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Jhuti D, Zakaryan G, El-Kechen H, Rehman N, Youssef M, Garcia C, Arora V, Zani B, Leenus A, Wu M, Makanjuola O, Mbuagbaw L. Describing Engagement in the HIV Care Cascade: A Methodological Study. HIV AIDS (Auckl) 2023; 15:257-265. [PMID: 37255532 PMCID: PMC10226482 DOI: 10.2147/hiv.s406524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Introduction Engagement in the HIV care cascade is required for people living with HIV (PLWH) to achieve an undetectable viral load. However, varying definitions of engagement exist, contributing to heterogeneity in research regarding how many individuals are actively participating and benefitting from care. A standardized definition is needed to enhance comparability and pooling of data from engagement studies. Objectives The objective of this paper was to describe the various definitions for engagement used in HIV clinical trials. Methods Articles were retrieved from CASCADE, a database of 298 clinical trials conducted to improve the HIV care cascade (https://hivcarecascade.com/), curated by income level, vulnerable population, who delivered the intervention, the setting in which it was delivered, the intervention type, and the level of pragmatism of the intervention. Studies with engagement listed as an outcome were selected from this database. Results 13 studies were eligible, of which five did not provide an explicit definition for engagement. The remaining studies used one or more of the following: appointment adherence (n=6), laboratory testing (n=2), adherence to antiretroviral therapy (n=2), time specification (n=5), intervention adherence (n=5), and quality of interaction (n=1). Conclusion This paper highlights the existing diversity in definitions for engagement in the HIV care cascade and categorize these definitions into appointment adherence, laboratory testing, adherence to antiretroviral therapy, time specification, intervention adherence, and quality of interaction. We recommend consensus on how to describe and measure engagement.
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Affiliation(s)
- Diya Jhuti
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Gohar Zakaryan
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Hussein El-Kechen
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Nadia Rehman
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Mark Youssef
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cristian Garcia
- Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vaibhav Arora
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Babalwa Zani
- Public Health Research Unit, AB Consulting, Cape Town, South Africa
| | - Alvin Leenus
- Faculty of Law, University of Ottawa, Ottawa, ON, Canada
| | - Michael Wu
- Michael DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Biostatistics Unit, Father Sean O’Sullivan Research Centre, Hamilton, ON, Canada
- Centre for Development of Best Practices in Health, Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
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Comparative efficacy and acceptability of non-pharmacological interventions for depression in people living with HIV: A systematic review and network meta-analysis. Int J Nurs Stud 2023; 140:104452. [PMID: 36821952 DOI: 10.1016/j.ijnurstu.2023.104452] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 01/11/2023] [Accepted: 01/26/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Treatment for depression in people living with HIV has increasingly turned to non-pharmacological treatments due to the adverse reactions of pharmacotherapy. However, it remains unclear which non-pharmacological treatment is the most effective and acceptable for depression in people living with HIV. OBJECTIVE To compare and rank the efficacy and acceptability of different non-pharmacological treatments for depression in people living with HIV. DESIGN A systematic review and Bayesian network meta-analysis. METHODS We systematically searched PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, PsycArticles, CINAHL, ProQuest, OpenGrey, and international trial registers for published and unpublished studies from their inception to September 1, 2022, and searched key conference proceedings from January 1, 2020, to September 25, 2022. We searched for randomized controlled trials of any non-pharmacological treatments for depression in adults living with HIV (≥18 years old). Primary outcomes were efficacy (mean change scores in depression) and acceptability (all-cause discontinuation). We used a random-effects network meta-analysis model to synthesize all available evidence. The methodological quality of the included studies was assessed using the Cochrane Collaboration Risk of Bias Tool. We registered this study in PROSPERO, number CRD42021244230. RESULTS A total of 53 randomized controlled trials were included in this network meta-analysis involving seven non-pharmacological treatments for depression in people living with HIV. For efficacy, mind-body therapy, interpersonal psychotherapy, cognitive-behavioral therapy, supportive therapy, and education were significantly more effective than most control conditions (standardized mean differences ranged from -0.96 to -0.36). Rankings probabilities indicated that mind-body therapy (79%), interpersonal psychotherapy (71%), cognitive-behavioral therapy (62%), supportive therapy (57%), and education (57%) might be the top five most significantly effective treatments for depression in people living with HIV, in that order. For acceptability, only supportive therapy and interpersonal psychotherapy were significantly less acceptable than most control conditions (odds ratios ranged from 1.92 to 3.43). Rankings probabilities indicated that education might be the most acceptable treatment for people living with HIV (66%), while supportive therapy (26%) and interpersonal psychotherapy (10%) might rank the worst. The GRADE assessment results suggested that most results were rated as "moderate" to "very low" for the confidence of evidence. CONCLUSIONS Our study confirmed the efficacy and acceptability of several non-pharmacological treatments for depression in people living with HIV. These results should inform future guidelines and clinical decisions for depression treatment in people living with HIV.
