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: 10684015
• 负责人: Pariya Fazeli Wheeler
• 金额: $ 22.28万
• 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/10684015
• 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.

项目总结/文摘