Exploring Symptom Burden Moderation of the Executive Function/Self-Management Adherence Process in People Living with HIV/AIDS

探索艾滋病毒/艾滋病患者执行功能/自我管理依从过程的症状负担调节

• 批准号: 9913939
• 负责人: ALLISON R WEBEL
• 金额: $ 18.52万
• 依托单位: CASE WESTERN RESERVE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-26 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9913939
• 关键词: AIDS/HIV problem; Address; Adherence; Affect; Age; Anxiety; Automobile Driving; Biological; Chronic; Chronic Disease; Cognitive; Databases; Decision Making; Development; Diet; Elements; Enrollment; Fatigue; Future; General Population; Goals; Gold; HIV; Health; Health Promotion; Human immunodeficiency virus test; Incidence; Individual; Intervention; Knowledge; Lead; Link; Literature; Measures; Mental Depression; Neurobiology; Outcome; Pain; Participant; Patients; Personal Satisfaction; Persons; Pharmaceutical Preparations; Physical activity; Population; Process; Provider; Public Health; Race; Regimen; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Self Management; Severities; Short-Term Memory; Sleeplessness; Stress; Symptoms; Testing; associated symptom; brain behavior; cognitive function; cognitive process; dietary adherence; executive function; flexibility; good diet; improved; innovation; medication compliance; negative affect; novel strategies; parent grant; recruit; routine care; sex; standard measure; symptom management; symptom science; symptom self management

Project Summary/Abstract Effective self-management, including adherence to medication, physical activity, and diet regimens, is essential to maintaining health and well-being in people living with HIV/AIDS (PLWH). Despite best efforts of providers and patients, self-management adherence is less than optimal, leading to subsequent health complications and poor health outcomes. This study will build on previous findings related to executive functioning in developing greater understanding of influences on self-management, identifying targets for intervention. The cognitive, “top-down” process of executive functioning is the mechanism by which a person decides to adhere or not adhere to a given self-management task. Executive functioning is comprised of three major components (inhibitory control, working memory, and cognitive flexibility) and individuals with higher levels of executive functioning demonstrate better adherence to some self-management tasks, such as maintaining a healthy diet. Despite some evidence that these components have relationships with self-management adherence tasks (e.g. inhibitory control has the strongest effects on decisions about diet and physical activity), specific effects of each component on specific self-management tasks, particularly in PLWH, have not been comprehensively tested. Symptoms (e.g. fatigue, pain, depression) also demonstrate a negative association with self-management adherence. This association is especially important to PLWH as they have a high (over 50%) incidence of one or more HIV-related symptom, increasing risk for poor self-management adherence/outcomes. Higher levels of symptoms also are associated with poorer executive functioning levels. Together, these findings suggest there are associations among executive functioning, HIV-related symptoms, and self-management in PLWH, though this hypothesis has not been explored. Building on these findings, this supplemental study will explore these important gaps in HIV/AIDS self-management literature. This is a cross-sectional, descriptive supplement to the PROSPER-HIV parent grant. Aims are to: (1) explore the effect of executive functioning (inhibitory control, working memory, cognitive flexibility) on self- management adherence (global self-management, medication adherence, diet, physical activity); (2) examine HIV-related symptom moderation of the executive function/self-management adherence process. We will recruit 200 participants enrolled in PROSPER-HIV over a two-year period to examine these aims. The supplement will abstract gold-standard measures of diet and physical activity, as well HIV-related symptoms, from the PROSPER-HIV database while adding executive function testing as a new study component. When this study is complete, we will be able to evaluate the impact of executive functioning and HIV-related symptoms on self-management adherence in PLWH. Findings will support future self-management research, including development of targeted interventions in order to improve adherence in PLWH.

项目总结/摘要 有效的自我管理，包括坚持药物治疗，体育活动和饮食方案，是必不可少的 维持艾滋病毒/艾滋病感染者（PLWH）的健康和福祉。尽管供应商尽了最大努力， 和病人，自我管理的坚持是不够理想，导致随后的健康并发症 以及健康状况不佳。这项研究将建立在以前的研究结果有关的执行功能， 进一步了解对自我管理的影响，确定干预目标。 执行功能的认知的、“自上而下”的过程是一个人决定 坚持或不坚持给定的自我管理任务。执行功能包括三个主要方面 成分（抑制控制，工作记忆和认知灵活性）和具有较高水平的个体 执行功能表现出更好的坚持一些自我管理的任务，如维持一个 健康饮食。尽管有一些证据表明这些成分与自我管理有关 坚持任务（例如，抑制控制对有关饮食和身体活动的决定具有最强的影响）， 每个组成部分对特定自我管理任务的具体影响，特别是在PLWH中，尚未被 全面测试。症状（如疲劳、疼痛、抑郁）也表现出负相关 坚持自我管理。这种关联对PLWH特别重要，因为他们有很高的（超过 50%）出现一种或多种艾滋病毒相关症状，增加自我管理不良的风险 依从性/结果。更高水平的症状也与更差的执行功能水平有关。 总之，这些发现表明，执行功能，艾滋病毒相关症状， 和自我管理的PLWH，虽然这个假设还没有被探讨。基于这些发现， 补充研究将探讨艾滋病毒/艾滋病自我管理文献中的这些重要空白。 这是对PROSPER-HIV父母补助金的横截面描述性补充。目标是：（1） 探讨执行功能（抑制控制、工作记忆、认知灵活性）对自我的影响， 管理依从性（整体自我管理，药物依从性，饮食，身体活动）;（2）检查 执行功能/自我管理依从性过程的HIV相关症状缓和。我们将 招募200名参加PROSPER-HIV的参与者，在两年的时间里检查这些目标。的 补充剂将提取饮食和身体活动的金标准措施，以及艾滋病毒相关症状， 从PROSPER-HIV数据库，同时增加执行功能测试作为一个新的研究组成部分。当 这项研究完成后，我们将能够评估执行功能和艾滋病毒相关的影响， 症状对PLWH自我管理依从性的影响。研究结果将支持未来的自我管理 研究，包括制定有针对性的干预措施，以提高艾滋病毒携带者的依从性。