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Bublitz MH, Salmoirago-Blotcher E, Sanapo L, Ayala N, Mehta N, Bourjeily G. Feasibility, acceptability, and preliminary effects of mindfulness training on antenatal blood pressure. J Psychosom Res 2023; 165:111146. [PMID: 36621212 PMCID: PMC10288303 DOI: 10.1016/j.jpsychores.2023.111146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/03/2023] [Accepted: 01/03/2023] [Indexed: 01/07/2023]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are one of the greatest causes of perinatal morbidity and mortality. Mindfulness training (MT) significantly reduces blood pressure in non-pregnant adults, yet MT has not been tested to reduce blood pressure in the prenatal period. OBJECTIVES The objectives of this pilot randomized clinical trial were to test the feasibility, acceptability, and effects of MT on rates of HDP among pregnant participants at risk for HDP. Exploratory analyses examined effects of MT on antenatal blood pressure. STUDY DESIGN Participants were randomized to an 8-week phone-delivered MT intervention or usual care. Feasibility was defined by MT completion. Acceptability was defined by participants' satisfaction with the intervention. HDP outcomes were collected by medical chart review. Antenatal blood pressure values were extracted from medical records. RESULTS Twenty-nine participants were randomized to phone-based MT (N = 15) or usual care (N = 14). 73% participants completed >5 MT sessions, indicating that MT was feasible. One hundred percent of participants indicated they were "satisfied" or "very satisfied" with the intervention, suggesting the intervention was acceptable. Rates of HDP were lower in the MT vs. usual care condition (9% vs. 29%; OR: 0.25, 95% C.I.: 0.02-2.65) although this did not reach statistical significance. Systolic and diastolic blood pressure levels were significantly lower at follow up among those randomized to MT vs. usual care. CONCLUSIONS Results from this pilot trial suggest that prenatal MT is feasible and acceptable and may be a useful adjunctive preventative treatment for HDP among at-risk pregnant patients. CLINICALTRIALS gov identifier is NCT03679117.
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Affiliation(s)
- Margaret H Bublitz
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Elena Salmoirago-Blotcher
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Laura Sanapo
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Nina Ayala
- Division of Maternal Fetal Medicine, Women and Infant's Hospital of Rhode Island, Providence, RI, USA; Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Niharika Mehta
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Ghada Bourjeily
- Women's Medicine Collaborative at The Miriam Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
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Kruse CS, Pacheco GJ, Rosenthal N, Kopp CJ, Omorotionmwan O, Cruz JE. Leveraging mHealth for the Treatment and Management of PLHIV. Risk Manag Healthc Policy 2023; 16:677-697. [PMID: 37077534 PMCID: PMC10106311 DOI: 10.2147/rmhp.s403946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/25/2023] [Indexed: 04/21/2023] Open
Abstract
Objective The objective of this systematic review was to analyze published literature from the last five years to assess facilitators and barriers to the adoption of mHealth as interventions to treat and manage HIV for PLHIV (people living with HIV). The primary outcomes were physical and mental conditions. The secondary outcomes were behavior based (substance use, care engagement, and healthy habits). Methods Four databases (PubMed, CINAHL, Web of Science, and ScienceDirect) were queried on 9/2/2022 for peer-reviewed studies on the treatment and management of PLHIV with mHealth as the intervention. The review was conducted in accordance with the Kruse Protocol and reported in accordance with PRISMA 2020. Results Five mHealth interventions were identified across 32 studies that resulted in improvements in physical health, mental health, care engagement, and behavior change. mHealth interventions offer both convenience and privacy, meet a digital preference, increase health knowledge, decrease healthcare utilization, and increase quality of life. Barriers are cost of technology and incentives, training of staff, security concerns, digital literacy gap, distribution of technology, technical issues, usability, and visual cues are not available over the phone. Conclusion mHealth offers interventions to improve physical health, mental health, care engagement, and behavior for PLHIV. There are many advantages to this intervention and very few barriers to its adoption. The barriers are strong, however, and should be addressed through policy. Further research should focus on specific apps for younger versus older PLHIV, based on preferences and the digital literacy gap.
