Telephone-Delivered Coping Improvement Intervention for HIV-Infected Older Adults

针对感染艾滋病毒的老年人的电话应对改善干预措施

• 批准号: 7163310
• 负责人: Timothy Glenn Heckman
• 金额: $ 35.45万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-15 至 2010-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7163310
• 关键词: AIDS; HIV infections; aging; behavior test; behavior therapy; behavioral /social science research tag; clinical research; comorbidity; coping; depression; group therapy; health care service utilization; human middle age (35-64); human old age (65+); human subject; human therapy evaluation; interview; longitudinal human study; patient oriented research; psychological aspect of aging; psychological stressor; quality of life; self care; social support network; therapy compliance

DESCRIPTION (provided by applicant): Through December 2003, more than 57,000 persons in the U.S. were 55 years of age or older when they were diagnosed with AIDS. Because AIDS researchers have focused primarily on younger persons living with HIV disease, there are very few age-appropriate interventions to enhance life quality in older persons living with HIV/AIDS. From 2001-2004, the P.I. was supported by NIA to pilot test a coping improvement group intervention delivered using teleconference technology with 90 HIV-infected older adults. Outcome analyses revealed that the intervention reduced participants' levels of psychological symptoms, life-stressor burden, and use of maladaptive coping strategies and increased coping self-efficacy. Following the success of our pilot research, this application proposes to evaluate the impact of a telephone-delivered, coping improvement group intervention on the adjustment efforts of 360 ethnically- and geographically-diverse HIV- infected older adults in relation to a telephone-delivered, information support group intervention and a standard of care comparison condition. Similar to our pilot intervention, the coping intervention will be guided by Lazarus and Folkman's (1984) Transactional Model of Stress and Coping and will use cognitive- behavioral principles to improve skills in stress appraisal, coping decisions, and obtaining social support. Participants will complete self-administered surveys at pre-intervention, post-intervention, and 4- and 8- month follow-up that assess the prevalence of comorbid health conditions, cognitive functioning, psychiatric distress, life-stressor burden, ways of coping, coping self-efficacy, and social support. Following the conduct of traditional statistical intervention outcome and mediational analyses, the intervention's efficacy will be further evaluated by identifying the proportion of intervention participants who report clinically-meaningful changes on key outcome measures. Furthermore, this research will evaluate the process by which teleconference-delivered interventions produce beneficial changes in this group (e.g., what characteristics of the telephone group environment are most related to beneficial changes in outcome measures?). If successful, this research will identify a telephone-delivered intervention that can improve life quality in HIV- infected older adults who might otherwise lack access to mental health support services due to geographic isolation, physical limitations, and confidentiality concerns.

描述（由申请人提供）：到2003年12月，美国有57,000多人被诊断出患有艾滋病。由于艾滋病研究人员主要关注患有艾滋病毒疾病的年轻人，因此很少有适合年龄的干预措施来提高艾滋病毒/艾滋病患者的生活质量。从2001年至2004年，P.I。由NIA支持了试点测试，一种使用Telecnerference Technology通过90名HIV感染的老年人进行的应对改进组干预措施。结果分析表明，干预措施降低了参与者的心理症状水平，生命压力负担，使用适应不良的应对策略并提高了应对自我效能感。在我们的试点研究成功之后，本申请提议评估电话交付，应对改进小组干预对360个种族和地理多样性感染的艾滋病毒感染的老年人的调整工作的影响，相对于电话销售，信息支持小组干预措施以及护理标准比较条件。与我们的飞行员干预类似，应对干预将由拉撒路和民俗（Folkman）（1984）的压力和应对方式进行指导，并将使用认知行为原则来提高压力评估，应对决策和获得社会支持的技能。参与者将在干预前，干预后以及4个月和8个月的随访中完成自我管理的调查，以评估合并症健康状况，认知功能，精神病学遇险，生命压力负担，应对方式，应对自我效能感和社会支持的流行。在进行了传统的统计干预结果和中介分析之后，将通过确定报告关键结果指标上临床上持续不断变化的干预参与者的比例来进一步评估干预措施的功效。此外，这项研究将评估电信分配干预措施在该组中产生有益的变化的过程（例如，电话组环境的哪些特征与结果指标的有益变化最相关？）。如果成功的话，这项研究将确定一项通过电话交付的干预措施，可以改善受艾滋病毒感染的老年人的生活质量，否则由于地理隔离，身体局限性和机密性问题，否则可能无法获得心理健康支持服务。