clinic administered assessments, participants will complete brief weekly phone assessments that will allow us to carefully track changes in perceived impact of disease and smoking behavior for the first three months of follow-up. Research staff will also conduct medical record reviews to document the timing and progression of disease (e.g., treatment failure, diagnosis of an HIV- or non-HIV related disease). This design will enable us to carefully track changes in smoking behavior over time, and to link these changes to both the course of HIV-disease and/or to participants' perceived impact of HIV. By identifying optimal time points for intervention, findings will have the potential to maximize the efficiency and efficacy of cessation treatments delivered in resource-limited settings. In addition, findings will be instrumental in identifying specific constructs that should be targeted for intervention, and will provide a strong foundation for the development of future cessation interventions targeting smokers living with HIV/AIDS. Project Narrative The proposed study will provide important information about the relationship between HIV-disease events/stages and smoking behavior among a low socio-economic status, racially/ethnically diverse population. Specifically, findings will identify potential teachable moments for cessation interventions in the course of HIV-disease, and will provide a strong foundation for the development of future cessation interventions targeting this population.

摘要： 虽然与艾滋病有关的疾病造成的死亡率在2000年大幅度下降， 在高效抗逆转录病毒疗法（HAART）时代， 其它疾病（例如，心血管疾病、肺部疾病和癌症）， 明显增加。因此，减少这些疾病的发病率和死亡率的努力， 非艾滋病界定疾病是一个重要的公共卫生优先事项。一种方法 改善这一人群的健康结果的目标是针对健康风险行为，如 吸烟。现有的证据表明，吸烟的流行程度是显着的， 艾滋病毒/艾滋病感染者的比例上升。此外，吸烟与 许多与艾滋病毒有关的不良后果。尽管有这些发现， 为这些人提供戒烟治疗。同样缺乏的是探索的努力 艾滋病毒疾病事件/阶段与吸烟之间的关系。因此， 该项目的目标是前瞻性地探索艾滋病毒疾病与 事件/阶段，艾滋病毒的影响，对吸烟的态度，以及吸烟 行为。HIV疾病事件/阶段（例如，HIV诊断时间，疾病进展， 和稳定的疾病）将被评估为潜在的吸烟教育时刻 停止具体来说，我们将从一个新的艾滋病毒诊断吸烟者中识别和招募 一个大型的市中心艾滋病毒/艾滋病护理中心，为不同种族/民族的人提供医疗服务， 贫困人口。参与者将完成一个计算机管理的评估 旨在衡量艾滋病毒的影响，对吸烟的态度， 研究入组时的吸烟行为。除了传统的自我报告 测量，某些变量（例如，艾滋病毒的影响）将使用 “内隐”认知心理测量，因为大量证据表明，两者都 外显和内隐测量产生预测结果的独特信息。 参与者将被跟踪一年，并要求完成后续计算机- 每隔三个月进行一次评估。除了诊所管理外， 评估，参与者将完成每周简短的电话评估， 我们需要仔细跟踪疾病和吸烟行为对健康的影响， 第一个三个月的后续行动。研究人员还将进行医疗记录 审查以记录疾病的时间和进展（例如，治疗失败， HIV或非HIV相关疾病的诊断）。这种设计将使我们能够仔细地 跟踪吸烟行为随时间的变化，并将这些变化与 艾滋病病程和/或参与者对艾滋病影响的感知。通过识别 干预的最佳时间点，研究结果将有可能最大限度地提高 在资源有限的环境中提供戒烟治疗的效率和功效。在 此外，研究结果将有助于确定应 有针对性的干预，并将为发展提供一个坚实的基础， 未来的戒烟干预措施将针对感染艾滋病毒/艾滋病的吸烟者。项目叙述 这项拟议中的研究将提供有关艾滋病毒与疾病之间关系的重要信息。 低社会经济地位、种族/民族多样化的事件/阶段和吸烟行为 人口具体来说，研究结果将确定潜在的可教的时刻，停止干预， 艾滋病的过程中，并将提供一个强大的基础，为今后的发展停止 针对这一人群的干预措施。