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.
The proposed study will tailor and assess the feasibility and acceptability of a two generation mindfulness-based stress reduction (MBSR) intervention among urban adolescents living with HIV (ALHIV). The intervention seeks to shift HIV care practices for ALHIV from a focus on individual medical outcomes to one that examines how family-based mindfulness impacts the self-regulatory and coping processes of ALHIV, and in turn their adherence to medication. Findings will provide the basis for future intervention studies to test the impact of a family-based MBSR approach on the HIV self-management behaviors and health outcomes among this understudied population.
| Denison, Julie A; Pettifor, Audrey; Mofenson, Lynne M et al. (2017) Youth engagement in developing an implementation science research agenda on adolescent HIV testing and care linkages in sub-Saharan Africa. AIDS 31 Suppl 3:S195-S201 |
| Denison, Julie A; Mitchell, Mary M; Maragh-Bass, Allysha C et al. (2017) Caregivers' Support Network Characteristics Associated with Viral Suppression among HIV Care Recipients. AIDS Behav 21:3599-3606 |
| Auld, Andrew F; Agolory, Simon G; Shiraishi, Ray W et al. (2014) Antiretroviral therapy enrollment characteristics and outcomes among HIV-infected adolescents and young adults compared with older adults--seven African countries, 2004-2013. MMWR Morb Mortal Wkly Rep 63:1097-103 |
