A smoking cessation/medication adherence intervention for African American MSM

描述(由申请人提供)：拟议的培训计划的目标是进一步发展申请人的知识、研究和临床技能，为感染艾滋病毒的非裔美国男性男男性行为者(MSM)制定、实施和评估行为健康促进干预措施。拟议的项目将作为一项论文研究进行，将：1)增加申请人对艾滋病毒药物不遵守和参与吸烟等健康危险行为在观察到的非裔美国MSM中艾滋病毒相关健康差距中的作用的知识；2)发展申请人在对高度脆弱和服务不足的患者人群进行行为健康干预方面的方法和分析技能；3)加深申请人对与关键干预结果相关的人口统计和社会文化因素的理解；即坚持使用艾滋病毒药物的水平和戒毒率。拟议的培训计划包括授课培训、有组织的课程作业、专业发展、定期赞助商会议和顾问会议。在拟议的项目中获得的知识和技能对于申请者未来成为大学、学术医院或政府机构的独立研究员是必要的。拟议的项目与申请者的目标高度一致；将在感染艾滋病毒的非裔美国MSM中检查戒烟和艾滋病毒药物依从性的促进者和障碍，并将其纳入针对这两种健康行为的文化针对性干预。在感染艾滋病毒的非裔美国MSM中，吸烟率和艾滋病毒药物不遵守的水平高得令人震惊。然而，很少有研究同时对这两种健康危险行为进行干预。这项研究的具体目的是：1)在新近诊断为HIV感染的非裔美国MSM中，确定戒烟和HIV药物依从性的障碍和促进者；2)开发针对HIV用药依从性和戒烟的文化针对性干预；3)对干预措施进行试点测试，以评估其可接受性、可行性和对吸烟和治疗依从性的影响；以及4)检查影响干预效果的个人和文化变量。数据将 从LGBT诊所和其他社区场所招募的50名感染艾滋病毒的非裔美国男男性接触者中收集。该项目的导师将由以下方面的专家提供：LGBT社区的健康行为干预文化目标(Alicia Matthews博士)、男男性接触者对艾滋病毒药物的依从性(David McKirnan博士)、干预发展和相关人群招募方面的文化能力(Sybil Hosek博士、Alicia Matthews博士和David McKirnan博士)以及多层次纵向数据分析(David McKirnan博士)。拟议的项目将是第一个在单一系统干预中解决戒烟和艾滋病毒药物坚持问题的项目。拟议的计划与申请者进一步增加技能和知识以建立研究计划的目标一致。

DESCRIPTION (provided by applicant): The goal of the proposed training plan is to further develop the applicant's knowledge, research, and clinical skills in the development, implementation and evaluation of behavioral health-promotion interventions for HIV-infected African American men who have sex with men (MSM). The proposed project will be conducted as a dissertation study that will: 1) Increase the applicant's knowledge of the role of HIV medication non-adherence and engagement in health risk behaviors, such as smoking, in observed HIV-related health disparities among African American MSM; and 2) Develop the applicant's methodological and analytical skills in conducting behavioral health interventions with a highly vulnerable and underserved patient population; and 3) Deepen the applicant's understanding of the demographic and socio-cultural factors associated with key intervention outcomes; that is, level of adherence to HIV medications and point-prevalence quit rates. The proposed training plan includes didactic training, structured coursework, professional development, regular sponsor and consultant meetings. The knowledge and skills gained in the proposed project are necessary for the applicant's future as an independent researcher at a university, academic hospital, or government institution. The proposed project is highly consistent with the applicant's goals; facilitators of and barriers to smoking cessation and HIV medication adherence will be examined in HIV-infected African American MSM and integrated into a culturally targeted intervention addressing both health behaviors. Smoking prevalence rates and levels of HIV medication non-adherence are alarmingly high in HIV-infected African American MSM. Yet, scant research has been conducted to simultaneously intervene on these two health risk behaviors. The specific aims of this study are to: 1) Identify barriers to and facilitators of smoking cessation and HIV medication adherence among recently diagnosed HIV-infected African American MSM; 2) Develop a culturally targeted intervention that addresses HIV medication adherence and smoking cessation; 3) Conduct a pilot-test of the intervention to assess its acceptability, feasibility, and effects on smoking and treatment adherence; and 4) Examine individual and cultural variables that influence the effects of the intervention. Data will be collected from 50 HIV-infected African American MSM recruited from LGBT clinics and other community-based venues. Mentorship for this project will be provided by experts in culturally targeting health behavior interventions for the LGBT community (Dr. Alicia Matthews), HIV-medication adherence among MSM (Dr. David McKirnan), cultural competency in intervention development and recruitment of the population of interest (Dr. Sybil Hosek, Dr. Alicia Matthews, and Dr. David McKirnan), and multilevel longitudinal data analyses (Dr. David McKirnan). The proposed project will be the first to address smoking cessation and HIV-medication adherence in a single systematic intervention. The proposed plan is consistent with the applicant's goals of further increasing skills and knowledge to establish a program of research.