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.

Public Health Relevance

With their prolonged survival, HIV-infected adults are at increased risk for cardiovascular disease (CVD) when compared with adults not infected with HIV. This research will examine, through individualized interviews, the perceptions of CVD risk and wellness potential of HIV infected adults. The study will develop and pilot test a tailored intervention to address diet, physical activity and exercise to improve CVD risk perception and adoption of heart-healthy behaviors in HIV-infected adults.

National Institute of Health (NIH)
National Institute of Nursing Research (NINR)
Mentored Patient-Oriented Research Career Development Award (K23)
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National Institute of Nursing Research Initial Review Group (NRRC)
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Hardy, Lynda R
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Brown University
Public Health & Prev Medicine
Schools of Public Health
United States
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Cioe, Patricia A; Gamarel, Kristi E; Pantalone, David W et al. (2016) Cigarette Smoking and Antiretroviral Therapy (ART) Adherence in a Sample of Heavy Drinking HIV-Infected Men Who Have Sex with Men (MSM). AIDS Behav :
Monnig, Mollie A; Kahler, Christopher W; Cioe, Patricia A et al. (2016) Alcohol use predicts elevation in inflammatory marker soluble CD14 in men living with HIV. AIDS Care 28:1434-40
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Cioe, Patricia A; Crawford, Sybil L; Stein, Michael D (2014) Cardiovascular risk-factor knowledge and risk perception among HIV-infected adults. J Assoc Nurses AIDS Care 25:60-9