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Affiliation(s)
- Clemens Scott Kruse
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
- Correspondence: Clemens Scott Kruse, Email
| | - Gerardo J Pacheco
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Noah Rosenthal
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Caris J Kopp
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - Omosigho Omorotionmwan
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
| | - John E Cruz
- Texas State University, School of Health Administration, 601 University Drive, San Marcos, TX, 78666, USA
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Salmoirago-Blotcher E, Walaska K, Trivedi D, Dunsiger S, Breault C, Levine D, Wu JR, Cohen R. Mind Your Heart: Exploring Feasibility, Acceptability, and Preliminary Effects of Phone-Delivered Mindfulness Training on Medication Adherence in Outpatients With Chronic Heart Failure. J Cardiovasc Nurs 2022; 37:595-602. [PMID: 35067596 PMCID: PMC9300764 DOI: 10.1097/jcn.0000000000000891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Mindfulness training (MT) may promote medication adherence in outpatients with heart failure. OBJECTIVE The aims of this study were to determine the feasibility and acceptability of MT (primary outcomes) and explore effects on medication adherence, functional capacity, cognitive function, depression, and mindfulness skills (secondary outcomes). METHODS In this pre/post-design study, participants received a 30-minute phone-delivered MT session weekly for 8 weeks. RESULTS We enrolled 33 outpatients (32% women; 69.7 White; mean age, 60.3 years). Retention was 100%, and session attendance was 91%. Overall, participants (97%) rated MT as enjoyable. Objectively assessed ( P < .05) adherence decreased post intervention, whereas improvements were noted in functional capacity ( P = .05), mindfulness ( P < .05), and cognitive function (reaching significance for Flanker scores). CONCLUSIONS Phone-delivered MT was feasible and acceptable. Whereas no improvements were noted in medication adherence and depression, cognitive function, functional capacity, and mindfulness levels increased post intervention, suggesting MT may have beneficial effects in outpatients with heart failure.
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Affiliation(s)
- Elena Salmoirago-Blotcher
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
- Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Kristen Walaska
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Dyuti Trivedi
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity, Department of Behavioral and Social Science, School of Public Health, Brown University, Providence, RI, United States
| | - Christopher Breault
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Daniel Levine
- Rhode Island Cardiovascular Institute, Providence, RI, United States
| | - Jia-Rong Wu
- University of Kentucky College of Nursing Lexington, KY, United States
| | - Ronald Cohen
- Cognitive Aging and Memory Program, McKnight Institute on Aging, University of Florida
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Terapias complementares para manejo de ansiedade em pessoas com HIV: revisão sistemática. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ar0002407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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The Style of Coping with Stress, the Health-Related Locus of Control, and the Level of Mindfulness of Patients with Chronic Somatic Diseases in Comparison to Healthy People. Healthcare (Basel) 2022; 10:healthcare10091752. [PMID: 36141364 PMCID: PMC9498608 DOI: 10.3390/healthcare10091752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 09/04/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Psychological factors may be involved in both the development and treatment of somatic diseases. Our study aimed to evaluate the style of coping with stress, health-related locus of control, and level of mindfulness of adult patients with the most common chronic somatic diseases compared with healthy subjects. Methods: 502 chronically ill people were examined (M = 49.27; SD = 14.25), including 288 women and 214 men. The control group consisted of 117 healthy people (M = 45.66; SD = 17.86). The diagnostic survey involved using the Coping Inventory for Stressful Situations (CISS), Multidimensional Health Locus of Control Scale (MHLC), and Mindful Attention Awareness Scale (MAAS). Results: Differences between the clinical and control groups were demonstrated for MHLC: Internal (p < 0.001), Powerful Others (p < 0.05), and Chance (p < 0.001); CISS: Task (p < 0.001) and Avoidance (p < 0.05); and MAAS (p < 0.01). Conclusion: People with chronic somatic diseases, compared to healthy people, have a stronger external and weaker internal health-related locus of control, lower level of task and avoidance style for coping with stress, and lower level of mindfulness.
