The overall objective of this Mentored Research Scientist Career Development Award is to support and develop Dr. Chapman Lambert?s transition to an independent investigator in mind and body research with a focus on developing, integrating, and testing mind and body strategies to improve clinical, psychological, and physical outcomes among African American (AA) women living with HIV (WLWH). HIV viral load (VL) suppression among AA WLWH are suboptimal when compared to women of other racial and ethnic backgrounds. Two essential self- care behaviors for people living with HIV (PLWH) to achieve and sustain HIV VL suppression ad improve health outcomes and survival are adherence to antiretroviral therapy and scheduled medical visits. Medical visit adherence is suboptimal among women in general, but VL suppression rates among AA WLWH are suboptimal with AA WLWH being nearly 3 times more likely than White WLWH not to achieve viral suppression. One important factor associated with adherence behaviors is stressful life events including traumatic life events. Thus, there is a critical need to develop culturally appropriate interventions aimed reducing stress and improving adherence behaviors and VL suppression. Mindfulness-based stress reduction (MBSR), developed by Jon Kabat-Zinn, has the potential to reduced stress through self-regulation of attention and awareness to stressful events. MBSR has demonstrated efficacy in improving stress management, psychological distress, physical and psychological symptoms, quality of life, and coping as well as ART adherence in predominately white and male patient populations. We propose to culturally adapt the MSBR intervention for AA WLWH to reduce stress and enhance HIV self-care behaviors and VL suppression, which has the potential to attenuate prominent racial and gender disparities experienced by AA WLWH in the US. Specifically, we aim to 1) culturally adapt the MBSR intervention for AA WLWH using ADAPT-ITT; 2) pre-pilot the adapted intervention via an open non-randomized pilot study to further refine the culturally adapted intervention; and 3) conduct a 2-armed pilot test of the behavioral intervention compared to standard of care to assess the feasibility and acceptability the adapted MBSR intervention for AA WLWH. Findings from this study will provide an important first step in establishing my program of research as an independent investigator in stress-related morbidity and HIV treatment adherence. In addition, findings maybe applicable for other chronic conditions and marginalized populations living with and without HIV.

Public Health Relevance

African American (AA) women living with HIV (WLWH)are at higher risk for experiencing stressful life events which can lead to deleterious health outcomes. Mindfulness Based Stress Reduction (MBSR) offers a complementary and integrative approach for reducing stress as a mechanism for improving HIV treatment adherence behaviors, HIV viral load suppression and survival. The objective of this study is to culturally adapt an existing MBSR intervention to meet the needs of AA WLWH, and assess the feasibility and acceptability of the adapted intervention among the target population.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZAT1)
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White, Della
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University of Alabama Birmingham
Other Health Professions
Schools of Nursing
United States
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