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

项目摘要/摘要 尽管有证据表明：1)老年艾滋病毒携带者(PLHIV)经历了高度的压力负担，即 2)心理弹性可能会缓冲压力的负面影响 在老年PLHIV和3)老年PLHIV中，这种保护因子的水平可能比血清阴性的低 在同行中，很少有工作研究加强老年PLHIV复原力的战略。符合 NIH和PAR-21-069的任务，这份R21提案在初步研究的指导下，为 行为干预发展和一个强大的研究团队将推动弹性科学的发展 干预措施包括：1)一个重要的未被研究的人群：深海中的老年艾滋病毒 南方；2)理论驱动的复原力框架：压力交易模型指导 和应对，弹性的保护因素模型，和扩大和建立模型，我们操作 恢复力是指拥有一套可延展的恢复力资源的个人用于评估和 应对压力能够更好地避免长期(或任何)功能中断。我们将使用 复原力课程，理论上以这些模型为基础，并利用我们的试点数据进行了优化； 3)效果和机制的严格检查：我们将测试干预效果 使用实时方法(即经验采样)的恢复力资源和瞬时压力响应 方法[ESM])。这项随机对照试验将100名50岁以上的老年PLHIV随机分配到干预条件或 注意匹配的控制条件。我们的综合电池将包括近端机械措施， (即，弹性资源和应激反应和恢复的ESM测量)，以及健康(即， 心理功能和艾滋病毒结果)措施。我们的主要目标是关注对以下方面的干预效果： 弹性资源的使用以及这种增加是否会改善情感应激反应能力和 恢复(目标1)和三个月后的远端健康结果(目标2)。我们的探索性目标将检验 治疗反应的主持人。调查结果将确定干预机制，并向 开发有效和可扩展的干预措施，以建立老年PLHIV和其他疾病的复原力 不同的老年人群体。

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.