Developing Internet-Delivered, Mindfulness-based Intervention to Reduce HIV Risk and Promote Mental and Sexual Health among Young Adult MSM

项目总结 与男性发生性关系的年轻男性(18-34岁的基督教青年会)感染艾滋病毒的比例更高。少数民族压力及其在青年男性接触者中的“下游”影响，包括精神健康问题、性危险行为和不理想的艾滋病毒检测，促成了围绕艾滋病毒的共同风险。基于正念的干预措施(MBIS)适用于基督教青年会艾滋病毒预防和基于互联网的交付，以最大限度地扩大覆盖面和参与度，可以提供一种创新和可扩展的方法来解决这一公共卫生问题。与NCCIH在疾病预防和终身健康促进方面的科学优先事项一致，目前的项目旨在开发一种通过互联网传递的MBI，用于在陷入困境的高危YMSM中预防艾滋病毒。具体地说，K23将通过采用基于正念的压力减轻(MBSR)和在YMSM中进行可行性试验，为早期探索性临床试验提供支持。候选人：孙博士是一名临床科学家，在少数族裔人群和边缘化社区的艾滋病毒预防和心理健康方面具有研究背景。近年来，她一直致力于正念方面的临床和研究发展。在之前工作的基础上，她正在申请为期五年的K23职业发展奖，以获得培训、指导和研究经验，成为一名适应和评估互联网提供的MBI以解决与艾滋病毒相关的健康差距的专家，以及一名能够获得R01资金的独立调查员。指导：咨询小组中有一支由一流的高级调查人员组成的团队。唐·奥帕里奥博士和贾德森·布鲁尔博士是共同的主要导师，他们在MSM的艾滋病毒预防和行为健康的互联网MBI方面拥有互补的专业知识。三位共同导师带来了基于互联网的年轻人艾滋病毒干预(Larry Brown博士)、人口健康正念(Eric Loucks博士)和压力生理学(Audrey Tyrka博士)方面的专业知识。研究：在Adapt-ITT模式的指导下，拟议的项目旨在：(1)通过与YMSM(n=30)和利益相关者(n=16)的焦点小组，使MBSR适用于陷入困境、高风险的YMSM和互联网交付；(2)通过剧院测试，向陷入困境、高风险的YMSM(n=18)和利益相关者(n=16)提供适应的材料，完善干预方案；(3)通过随机将40名陷入困境、高风险的YMSM随机分配到IMBI(n=20)和健康教育条件(n=20)，检查经调整的IMBI预防艾滋病毒的可行性和可接受性。这项研究将审查招募和保留、干预措施的遵守情况(例如，出勤、在家实践)、评估的完成情况(艾滋病毒检测、性危险行为、头发样本采集、心理健康、少数族裔压力和应对)，以及干预措施的可接受性。培训：孙博士将接受MBSR的培训，YMSM和互联网交付的干预适应和实施，以及通过课程作业、研讨会、研讨会、定向阅读和指导研究基于生物心理社会对压力的理解。在一个优秀的指导团队的指导下，这些培训和研究经验将奠定候选人作为艾滋病毒相关行为健康专家和少数族裔健康IMBI专家的职业生涯。这位候选人得到了布朗大学公共卫生学院的制度支持。

PROJECT SUMMARY Young men who have sex with men (YMSM; age 18-34) are disproportionately burdened by HIV. Minority stress and its “downstream” effects in YMSM, including mental health issues, sexual risk behaviors, and suboptimal HIV testing, contribute to the syndemic risks surrounding HIV. Mindfulness-based interventions (MBIs), adapted for HIV prevention among YMSM and internet-based delivery to maximize reach and engagement, could offer an innovative and scalable method to address this public health issue. Consistent with NCCIH’s scientific priority in Disease Prevention and Health Promotion across Lifespan, the current project aims to develop an internet-delivered MBI for HIV prevention among distressed, high-risk YMSM. Specifically, this K23 will provide support for an early phase, exploratory clinical trial by adapting mindfulness-based stress reduction (MBSR) and conducting a feasibility trial among YMSM. Candidate: Dr. Sun is a clinical scientist with a research background in HIV prevention and mental health concerning minority populations and marginalized communities. In recent years, she has pursued clinical and research development in mindfulness. Building on her prior work, she is applying for a five-year K23 Career Development Award to obtain training, mentorship, and research experience to become an expert in adapting and evaluating internet-delivered MBI to address HIV-related health disparities and an independent investigator capable of R01 funding. Mentoring: A stellar team of senior investigators serve on the advisory panel. Drs. Don Operario and Judson Brewer are co-primary mentors, who have complimentary expertise in HIV prevention for MSM and internet-based MBI for behavioral health. Three co-mentors bring expertise in internet-based HIV intervention with young adults (Dr. Larry Brown), mindfulness for population health (Dr. Eric Loucks), and stress physiology (Dr. Audrey Tyrka). Research: Guided by the ADAPT-ITT model, the proposed project aims to (1) adapt MBSR for distressed, high risk YMSM and internet-delivery using focus groups with YMSM (n=30) and stakeholders (n=16), (2) refine the intervention protocol by administering adapted materials to distressed, high risk YMSM (n=18) and stakeholders (n=16) via theatre testing, and (3) examine the feasibility and acceptability of the adapted iMBI for HIV prevention by randomizing 40 distressed, high-risk YMSM to the iMBI (n=20) and a Health Education condition (n=20). The study will examine recruitment and retention, intervention adherence (e.g., attendance, at-home practice), completion of assessment (HIV testing, sexual risk behaviors, hair sample collection, mental health, minority stress and coping), and acceptability of the intervention. Trainings: Dr. Sun will receive training in MBSR, intervention adaptation and implementation for YMSM and internet-delivery, and a biopsychosocial-based understanding of stress through coursework, seminars, workshops, directed readings, and mentored research. Guided by an excellent mentorship team, these training and research experiences will establish the candidate’s career as an expert in HIV-related behavioral health and iMBI for minority health. The candidate is institutionally supported by Brown University School of Public Health.