Health Promotion for Positives: A Randomized Trial with HIV Positive Black Men

描述(申请人提供)：本申请是对RFA-MD-12-001，“NIMHD健康差距研究(R01)”的回应。感染艾滋病毒的非裔美国人男性寿命更长，并受到同样的慢性病的影响，这些疾病影响着40岁以上的非洲裔美国人男性的一般人口。可以肯定的是，总的来说，非裔美国男性患心血管疾病、高血压、糖尿病、肾脏疾病和癌症的比例高得不成比例，特别是前列腺癌和结肠癌。然而，艾滋病毒感染与慢性病合并发病的风险增加有关。艾滋病毒感染以及高效抗逆转录病毒疗法(HAART)中使用的某些药物的治疗都会增加这种增加的风险。这些慢性病中的许多都有行为因素--风险受到人们做什么和不做什么、他们的饮食和他们进行的体力活动的数量的影响。虽然已经认识到艾滋病毒阳性个人患多种与行为有关的慢性病的高风险，但缺乏专门针对他们的需求的循证干预措施。因此，总体目标是降低风险。 艾滋病病毒阳性的非洲裔美国男性中的慢性病。具体目的是测试基于理论的、背景适当的健康促进干预措施在40岁或40岁以上艾滋病毒阳性非裔美国人男性中诱导与慢性病风险相关的行为积极变化的有效性，并确定影响其有效性的理论变量。这项研究将采用随机对照试验。参与者将是384名年龄在40岁或以上的非裔美国艾滋病毒阳性男性，他们正在接受艾滋病毒HAART。这些男性将被随机分配到基于理论的、背景合适的健康促进干预中，该干预包括每周三次、每次3小时的干预会议或一个注意力控制组。健康促进干预将是基于社会认知理论和形成性研究相结合的干预措施的改编，在申请者的初步研究中发现，该干预措施在增加对每日5-5饮食和体力活动指南以及前列腺癌筛查指南的遵守方面是有效的。将在基线、干预后立即、3个月、6个月和12个月收集数据，以评估干预的短期和长期影响以及干预的效果是否随着时间的推移而变化。音频计算机辅助自我访谈将被用来评估自我报告的遵守体力活动指南、每天5水果和蔬菜指南、前列腺癌筛查指南和结肠癌筛查指南以及行为改变的理论中介的情况。目标结果将包括与健康相关的健康状况(6分钟步行测试、1分钟俯卧撑测试、1分钟仰卧起坐测试)、生理变量(血压、体重指数、腰围和腰臀比)，以及基于病历回顾的前列腺癌和结肠癌筛查。

DESCRIPTION (provided by applicant): This application is in response to RFA-MD-12-001, "NIMHD Health Disparities Research (R01)." African American men who are infected with HIV are living longer and are being impacted by the same chronic diseases that affect the general population of African American men over 40. To be sure, African American men, in general, have disproportionately high rates of cardiovascular disease, hypertension, diabetes, kidney disease, and cancer, particularly prostate and colon cancer. However, HIV infection is associated with an increased risk for co-morbidity from chronic diseases. This increased risk is heightened by HIV infection, but also its treatment with certain agents used in highly active antiretroviral therapy (HAART) combinations. Many of these chronic illnesses have behavioral components-risk is influenced by what people do and do not do, their diet, and the amount of physical activity they get. Although the high risk for multiple behavior-linked chronic diseases among HIV-positive individuals has been recognized, there is a lack of evidence-based intervention specifically tailored to their needs. Hence, the broad objective is to reduce the risk of chronic diseases among HIV positive African American men. The Specific Aims are to test the efficacy of a theory- based, contextually appropriate health promotion intervention in inducing positive changes in behaviors linked to risk of chronic diseases among HIV positive African American men age 40 years or older and to identify the theoretical variables that mediate its efficacy. The study will utilize a randomized controlled trial. The participants willbe 384 African American HIV positive men age 40 or older who are receiving HAART for HIV. The men will be randomized to a theory-based contextually appropriate health promotion intervention that involves three, 3-hour weekly intervention sessions or an attention-control group. The health promotion intervention will be an adaptation of an intervention based on social cognitive theory integrated with formative research and found to be efficacious in increasing adherence to 5-a-Day diet and physical activity guidelines and prostate cancer screening guidelines in the applicants' preliminary studies. Data will be collected at baseline, immediately post, 3, 6 and 12 months post intervention, which will permit assessment of the short- term and long-term effects of the intervention and whether the intervention's efficacy varies over time. Audio computer-assisted self-interviewing will be used to assess self-reported adherence to physical activity guidelines, 5-a-Day fruit and vegetable guidelines, prostate screening guidelines, and colon cancer screening guidelines and theoretical mediators of behavior change. Objective outcomes will include health-related fitness (6-minute walk test, 1-minute push-up test, 1-minute sit-up test, sit-and-reach test), physiological variables (blood pressure, body mass index, waist circumference, and waist-hip ratio), and prostate and colon cancer screening based on medical record review.