Testing the Efficacy and Mechanisms of an Adapted Resilience Building Intervention in People Aging with HIV

测试针对艾滋病毒感染者的适应能力建设干预措施的功效和机制

• 批准号: 10840190
• 负责人: Pariya Fazeli Wheeler
• 金额: $ 7.05万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-15 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10840190
• 关键词: Adverse effects; Affect; Affective; Age; Aging; Attention; Behavioral; Behavioral Model; Biological Markers; Buffers; CD4 Lymphocyte Count; Chronic Disease; Cognitive; Control Groups; Control Locus; Coping Skills; Data; Deep South; Development; Discrimination; Disease Management; Distal; Education; Educational Curriculum; Ego; Elderly; Failure; Feedback; Future; Goals; HIV; Health; Health Promotion; Hour; Individual; Intervention; Intervention Studies; Maintenance; Measurement; Measures; Mediating; Mental Health; Methods; Mission; Modeling; Outcome; Participant; Pathway interactions; Personal Satisfaction; Personality; Persons; Pilot Projects; Population; Population Heterogeneity; Process; Program Acceptability; Quality of life; Randomized; Recovery; Reporting; Research; Resources; Sampling; Science; Self Administration; Self Efficacy; Severities; Social support; Stress; Stress and Coping; Stressful Event; Taxonomy; Testing; Time; Transact; Translations; Trauma; Treatment Efficacy; United States National Institutes of Health; Viral; Vulnerable Populations; Work; Writing; acceptability and feasibility; adverse childhood events; aged; allostatic load; biological adaptation to stress; cognitive function; comparison control; coping; daily functioning; demographics; depressive symptoms; design; effectiveness/implementation trial; efficacy evaluation; efficacy testing; emotion regulation; experience; feasibility testing; health assessment; health management; improved; innovation; intervention effect; mindfulness meditation; model building; multiphase optimization strategy; optimism; poor health outcome; primary outcome; programs; promote resilience; protective factors; psychoeducation; psychoeducational; psychologic; resilience; response; social; social stigma; socioeconomic adversity; stress reactivity; stressor; symptomatology; theories; therapy development; treatment response; visit adherence

PROJECT SUMMARY/ABSTRACT Despite evidence that: 1) older people living with HIV (PLHIV) experience a high burden of stress that is associated with myriad poorer outcomes, 2) psychological resilience may buffer the negative effects of stress in older PLHIV, and 3) older PLHIV may possess lower levels of this protective factor than seronegative counterparts, little work has examined strategies to bolster resilience in older PLHIV. In line with the mission of NIH and PAR-21-069, this R21 proposal, guided by preliminary studies, the Stage Model for Behavioral Intervention Development, and a strong research team, will advance the science on resilience interventions by including: 1) AN IMPORTANT UNDERSTUDIED POPULATION: older PLHIV in the Deep South; 2) A THEORY-DRIVEN RESILIENCE FRAMEWORK: Guided by The Transactional Model of Stress and Coping, the Protective Factor Model of Resilience, and the Broaden-and-Build Model, we operationalize resilience as a process whereby individuals with a set of malleable resilience resources for both appraising and responding to stress are better able to avoid prolonged (or any) disruptions in functioning. We will use a resilience curriculum that is theoretically grounded in these models and has been optimized with our pilot data; 3) RIGOROUS EXAMINATION OF EFFICACY AND MECHANISMS: We will test intervention efficacy on resilience resources and momentary stress responses using real-time methods (i.e., experience sampling method [ESM]). This RCT will randomize 100 older PLHIV aged 50+ to either an intervention condition or an attention-matched control condition. Our comprehensive battery will include proximal mechanistic measures, (i.e., ESM measurement of resilience resources and stress reactivity and recovery), and health (i.e., psychological functioning and HIV outcomes) measures. Our Primary Aims focus on intervention effects on: the use of resilience resources and whether such increases drive improved affective stress reactivity and recovery (Aim 1) and distal health outcomes at three months (Aim 2). Our exploratory aim will examine moderators of treatment response. Findings will identify intervention mechanisms and inform the development of potent and scalable interventions for building resilience in older PLHIV and other diverse populations of older adults.

项目摘要/摘要 尽管有证据表明：1）患有艾滋病毒（PLHIV）的老年人经历了很大的压力负担 与无数差的结果相关，2）心理弹性可能会缓解压力的负面影响 在较旧的PLHIV中，3）较老的PLHIV可能比血清调节性具有较低的保护因子 同行几乎没有工作研究了在较老的PLHIV中增强弹性的策略。与 NIH和PAR-21-069的任务，该R21提案，在初步研究的指导下，是舞台模型 行为干预发展和强大的研究团队将提高科学的韧性 干预措施包括：1）一个重要的研究人群：深处的老年人 南; 2）理论驱动的弹性框架：由压力的交易模型引导 和应对，弹性的保护因素模型以及拓宽和构建模型，我们运行 弹性作为一个过程，具有一组可延展的弹性资源来评估和 应对压力可以更好地避免功能中的长时间（或任何）中断。我们将使用一个 理论上基于这些模型的弹性课程，并通过我们的试点数据进行了优化； 3）严格检查功效和机制：我们将测试干预功效 使用实时方法（即，经验抽样）的弹性资源和瞬时的压力反应 方法[ESM]）。该RCT将将50岁以上年龄较高的100个年龄较大的PLHIV随机为干预条件或 注意匹配的控制条件。我们的全面电池将包括近端机械措施， （即，ESM测量弹性资源以及压力反应性和恢复）以及健康（即 心理功能和艾滋病毒结局）措施。我们的主要目的是针对干预的影响： 使用弹性资源以及这种增加是否促进了情感压力反应性的改善和 恢复（目标1）和三个月的远端健康结果（AIM 2）。我们的探索目的将检查 治疗反应的主持人。调查结果将确定干预机制，并告知 开发有效和可扩展的干预措施，以建立较老的PLHIV和其他 老年人的多样化人群。