Cardiovascular Risk Perception and Wellness Perspectives in HIV-infected Adults

这项为期三年的K23研究和培训奖将使PI获得成为独立护士科学家所需的知识和技能，其长期目标是进行研究，以开发和实施创新干预措施，降低心血管风险并促进HIV感染患者的健康。与未感染者相比，心血管疾病（CVD）已成为艾滋病毒感染者（PLWH）发病率和死亡率的主要原因（年轻人急性心肌梗死的发生率较高）。PLWH具有更高的传统CVD危险因素的患病率，以及增加的合并症，如高血压、糖尿病、肥胖和高脂血症。鉴于心血管疾病在HIV感染患者死亡率中的作用，了解心血管疾病风险认知和风险因素知识，并制定有针对性的干预措施势在必行。该项目借鉴了健康信念模型，以更好地了解PLWH如何看待他们的心血管疾病风险，并制定一个动机访谈（MI）为基础的干预措施，以改善不仅心血管疾病风险的认知，但也通过健康促进行为PLWH。该研究的具体目的是：1）描述和探索心血管疾病风险的看法和采取健康促进行为的可能性，偏好，益处和障碍; 2.a）为单独提供的CVD风险评估和生活方式改变管理干预制定治疗手册，以及2.b.）进行试点研究，以测试两次干预的可行性和可接受性。第一阶段将包括与30-40名艾滋病毒携带者进行深入的个人定性访谈。阶段2.a.将包括手册的开发，一个试点的初步协议与8-10 PLWH，和手册的修订。阶段2.b.将包括40例PLWH的随机化2组（干预或简要建议）初步临床试验。从这项研究中获得的知识将为未来全面随机临床试验的发展提供信息 研究量身定制的干预措施对改善心血管疾病风险认知、改善心脏健康行为的采用和降低HIV感染患者心血管疾病风险的有效性。拟议的K23研究将为我们理解和管理HIV感染患者的CVD风险提供一个缺失的基本要素。PI将与经验丰富的导师合作，以建立以下方面的专业知识：（1）定性研究方法和分析;（2）干预措施的开发和试点测试。该K23提案解决了HIV治疗科学的关键优先事项，并将为PI作为HIV干预科学家的研究生涯做好充分准备。

DESCRIPTION (provided by applicant): This three-year K23 research and training award will enable the PI to acquire the knowledge and skills needed to become an independent nurse scientist, with the long-term goal of conducting research to develop and implement innovative interventions that reduce cardiovascular risk and promote wellness in HIV-infected patients. Cardiovascular disease (CVD) has emerged as a major cause of morbidity and mortality (evidenced by a higher rate of acute myocardial infarction at younger ages) in persons living with HIV (PLWH) compared with uninfected individuals. PLWH have a higher prevalence of traditional CVD risk factors, as well as increased comorbidities, such as hypertension, diabetes, obesity, and hyperlipidemia. Given the role of CVD in HIV-infected patients' mortality, understanding CVD risk perception and risk factor knowledge, and developing tailored interventions is imperative. This project draws on the Health Belief Model to better understand how PLWH perceive their risk for CVD, and to develop a motivational interviewing (MI)-based intervention to improve not only CVD risk perception but also the adoption of health-promoting behaviors in PLWH. The specific aims of the study are to: 1) describe and explore perceptions of CVD risk and the likelihood, preferences, benefits, and barriers of adopting health-promoting behaviors; 2.a.) develop a treatment manual for an individually delivered CVD risk assessment and lifestyle modification management intervention, and, 2.b.) conduct a pilot study to test the feasibility and acceptability of the 2-session intervention. Phase 1 will include in-depth individul qualitative interviews with 30-40 PLWH. Phase 2.a. will include manual development, a pilot of the preliminary protocol with 8-10 PLWH, and manual revisions. Phase 2.b. will include a randomized 2-arm (intervention or brief advice) pilot clinical trial with 40 PLWH. The knowledge gained from this study will inform the future development of a full-scale randomized clinical trial to examine the effectiveness of a tailored intervention to improve CVD risk perception, improve adoption of heart-healthy behaviors, and reduce CVD risk in HIV-infected patients. The proposed K23 research will contribute a missing and fundamental element to our understanding and management of CVD risk in HIV-infected patients. The PI will work with experienced mentors to build expertise in: (1) qualitative research methods and analyses; and, (2) intervention development and pilot testing. This K23 proposal addresses a key priority in HIV treatment science and will fully prepare the PI for a research career as an HIV intervention scientist.