Developing a mobile emotion regulation intervention for HIV-positive men

 描述：男同性恋者和双性恋者(GBM)和其他男男性行为者(MSM)继续受到艾滋病毒流行的不成比例的影响。虽然少数群体的健康压力模型已经被研究过，但这种模型还没有被测试，这些模型包含了艾滋病毒相关应激源对HIV阳性的GBM的独特作用。研究表明，艾滋病毒相关的压力源与情绪调节和健康危险行为有关，情绪调节可能是压力源影响行为结果的一条途径。此外，神经认知功能已被发现与情绪调节和健康风险行为(例如，药物使用、性风险和不遵守药物治疗)以及旨在减少健康风险行为的行为干预的有效性有关。该指导研究科学家发展奖(K01)将为候选人提供必要的保护时间、培训和资源，以开展旨在将少数人压力模型应用于艾滋病毒阳性GBM的研究。具体地说，该奖项的目标是测试HIV阳性GBM中与HIV相关的少数族裔压力模型的情绪调节和健康风险行为，并开发针对这些少数族裔压力和情绪调节途径的干预措施。为了实现这些目标，应聘者需要在两个领域进行培训和指导：(1)行为干预的设计及其向基于技术的平台的转换；(2)行为和认知神经科学的理论和方法。培训将通过教学课程、研讨会、培训、会议和有指导的研究项目相结合的方式完成。这些研究项目的总体目标是：(1)进行二次数据分析，以测试艾滋病毒相关少数群体压力模型，根据该模型，艾滋病毒相关应激源导致较差的情绪调节，而情绪调节与神经认知功能有关，并导致健康风险行为和艾滋病毒相关健康结果；(2)利用生态瞬时评估(EMA)进行一项试点研究，以制定一种衡量艾滋病毒相关少数群体压力源的情景(即日常)指标，并收集有关其与神经认知功能和情绪调节困难、性风险行为、药物使用(即酒精和俱乐部药物使用/滥用)和服药依从性的日常经验的初步数据；以及(3)开发和试点测试基于生态瞬时评估的行为干预措施的可行性和可接受性，旨在管理艾滋病毒相关少数群体应激源对情绪调节、物质使用、性风险行为、服药依从性和健康结果的影响。这些研究项目将共同解决艾滋病毒相关应激源在HIV阳性的GBM的健康中的作用的新问题，提供可修改的干预目标，检查针对这些目标的移动干预的可行性和可接受性的初步估计，并探索神经认知功能在模型中所起的作用。培训和研究计划将使候选人发展成为一名独立的调查员，专注于创建创新和高影响力的干预措施，以解决HIV阳性GBM的药物使用、性风险和HIV药物依从性问题。

 DESCRIPTION: Gay and bisexual men (GBM) and other men who have sex with men (MSM) continue to be disproportionately affected by the HIV epidemic. Though minority stress models of health have been investigated for GBM in general, such models that incorporate the unique role of HIV-related stressors for HIV- positive GBM have yet to be tested. Research suggests that HIV-related stressors are associated with emotion regulation and health risk behaviors and that emotion regulation may be one path through which stressors impact behavioral outcomes. Moreover, neurocognitive functioning has been found to be associated with both emotion regulation and health risk behaviors (e.g., substance use, sexual risk, and medication non-adherence) as well as with the efficacy of behavioral interventions aimed at reducing health risk behavior. This Mentored Research Scientist Development Award (K01) will provide the candidate with the protected time, training, and resources necessary to carry out research aimed at applying a minority stress model to HIV-positive GBM. Specifically, the goal of this award is to test an HIV-related minority stress model of emotion regulation and health risk behavior among HIV-positive GBM and developing an intervention to target these minority stress and emotion regulation pathways. To accomplish these goals, the candidate requires training and mentorship in two areas: (1) the design of behavioral interventions and their translation to technology-based platforms; and (2) the theory and methods of behavioral and cognitive neuroscience. Training will be accomplished through a combination of didactic coursework, seminars, trainings, conferences, and mentored research projects. The overarching aims of these research projects are to: (1) conduct secondary data analyses to test an HIV-related minority stress model whereby HIV-related stressors lead to poorer emotion regulation which is associated with neurocognitive functioning and leads to health risk behavior and HIV-related health outcomes; (2) conduct a pilot study utilizing ecological momentary assessment (EMA) to develop a measure of situational (i.e., daily) HIV-related minority stressors and gather preliminary data on its association with neurocognitive functioning and daily experiences of emotion regulation difficulties, sexual risk behavior, substance use (i.e., alcohol and club drug use/abuse), and medication adherence; and (3) develop and pilot test for feasibility and acceptability an EMA-based behavioral intervention aimed at managing the impact of HIV-related minority stressors on emotion regulation, substance use, sexual risk behavior, medication adherence, and health outcomes. Together, these research projects will address novel questions about the role of HIV-related stressors in the health of HIV-positive GBM, provide modifiable targets for intervention, examine preliminary estimates of feasibility and acceptability of a mobile intervention to address these targets, and explore the role that neurocognitive functioning plays within the model. The training and research plan will allow the candidate to develop into an independent investigator focusing on creating innovative and high-impact interventions to address substance use, sexual risk, and HIV medication adherence for HIV-positive GBM.