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8
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The Influence of Selected Psychological Factors on Medication Adherence in Patients with Chronic Diseases. Healthcare (Basel) 2022; 10:healthcare10030426. [PMID: 35326906 PMCID: PMC8955226 DOI: 10.3390/healthcare10030426] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/20/2022] [Accepted: 02/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background: Insufficient adherence to treatment is a relevant problem. This study aims to determine the impact of health locus of control, stress coping style and level of mindfulness on medication adherence in patients with a chronic illness. Methods: The study included 768 people. The diagnostic survey involved the use of: Medication Adherence Questionnaire (MAQ), Multidimensional Health Locus of Control Scale (MHLC), The Coping Inventory for Stressful Situations (CISS), and The Mindful Attention Awareness Scale (MAAS). Results: Participants were divided into two subgroups, i.e., adherent (n = 219) and non-adherent (n = 549). We observed significant differences between the subgroups in age, BMI, sex, place of residence, education, and for all MHLC subscales, two CISS subscales and MAAS. The identified medication adherence variables were: female gender (OR = 1.55), BMI (OR = 0.95), MHLC/Internal (OR = 0.95), CISS/Emotional (OR = 1.03), MAAS (OR = 0.97). Conclusions: A strong internal health locus of control, a higher level of mindfulness and a lower level of emotional-stress coping style increase the likelihood of adherence with medication recommendations in patients with chronic diseases.
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Mindfulness-based interventions for medication adherence: A systematic review and narrative synthesis. J Psychosom Res 2021; 149:110585. [PMID: 34332271 PMCID: PMC8453130 DOI: 10.1016/j.jpsychores.2021.110585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 07/20/2021] [Accepted: 07/22/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Inadequate medication adherence is a significant limitation for achieving optimal health outcomes across chronic health conditions. Mindfulness-based interventions (MBIs) have been increasingly applied to promote medical regimen adherence as MBIs have been shown to improve patient-level barriers to adherence (i.e., depressive symptoms, cognitive impairment, stress). The purpose of this review is to investigate the state of research regarding MBIs targeting medication adherence in chronic illnesses and to identify evidence gaps to inform future studies. METHODS The search reviewed 5 databases (e.g., PubMed, PsycINFO, Embase, CINAHL, Proquest Thesis/Dissertations) to identify trials that quantitatively evaluated the effect of MBIs on medication adherence. Study abstracts and full texts were screened identifying eligible studies, and findings were summarized using a narrative synthesis. RESULTS A total of 497 studies were reviewed; 41 were eligible for full text review and 9 were included in narrative synthesis: seven were RCTs and two were pre-post designs. Study quality varied, with five rated moderate or high risk for bias. Clinical populations tested included living with HIV (k = 3), cardiovascular disease (k = 3), psychological disorders (k = 2), and men who underwent a radical prostatectomy (k = 1). Four studies found significant improvements in medication adherence, however only two of these studies had low risk of bias. CONCLUSIONS Research on MBI's for medication adherence is developing, but the effectiveness of MBIs remains unclear due to the nascent stage of evidence and methodological limitations of existing studies. Researchers should prioritize rigorous experimental designs, theory-driven investigations of behavioral mechanisms, and the use of objective measurements of adherence.
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10
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Selected psychological factors and medication adherence in patients with rheumatoid arthritis. Reumatologia 2021; 59:90-97. [PMID: 33976462 PMCID: PMC8103406 DOI: 10.5114/reum.2021.105433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/06/2021] [Indexed: 11/27/2022] Open
Abstract
Objectives The aim of the study was to determine the relationship between medication adherence (MA) and selected psychological factors in a group of patients with rheumatoid arthritis (RA). Material and methods The cross-sectional study was conducted in four rheumatology outpatient clinics in Silesia, Poland. The tests used were the Medication Adherence Questionnaire (MAQ), the Multidimensional Health Locus of Control Scale (MHLC), the Coping Inventory for Stressful Situations (CISS), and the Mindful Attention Awareness Scale (MAAS). The analysis involved 106 adult patients diagnosed with RA at least 6 months before, who were prescribed medication, with disease at any stage and with stable comorbidities. Software was used to perform analyses of frequency, basic descriptive statistics, including the Kolmogorov-Smirnov test, Student’s t-test for independent samples, intergroup univariate variance, Pearson’s r correlation coefficient, Spearman’s rank correlation ρ coefficient, Fisher’s exact test and stepwise linear regression. Results Powerful Others Health Locus of Control (PHLC), Internal Health Locus of Control (IHLC) and age of the subjects, F(3, 102) = 8.05; p < 0.001 explained 16.8% of the variation in the adherence level for the entire group. In the group of women PHLC and IHLC, F(2, 80) = 10.04; p < 0.001 were included in the model, which explained 18.1% of variation in MA. PHLC was the most significant factor in the group of women (β = 0.55; p < 0.001) and in the entire group (β = 0.48; p < 0.001). In the group of men, Social Diversion Style (SDS), F(1, 21) = 5.81; p = 0.02 was included in the model, which explained 17.9% of the variation in the MA level. Conclusions The study identified some psychological predictors of adherence, which explained 16.8% of the variability. Factors increasing the likelihood of medication adherence in patients with rheumatoid arthritis include a strong belief in the power of others, low level of internal health locus of control, and advanced age.
