Developing a group singing intervention for promoting psychosocial wellbeing among older people living with HIV

项目总结/摘要 到2030年，美国大约73%的艾滋病毒感染者（PLWH）将超过50岁。50岁是 艾滋病毒老年病护理的基准年龄，因为艾滋病毒通过慢性 炎症和免疫衰老。孤独和社交孤立在老年人中很常见， 我们对老年PLWH的初步研究和新出现的证据表明，老年PLWH渴望社交， 与其他老年艾滋病毒携带者的联系，不需要披露艾滋病毒状况，并帮助他们重新获得 控制感和目标感，在感染艾滋病毒的情况下过上充实的生活。合唱创造了社交机会， 与改善老年人的社会心理健康有关，因此对老年人来说具有巨大的潜力。 PLWH。合唱通过增加归属感和社会联系来改善心理健康， 尽管对集体歌唱如何影响那些患有耻辱性健康状况的人知之甚少。 我们建议发展联合之声（UV），一个社区合唱团干预，以提高心理社会健康 在老年PLWH中，基于社区之声（COV; R 01 AG 042526），社区合唱团干预 在一项随机分组、等待名单对照的老年人试验中， 成年人了R21的目标如下。目标1：发展联合之声，一个社区唱诗班干预， 通过增强群体自豪感和个人幸福感，改善老年（≥50岁）艾滋病毒感染者的心理健康状况 控制为了实现目标1，我们将与社区咨询理事会（CAC）的主要利益相关者（例如， 有和/或正在从事合唱的老年PLWH），以适应COV干预起草新的 方案和程序，修改和完善COV干预方案和程序，以及 将CAC的反馈意见纳入UV手册和培训程序的最终版本， 随后在目标2进行试点试验。目标2：对联合之声进行一项试点、随机等待名单对照试验 对两个社区站点进行干预，以评估实施的可接受性和可行性， 评估程序和方案，包括随机化程序。我们将修订、整合和 最后确定干预方案和程序，为随后的全面试验做准备。时发现的问题 R21研究将为随后的R 01提案提供所需的基础数据，以严格评估 第一次社区合唱团干预，以解决日益增长和服务不足的需求 人口从基于理论的研究中获得的知识将为未来的原则驱动的 干预发展研究。

PROJECT SUMMARY/ABSTRACT By 2030, approximately 73% of people living with HIV (PLWH) in the U.S. will be older than 50 years. Age 50 is a benchmark age in HIV-geriatrics care because HIV accelerates aging via the processes of chronic inflammation and immunosenescence. Loneliness and social isolation are common among older adults, but our preliminary research and emergent evidence with older PLWH show that older PLWH desire social connections with other older PLWH that do not require disclosure of HIV-status and that help them regain a sense of control and purpose in living a fulfilling life with HIV. Group singing creates social opportunities that are linked to improved psychosocial wellbeing in older adults, thus holding tremendous potential for older PLWH. Group singing improves psychosocial wellbeing via increased feelings of belonging and social bonding, although less is known regarding how group singing impacts those living with a stigmatizing health condition. We propose to develop United Voices (UV), a community choir intervention to enhance psychosocial wellbeing among older PLWH, based on Community of Voices (COV; R01AG042526), a community choir intervention that significantly improved psychosocial outcomes in a cluster-randomized, waitlist controlled trial of older adults. The aims to this R21 are as follows. Aim 1: Develop United Voices, a community choir intervention to improve psychosocial wellbeing among older (≥50 years) PLWH by enhancing group pride and personal control. To achieve Aim 1, we will work with a community advisory council (CAC) of key stakeholders (e.g., older PLWH who have and/or are engaged in group singing) to adapt the COV intervention by drafting new protocols and procedures, modifying and refining the COV intervention protocols and procedures, and integrating the CAC's feedback into a final version of the UV manual and training procedures for the subsequent pilot trial in Aim 2. Aim 2: Conduct a pilot, randomized waitlist controlled trial of the United Voices intervention with two community sites to evaluate the acceptability and feasibility of implementation and assessment procedures and protocols, including randomization procedures. We will revise, integrate, and finalize intervention protocols and procedures to prepare for a subsequent full-scale trial. Findings from this R21 research will provide the foundational data needed for a subsequent R01 proposal to rigorously evaluate the first community choir intervention for addressing unmet needs among a growing and underserved population. Knowledge gained from the theory-based research proposed will inform future principles-driven intervention development research.