Feasibility of the Mindfulness-Based Stress Reduction Intervention for Black Women Living with HIV

项目摘要/摘要 这个导师研究科学家职业发展奖的总体目标是支持和发展 查普曼·兰伯特博士在头脑和身体研究方面向独立调查员的转变，重点是 开发、整合和测试心智和身体策略，以改善临床、心理和生理 非裔美国人(AA)艾滋病毒携带者(WLWH)的结果。HIV病毒载量(VL)的抑制 与其他种族和民族背景的妇女相比，妇女的WLWH是次要的。两个基本的自我-- 艾滋病毒携带者(PLWH)实现和维持抑制HIV VL并改善健康的护理行为 结果和存活率取决于坚持抗逆转录病毒治疗和定期就诊。就诊 一般来说，女性的依从性是次优的，但在AA WLWH中，VL抑制率是次优的 AA WLWH没有达到病毒抑制的可能性几乎是白色WLWH的3倍。一 与坚持行为相关的重要因素是应激性生活事件，包括创伤性生活事件。因此， 迫切需要制定文化上适当的干预措施，以减轻压力和改善 黏附行为和VL抑制。Jon开发的基于正念的压力减轻(MBSR) Kabat-Zinn有可能通过自我调节注意力和对压力的意识来减少压力 事件。MBSR已被证明在改善压力管理、心理困扰、身体和 以白人和男性为主的患者的心理症状、生活质量、应对方式以及对艺术的坚持 患者群体。我们建议在文化上适应AA WLWH的MSBR干预，以减少压力和 加强艾滋病毒自我护理行为和VL抑制，这有可能削弱突出的种族和 AA WLWH在美国经历的性别差异。具体地说，我们的目标是1)从文化上适应MBSR 使用Adapt-ITT对AA WLWH进行干预；2)通过开放的非随机试验预导适应性干预 进行试点研究，以进一步完善适应文化的干预措施；以及3)进行一项双臂试点试验 行为干预对照标准护理评估适应的可行性和可接受性 MBSR对AA WLWH的干预。这项研究的发现将为建立我的 作为压力相关发病率和艾滋病毒治疗依从性的独立调查者的研究计划。在……里面 此外，研究结果可能也适用于其他慢性病和边缘化人群。 没有艾滋病病毒。

Project Summary/Abstract The overall objective of this Mentored Research Scientist Career Development Award is to support and develop Dr. Chapman Lambert’s transition to an independent investigator in mind and body research with a focus on developing, integrating, and testing mind and body strategies to improve clinical, psychological, and physical outcomes among African American (AA) women living with HIV (WLWH). HIV viral load (VL) suppression among AA WLWH are suboptimal when compared to women of other racial and ethnic backgrounds. Two essential self- care behaviors for people living with HIV (PLWH) to achieve and sustain HIV VL suppression ad improve health outcomes and survival are adherence to antiretroviral therapy and scheduled medical visits. Medical visit adherence is suboptimal among women in general, but VL suppression rates among AA WLWH are suboptimal with AA WLWH being nearly 3 times more likely than White WLWH not to achieve viral suppression. One important factor associated with adherence behaviors is stressful life events including traumatic life events. Thus, there is a critical need to develop culturally appropriate interventions aimed reducing stress and improving adherence behaviors and VL suppression. Mindfulness-based stress reduction (MBSR), developed by Jon Kabat-Zinn, has the potential to reduced stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping as well as ART adherence in predominately white and male patient populations. We propose to culturally adapt the MSBR intervention for AA WLWH to reduce stress and enhance HIV self-care behaviors and VL suppression, which has the potential to attenuate prominent racial and gender disparities experienced by AA WLWH in the US. Specifically, we aim to 1) culturally adapt the MBSR intervention for AA WLWH using ADAPT-ITT; 2) pre-pilot the adapted intervention via an open non-randomized pilot study to further refine the culturally adapted intervention; and 3) conduct a 2-armed pilot test of the behavioral intervention compared to standard of care to assess the feasibility and acceptability the adapted MBSR intervention for AA WLWH. Findings from this study will provide an important first step in establishing my program of research as an independent investigator in stress-related morbidity and HIV treatment adherence. In addition, findings maybe applicable for other chronic conditions and marginalized populations living with and without HIV.