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Dunne EM, Rosen RK, Rich C, Norris AL, Salmoirago-Blotcher E, Carey MP. Telephone-delivered behavioral health interventions for people living with HIV: patients' perspectives from a qualitative study. AIDS Care 2020; 33:1155-1158. [PMID: 33138622 DOI: 10.1080/09540121.2020.1838427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
People living with HIV (PLWH) often experience mental health concerns as well as difficulties with medication adherence; they also report barriers to receipt of health services. Telephone-delivered interventions can overcome some of these barriers. To obtain patients' perspectives on telephone-delivered behavioral health services, we conducted a qualitative study with patients who participated in one of two telephone-delivered interventions (mindfulness training, health coaching) in a research trial. Patients (N = 42; M age = 46 years, 50% female, 26% Black) participated in semi-structured qualitative interviews after completing the study. They identified several advantages (e.g., being able to schedule sessions more flexibly compared to in-person appointments, ease of developing rapport with interventionists) as well as occasional challenges of phone delivery (e.g., network connectivity). Overall, PLWH view telephone-delivery as a convenient and flexible method to engage in behavioral health interventions.
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Affiliation(s)
- Eugene M Dunne
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Rochelle K Rosen
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
| | - Carla Rich
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Alyssa L Norris
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
| | - Michael P Carey
- Center for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA.,Alpert Medical School, Brown University, Providence, RI, USA.,School of Public Health, Brown University, Providence, RI, USA
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12
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Jiang T, Hou J, Sun R, Dai L, Wang W, Wu H, Zhang T, Su B. Immunological and Psychological Efficacy of Meditation/Yoga Intervention Among People Living With HIV (PLWH): A Systematic Review and Meta-analyses of 19 Randomized Controlled Trials. Ann Behav Med 2020; 55:505-519. [PMID: 33119732 DOI: 10.1093/abm/kaaa084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND An expanding number of mind-body therapies are being used to reduce the psychological burden of peoples living with human immunodeficiency virus (HIV). However, the effects on the immune system and mental health varied among studies. PURPOSE This meta-analysis was conducted to summarize the randomized controlled trials to draw comprehensive conclusions regarding the psycho-immunological efficacy. METHODS Random-effects models were used to assess the outcome of interest. Egger's tests were used to identify publication bias. Subgroup and meta-regression were used to explore potential moderators. This review was registered on the PROSPERO database (CRD42019148118). RESULTS Nineteen randomized controlled trials with a total sample size of 1,300 were included in this meta-analysis. Regarding immune system outcome, mind-body therapy significantly improved CD4 T-cell counts (Cohen's d = 0.214, p = .027) and maintained (0.427, p = .049). In addition, baseline CD4 T-cell counts and years since HIV diagnosis significantly moderated the efficacy of mind-body practices on CD4 improvement (all ps < .001). Regarding mental health outcome, mind-body therapy significantly reduced stress, depression, and anxiety symptoms (0.422, p < .001; 0.506, p < .001, and 0.709, p < .001, respectively) while improving quality of life (0.67, p < .001). CONCLUSIONS Meditation/yoga intervention could result in potential benefits with regard to improved CD4 T-cell counts immediately after the intervention and at long-term follow-up, while also improving their mental health. The cost-effective meditation/yoga intervention should be integrated into routine care for people living with HIV, especially for those with lower CD4 baseline and fewer years since diagnosis.
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Affiliation(s)
- Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Jianhua Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Runsong Sun
- Department of Sociology and Social Work, School of Sociology, Beijing Normal University, Beijing, China
| | - Lili Dai
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
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Newman PA, Guta A. How to Have Sex in an Epidemic Redux: Reinforcing HIV Prevention in the COVID-19 Pandemic. AIDS Behav 2020; 24:2260-2264. [PMID: 32500463 PMCID: PMC7271640 DOI: 10.1007/s10461-020-02940-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Peter A Newman
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S 1V4, Canada.
| | - Adrian Guta
- School of Social Work, University of Windsor, Windsor, ON, Canada
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