Efficacy of a Computerized Stress Management Training Program for HIV+ Women

描述（由申请人提供）：拟议研究的总体目标是开发和试点测试一个简短的，计算机管理的压力管理培训计划的艾滋病毒+妇女。艾滋病毒阳性妇女在美国艾滋病毒感染者中所占比例越来越大，并承受着不成比例的疾病负担。虽然艾滋病毒治疗的进步延长了生存时间，提高了生活质量，但艾滋病毒阳性妇女继续面临各种压力，导致心理健康困难和疾病管理不善的比例上升。以前针对艾滋病毒阳性者的压力管理干预措施主要针对男性，通常依赖于多次会议的小组形式，这种方法有希望，但费用昂贵，难以广泛传播。为了开发和试点测试艾滋病毒阳性妇女的计算机化压力管理培训计划，拟议的研究将包括三个阶段。首先，将与艾滋病毒阳性妇女（n = 28）进行焦点小组讨论，以协助制定干预内容和形式。第二，一个简短的，互动的，计算机化的，教育压力管理干预措施将设计的基础上形成的研究，过去的经验研究的压力和应对艾滋病毒+个人的干预措施，和拉撒路和福克曼的压力和应对的跨学科模型。第三，将在HIV阳性女性门诊患者中实施干预措施，以提供有关该方案可行性、可接受性和有效性的初步数据。参与者将被随机分配到即时干预组（n = 30）或时滞干预对照组（n = 30）。我们预测，干预将导致：（a）提高应对自我效能;（B）降低感知压力水平;（c）减少使用回避应对策略;（d）减少自我报告的焦虑和抑郁情绪症状。这项研究涉及一个重要的公共卫生优先事项。如果证明是可行和有效的，使用计算机化的压力管理培训方案有可能提高艾滋病毒阳性妇女科普健康和生活压力的能力，并可广泛传播，供忙碌的门诊诊所使用。最终，通过提高压力管理技能，拟议的干预措施可能有助于提高艾滋病毒阳性妇女的疾病管理技能和更好的健康结果。

DESCRIPTION (provided by applicant): The overarching goal of the proposed research is to develop and pilot test a brief, computer-administered stress management training program for HIV+ women. HIV+ women represent a growing proportion of people living with HIV in the U.S. and experience disproportionate disease burden. Although HIV treatment advances have increased survival time and improved quality of life, HIV+ women continue to face a myriad of stressors that contribute to elevated rates of mental health difficulties and poor disease management. Previous stress management interventions for HIV+ individuals have primarily targeted men and have typically relied upon a multi-session group format, an approach that shows promise but is expensive and difficult to disseminate widely. To develop and pilot test a computerized stress management training program for HIV+ women, the proposed research will involve three phases. First, focus groups will be conducted with HIV+ women (n = 28) to assist in the development of intervention content and format. Second, a brief, interactive, computerized, educational stress management intervention will be designed based on the formative research, past empirical studies of stress and coping interventions with HIV+ individuals, and Lazarus and Folkman's Transactional Model of Stress and Coping. Third, the intervention will be implemented in a sample of HIV+ female outpatients to provide preliminary data regarding the feasibility, acceptability, and efficacy of the program. Participants will be randomly assigned to either an immediate intervention (n = 30) or time-lagged intervention control (n = 30) group. We predict that the intervention will result in: (a) improved coping self-efficacy; (b) lower levels of perceived stress; (c) decreased use of avoidant coping strategies; and (d) a reduction in self-reported symptoms of anxiety and depressed mood. This study addresses an important public health priority. If shown to be feasible and efficacious, the use of a computerized stress management training program has the potential to improve HIV+ women's ability to cope with health and life stressors and could be widely disseminated for use in busy outpatient clinic settings. Ultimately, by improving stress management skills, the proposed intervention may contribute to improved disease management skills and better health outcomes among HIV+ women.