A technology-based psychosocial intervention to support social engagement and well-being in adults aging with HIV

项目摘要 老年艾滋病毒携带者(OPH)经常面临严重的心理健康挑战，如社会孤立， 孤独和抑郁。然而，到目前为止，针对心理社会的干预研究有限。 老年艾滋病毒携带者，特别是长期幸存者的社会孤立和孤独等问题，以及 考虑到新冠肺炎大流行和“原地不动”的要求，这一领域尤其相关。这项建议 探索性/开发性研究解决了这些问题，并响应了NIH PAR-18-190多学科 艾滋病毒与老龄化的研究。与《行动纲领》一致，强调通过交叉改善成果 研究艾滋病毒相关的合并症和并发症，研究目标是开发和 评估以技术为基础的心理社会干预计划，旨在：增强社会参与度和 支持、资源获取和教育；减少孤独；改善老年人的幸福感 长期存活的艾滋病毒患者(被诊断为艾滋病毒≥已有20年)。这个节目，连接了更老的积极 人们增强健康和韧性(COPPEhR)，将建立在PRISM平板电脑平台[13]和 威尔·康奈尔医学院(WCM)特殊研究中心(CSS)提供的计划和服务(请参阅 初步研究)。研究的第一阶段将涉及为这一未被研究的项目开发和调整系统 人口、焦点群体和可用性测试，对感染艾滋病毒的老年成年人进行小样本测试，第二阶段将 包括两组试点疗效试验(类似于NIH阶段1b试验)。COPPEhR的干预措施将是 与仅使用平板电脑的对照条件(TCC)相比。68名50岁以上的成年人，按年龄分层，感染艾滋病毒的人 长期幸存者(被诊断感染艾滋病毒≥20年)将被招募并随机分配到1：1 COPPEHR或TCC条件。干预期限为六个月。结果将包括衡量 抑郁、孤独、社会支持、社会网络的变化、生活质量和健康指数。 评估将在基线和随机化后3个月和6个月进行。我们亦会评估 COPPEhR系统的可行性、有用性和可用性，并收集关于系统使用的实时数据。这个 该开发项目的具体目标是：1)评估一种 基于最先进技术的多组分COPPEhR干预，用于老年艾滋病毒携带者；以及，2) 获得关于COPPEhR计划在以下方面的潜在功效的初步信息 社会参与、福祉和资源获取，以及减少感染艾滋病毒的老年人的孤独感。 研究的总体目标是支持以技术为基础的有效干预措施的发展 对于OPH，可以在更大规模的试验中进行评估，并在各种不同的老年人中提供 社区和住宅环境。

Project Summary Older people with HIV (OPH) often live with significant mental health challenges such as social isolation, loneliness, and depression. Yet to date, there has been limited intervention research directed at psychosocial issues such as social isolation and loneliness among aging adults with HIV, especially long-term survivors, an area especially relevant given the COVID-19 pandemic and “stay in place” requirements. This proposed exploratory/development study addresses these issues and is responsive to NIH PAR-18-190 Multidisciplinary Studies of HIV and Aging. Consistent with OAR emphasis on improving outcomes through Cross-Cutting research to address HIV-associated comorbidities and complications, the study objectives are to develop and evaluate a technology-based psychosocial intervention program designed to: enhance social engagement and support, resource access and education; reduce loneliness; and improve well-being among older adults with HIV who are long-term survivors (diagnosed with HIV ≥ 20 years). The program, Connecting Older Positive People to Enhance Health and Resilience (COPPEhR), will build on the PRISM tablet platform [13] and the programs and services available at the Center for Special Studies (CSS) at Weill Cornell Medicine (WCM) (see preliminary studies). Phase 1 of the study will involve developing and tailoring the system for this understudied population, focus groups, and usability testing with a small sample of aging adults with HIV, and Phase 2 will involve a two-group pilot efficacy trial (akin to an NIH Stage 1b trial). The COPPEhR intervention will be compared to a tablet-only control condition (TCC). Sixty-eight adults aged 50+, stratified by age, with HIV who are long-term survivors (diagnosed with HIV ≥ 20 years) will be recruited and randomly assigned 1:1 to the COPPEhR or TCC conditions. The intervention duration will be six months. Outcomes will include measures of depression, loneliness, social support, changes in social network, quality of life, and indices of health. Assessments will be conducted at baseline and 3 & 6-months post-randomization. We will also assess the feasibility, usefulness, and usability of the COPPEhR system and collect real time data on system use. The specific aims of this developmental project are to: 1) Evaluate the feasibility, usefulness, and usability of a state-of-the art technology-based multicomponent COPPEhR intervention for aging adults with HIV; and, 2) Obtain preliminary information on the potential efficacy of the COPPEhR program in terms of enhancing social engagement, well-being, and resource access, and reducing loneliness among older adults with HIV. The overall goal of the research is to support the development of an efficacious technology-based intervention for OPH that can be evaluated in a larger scale trial and be delivered to diverse older adults in a variety of community and residential settings.