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为艾滋病毒阳性妇女开发和试点一个简短的、计算机管理的压力管理培训计划。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，她们承受着不成比例的疾病负担。尽管艾滋病毒治疗的进步延长了生存时间并改善了生活质量，但艾滋病毒阳性妇女仍然面临着无数的压力因素，导致精神健康困难率上升和疾病管理不善。以前针对艾滋病毒阳性个体的压力管理干预措施主要针对男性，并且通常依赖于多疗程的小组形式，这种方法显示出希望，但价格昂贵且难以广泛传播。为了开发和试点一项针对艾滋病毒阳性妇女的计算机压力管理培训计划，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。其次，基于形成性研究、以往HIV+个体压力与应对干预的实证研究，以及Lazarus和Folkman的压力与应对的交易模型，设计一个简短的、交互式的、计算机化的教育压力管理干预。第三，在HIV阳性门诊女性患者样本中实施干预，为干预方案的可行性、可接受性和有效性提供初步数据。参与者将被随机分配到立即干预组（n = 30）或滞后干预组（n = 30）。我们预测干预将导致：(a)提高应对自我效能；(b)较低的感知压力水平；(c)回避应对策略的使用减少；(d)减少自我报告的焦虑和抑郁情绪症状。这项研究解决了一个重要的公共卫生优先事项。如果证明可行和有效，计算机化压力管理培训方案的使用有可能提高艾滋病毒阳性妇女应对健康和生活压力源的能力，并可广泛传播，以便在繁忙的门诊诊所环境中使用。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改善健康结果。

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.