Mindfulness training with HIV-positive youth and adult family members to improve treatment adherence

 拟议的指导研究科学家职业发展奖（K 01）的目的是促进丹尼森博士作为正念研究的独立科学家的发展，重点是以家庭为基础的正念方法，以支持艾滋病毒感染者（ALHIV）中的艾滋病毒结果。ALHIV的药物依从性低，增加了他们与HIV相关的发病率和死亡率。目前的策略，以提高依从性，如同伴小组会议和依从性咨询，依赖于教育和认知的方法，往往针对个人的行为改变，而不解决家庭和社会背景下发生的艾滋病毒管理。这个职业发展奖通过检查是否正念提供给ALHIV和一个成年家庭照顾者，目标是思想的意识，而不是改变思想的内容，支持ALHIV在巴尔的摩市的自我调节和药物依从性行为，挑战这种范式，马里兰州。本研究的具体目的是：（1）评估191名父母R 01参与者的家庭支持网络。数据将描述家庭支持网络的组成和特征，以告知家庭照顾者的定义和目标2和 3. (2)通过对20名ALHIV和20名成年家庭成员进行定性深入访谈，研究正念减压疗法对家庭支持关系的影响以及两代正念减压疗法干预的后勤保障;（3）研究在25名ALHIV和成年家庭成员中进行试点正念减压疗法干预的可接受性和可行性，以通过增加家庭支持来提高青少年对ART的依从性。约翰霍普金斯大学是这个拟议的培训的理想环境，候选人将在整个奖项中获得高级教师导师和咨询委员会成员的指导，这些导师和咨询委员会成员具有正念研究和与在青少年人群中实施正念相关的主题的专业知识，例如青少年健康，统计方法和基于家庭的干预措施。通过指导阅读，课程作业和监督研究机会的结合，这个指导团队将支持丹尼森博士实现她的培训目标，以（1）获得正念理论，干预和研究方法的专业知识;（2）完善和测试两代正念为基础的减压干预;（3）发展网络和二元数据分析的统计技能;（4）提高对家庭干预方法和理论的认识。候选人的培训和研究计划将为丹尼森博士提供技能和初步数据，以寻求资金，并成功成为正念和以家庭为基础的正念方法的独立研究人员，以改善慢性病青少年的自我管理。

 DESCRIPTION (provided by applicant): The purpose of the proposed Mentored Research Scientist Career Development Award (K01) is to promote Dr. Denison's development as an independent scientist in mindfulness research with a focus on family-based mindful approaches to support HIV outcomes among adolescents living with HIV (ALHIV). ALHIV have low rates of medication adherence, increasing their risk for HIV-related morbidities and mortality. Current strategies to improve adherence, such as peer group meetings and adherence counseling, rely on educational and cognitive approaches often targeting individual behavior change without addressing the familial and social context where HIV management occurs. This career development award challenges this paradigm by examining if mindfulness offered to ALHIV and an adult family caregiver, that targets awareness of thought rather than changing the content of thought, supports the self-regulatory and medication adherence behaviors of ALHIV in Baltimore City, Maryland. The study's specific aims are to: (1) assess the family support networks among 191 participants in the parent R01. Data will characterize family support network composition and characteristics to inform family caregiver definitions and participant selection for Aims 2 and 3. (2) Examine the effects of MBSR on family support relationships and the logistics of a two-generation MBSR intervention, by conducting qualitative in-depth interviews with 20 ALHIV and 20 adult family members; and (3) examine the acceptability and feasibility of a pilot MBSR intervention among 25 ALHIV and adult family member pairs to improve adolescent adherence to ART through increased family support. The Johns Hopkins University is an ideal environment for this proposed training where the candidate will receive guidance throughout the award from Senior Faculty mentors and advisory committee members with expertise in mindfulness research and topics related to implementing mindfulness in this adolescent population, such as adolescent health, statistical methods and family-based interventions. Through a combination of directed readings, coursework, and supervised research opportunities, this mentoring team will support Dr. Denison in achieving her training goals to (1) gain expertise in mindfulness theory, interventions and research methods; (2) refine and test a two generation mindfulness-based stress reduction intervention; (3) develop statistical skills in network and dyadic data analysis; and 4) enhance knowledge of family-based interventions methods and theory. The candidate's training and research plan will provide the skills and preliminary data for Dr. Denison to pursue funding and successfully become an independent researcher in mindfulness and family-based mindful approaches to improve self-management among chronically ill adolescents.