Influence of Food Insecurity on Adherence

粮食不安全对依从性的影响

• 批准号: 8603060
• 负责人: SETH C KALICHMAN
• 金额: $ 32万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8603060
• 关键词: 18 year old; AIDS/HIV problem; Address; Adherence; Advertisements; Advocate; Alcohol consumption; Alcohol or Other Drugs use; Alcoholism; Anti-Retroviral Agents; Attention; Behavior Therapy; Behavior monitoring; Case Management; Case Manager; Cities; Collaborations; Communities; Consent; Consultations; Counseling; Data Collection; Development; Evaluation; Feedback; Focus Groups; Food; Food Access; HIV; HIV Infections; HIV Seropositivity; Health; Health Services; Health Services Accessibility; Hunger; Individual; Individual Differences; Intervention; Intervention Studies; Interview; Life; Malnutrition; Mediating; Mental Depression; Methods; Monitor; Moods; Outcome; Participant; Patients; Pharmaceutical Preparations; Population; Poverty; Procedures; Protocols documentation; Provider; Randomized; Recruitment Activity; Regimen; Reporting; Request for Proposals; Research; Research Personnel; Research Proposals; Resources; Sampling; Site; Social Work; Social support; Source; Staging; Stress; Stress and Coping; Substance abuse problem; Surveys; System; Testing; Text; Time; United States; Woman; addiction; antiretroviral therapy; base; clinical care; coping; design; drinking; experience; follow-up; health disparity; improved; inner city; innovation; instrument; intervention effect; medication compliance; meetings; men; novel; nutrition; prevent; public health relevance; research and development; skills; social; standard of care; substance abuse treatment; theories; therapy adherence; therapy design; therapy development; treatment adherence; urban area

DESCRIPTION (provided by applicant): This research proposal requests 3 years of support to conduct developmental intervention studies to design and field test a theory-based intervention to address food insecurity and improve antiretroviral therapy (ART) adherence among men and women living with HIV infection. Food insecurity is prevalent among people living with HIV in US inner-cities, with as many as 43% not having sufficient food and experiencing intermittent hunger. Food insecurity has demonstrated direct associations with ART adherence including predicting non-adherence over and above other factors including depression, social support, and alcohol use. Food insecurity is particularly problematic in relation to substance abuse given competing survival needs and the dire combined health consequences of alcoholism, addiction and malnutrition. Guided by the Conservation of Resources Theory of Stress and Coping, we will conduct 3 stages of intervention development research: (1) initial interviews and focus groups with people living with HIV who take ART, use substances, and experience food insecurity. Based on information gained from rapid formative studies, this first stage of research will be used to develop a theory-based intervention to address accessing food and sustaining ART adherence; (2) Test the feasibility of the newly developed food insecurity and adherence intervention with a small sample of HIV positive men and women who are taking ART, use substances, and experience food insecurity. Stage 2 will also finalize and pilot test all assessment instruments and protocols for data collection; and (3) Conduct a randomized field test to determine the potential efficacy of the food insecurity and ART adherence intervention. Participants in the field test will be randomly assigned to either receive the newly developed intervention or a time matched attention comparison condition. Following a 6- month follow-up period, we will test for differences between groups on ART adherence, food access, nutrition, and coping resource outcomes. The intervention development will include pilot testing daily food, mood, and substance use behaviors monitored by interactive text-message surveys. We will also examine the intervention effects on mediating theoretical constructs derived by Conservation of Resources Theory. Our developmental research will also examine the feasibility and acceptability of conducting the intervention in face-to-face intervention sessions. The proposed intervention research will therefore develop new strategies for use with people living with HIV who are taking ART under adverse conditions with multiple competing needs.

描述(由申请人提供)：这项研究提案要求提供3年的支持，以进行发育干预研究，以设计和现场测试一种基于理论的干预措施，以解决粮食不安全问题，并提高艾滋病毒感染患者的抗逆转录病毒疗法(ART)的依从性。食品不安全在美国市中心的艾滋病毒携带者中很普遍，多达43%的人没有足够的食物，并经历间歇性饥饿。食品不安全与抗逆转录病毒治疗的坚持直接相关，包括预测不坚持抗逆转录病毒治疗，而不是抑郁、社会支持和饮酒等其他因素。鉴于相互竞争的生存需求以及酗酒、上瘾和营养不良的可怕综合健康后果，与药物滥用有关的粮食不安全问题尤为严重。在压力和应对的资源节约理论指导下，我们将进行3个阶段的干预发展研究：(1)对服用抗逆转录病毒药物、使用药物和经历食物不安全的艾滋病毒携带者进行初步访谈和焦点小组。基于从快速形成研究中获得的信息，这一第一阶段的研究将用于开发一种以理论为基础的干预措施，以解决获得食物和维持抗逆转录病毒药物的坚持问题；(2)在正在服用抗逆转录病毒药物、使用药物并经历食物不安全的艾滋病毒阳性男女中，测试新开发的粮食不安全和坚持干预措施的可行性。第二阶段还将最后确定和试点测试数据收集的所有评估工具和方案；以及(3)进行随机实地测试，以确定粮食不安全和遵守抗逆转录病毒药物干预措施的潜在效力。现场测试的参与者将被随机分配到接受新开发的干预或时间匹配的注意力比较条件。在6个月的随访期后，我们将测试不同组之间在抗逆转录病毒治疗依从性、食物获取、营养和应对资源结果方面的差异。干预措施的开发将包括通过互动短信调查监测日常食物、情绪和物质使用行为的试点测试。我们还将考察资源节约理论对中介理论结构的干预效应。我们的发展研究还将检查在面对面干预会议中进行干预的可行性和可接受性。因此，拟议的干预研究将开发新的策略，用于在多种相互竞争的需求的不利条件下接受抗逆转录病毒治疗的艾滋病毒携带者。