Mindfulness training with HIV-positive youth and adult family members to improve treatment adherence

 简介(由申请人提供)：拟议的导师研究科学家职业发展奖(K01)的目的是促进Denison博士作为正念研究的独立科学家的发展，重点是以家庭为基础的正念方法，以支持青少年艾滋病毒携带者(ALHIV)的艾滋病毒结果。ALHIV的服药依从率很低，增加了他们患艾滋病毒相关疾病和死亡的风险。目前提高遵从性的战略，如同龄人小组会议和遵从性咨询，依赖于教育和认知方法，往往以个人行为改变为目标，而不涉及艾滋病毒管理发生的家庭和社会背景。这一职业发展奖挑战了这一范式，考察了向ALHIV和成年家庭照顾者提供的正念是否支持马里兰州巴尔的摩市ALHIV的自我调节和服药遵守行为。本研究的具体目的是：(1)评估家长R01中191名参与者的家庭支持网络。数据将描述家庭支持网络的组成和特征，以告知家庭照顾者的定义和AIMS 2和 3.(2)通过对20名ALHIV和20名成年家庭成员进行定性深入访谈，研究MBSR对家庭支持关系和两代MBSR干预的后勤保障的影响；以及(3)检查25对ALHIV和成年家庭成员对MBSR干预试点的可接受性和可行性，以通过增加家庭支持来提高青少年对艺术的依从性。约翰霍普金斯大学是这项拟议培训的理想环境，候选人将在整个奖项期间接受资深教师导师和咨询委员会成员的指导，他们拥有正念研究和与在青少年人群中实施正念相关的主题，如青少年健康、统计方法和基于家庭的干预方面的专业知识。通过定向阅读、课程作业和有指导的研究机会的结合，这个指导团队将支持Denison博士实现她的培训目标，以(1)获得正念理论、干预和研究方法方面的专业知识；(2)改进和测试基于正念的两代压力减轻干预；(3)发展网络和二元数据分析方面的统计技能；以及4)增强基于家庭的干预方法和理论的知识。候选人的培训和研究计划将为丹尼森博士提供技能和初步数据，以寻求资金，并成功成为正念和基于家庭的正念方法的独立研究人员，以改善患有慢性病的青少年的自我管理。

 DESCRIPTION (provided by applicant): The purpose of the proposed Mentored Research Scientist Career Development Award (K01) is to promote Dr. Denison's development as an independent scientist in mindfulness research with a focus on family-based mindful approaches to support HIV outcomes among adolescents living with HIV (ALHIV). ALHIV have low rates of medication adherence, increasing their risk for HIV-related morbidities and mortality. Current strategies to improve adherence, such as peer group meetings and adherence counseling, rely on educational and cognitive approaches often targeting individual behavior change without addressing the familial and social context where HIV management occurs. This career development award challenges this paradigm by examining if mindfulness offered to ALHIV and an adult family caregiver, that targets awareness of thought rather than changing the content of thought, supports the self-regulatory and medication adherence behaviors of ALHIV in Baltimore City, Maryland. The study's specific aims are to: (1) assess the family support networks among 191 participants in the parent R01. Data will characterize family support network composition and characteristics to inform family caregiver definitions and participant selection for Aims 2 and 3. (2) Examine the effects of MBSR on family support relationships and the logistics of a two-generation MBSR intervention, by conducting qualitative in-depth interviews with 20 ALHIV and 20 adult family members; and (3) examine the acceptability and feasibility of a pilot MBSR intervention among 25 ALHIV and adult family member pairs to improve adolescent adherence to ART through increased family support. The Johns Hopkins University is an ideal environment for this proposed training where the candidate will receive guidance throughout the award from Senior Faculty mentors and advisory committee members with expertise in mindfulness research and topics related to implementing mindfulness in this adolescent population, such as adolescent health, statistical methods and family-based interventions. Through a combination of directed readings, coursework, and supervised research opportunities, this mentoring team will support Dr. Denison in achieving her training goals to (1) gain expertise in mindfulness theory, interventions and research methods; (2) refine and test a two generation mindfulness-based stress reduction intervention; (3) develop statistical skills in network and dyadic data analysis; and 4) enhance knowledge of family-based interventions methods and theory. The candidate's training and research plan will provide the skills and preliminary data for Dr. Denison to pursue funding and successfully become an independent researcher in mindfulness and family-based mindful approaches to improve self-management among chronically ill adolescents.