Cardiovascular Risk Perception and Wellness Perspectives in HIV-infected Adults

描述（由申请人提供）：这个为期三年的K23研究和培训奖将使PI获得成为一名独立护士科学家所需的知识和技能，其长期目标是开展研究，开发和实施创新干预措施，降低心血管风险，促进艾滋病毒感染者的健康。与未感染者相比，心血管疾病（CVD）已成为艾滋病毒感染者（PLWH）发病和死亡的主要原因（年轻时急性心肌梗死的发生率较高）。PLWH具有较高的传统心血管疾病危险因素患病率，以及增加的合并症，如高血压、糖尿病、肥胖和高脂血症。鉴于心血管疾病在hiv感染患者死亡率中的作用，了解心血管疾病风险认知和风险因素知识，并制定量身定制的干预措施势在必行。本项目利用健康信念模型来更好地了解PLWH如何感知其心血管疾病风险，并开发基于动机访谈（MI）的干预措施，以提高PLWH对心血管疾病风险的认知，并采取健康促进行为。本研究的具体目的是：1)描述和探讨对心血管疾病风险的认知，以及采取促进健康行为的可能性、偏好、益处和障碍；2.a)为单独提供的心血管疾病风险评估和生活方式改变管理干预制定治疗手册，以及2.b)进行一项试点研究，以测试两阶段干预的可行性和可接受性。第一阶段将包括对30-40名PLWH进行深入的个人定性访谈。2.阶段。将包括手工开发，与8-10个PLWH的初步协议试点，以及手工修订。2. b阶段。将包括一项随机两组（干预或简短建议）的试点临床试验，共有40名PLWH。从这项研究中获得的知识将为未来全面随机临床试验的发展提供信息

DESCRIPTION (provided by applicant): This three-year K23 research and training award will enable the PI to acquire the knowledge and skills needed to become an independent nurse scientist, with the long-term goal of conducting research to develop and implement innovative interventions that reduce cardiovascular risk and promote wellness in HIV-infected patients. Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality (evidenced by a higher rate of acute myocardial infarction at younger ages) in persons living with HIV (PLWH) compared with uninfected individuals. PLWH have a higher prevalence of traditional CVD risk factors, as well as increased comorbidities, such as hypertension, diabetes, obesity, and hyperlipidemia. Given the role of CVD in HIV-infected patients' mortality, understanding CVD risk perception and risk factor knowledge, and developing tailored interventions is imperative. This project draws on the Health Belief Model to better understand how PLWH perceive their risk for CVD, and to develop a motivational interviewing (MI)-based intervention to improve not only CVD risk perception but also the adoption of health-promoting behaviors in PLWH. The specific aims of the study are to: 1) describe and explore perceptions of CVD risk and the likelihood, preferences, benefits, and barriers of adopting health-promoting behaviors; 2.a.) develop a treatment manual for an individually delivered CVD risk assessment and lifestyle modification management intervention, and, 2.b.) conduct a pilot study to test the feasibility and acceptability of the 2-session intervention. Phase 1 will include in-depth individul qualitative interviews with 30-40 PLWH. Phase 2.a. will include manual development, a pilot of the preliminary protocol with 8-10 PLWH, and manual revisions. Phase 2.b. will include a randomized 2-arm (intervention or brief advice) pilot clinical trial with 40 PLWH. The knowledge gained from this study will inform the future development of a full-scale randomized clinical trial to examine the effectiveness of a tailored intervention to improve CVD risk perception, improve adoption of heart-healthy behaviors, and reduce CVD risk in HIV-infected patients. The proposed K23 research will contribute a missing and fundamental element to our understanding and management of CVD risk in HIV-infected patients. The PI will work with experienced mentors to build expertise in: (1) qualitative research methods and analyses; and, (2) intervention development and pilot testing. This K23 proposal addresses a key priority in HIV treatment science and will fully prepare the PI for a research career as an HIV intervention scientist.