Testing the Efficacy of 2 Interventions to Improve Health Outcomes and Quality of Life Among Rural Older Adults Living With HIV: Protocol for a Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: Rural people living with HIV in the United States have higher mortality rates and lower rates of HIV suppression compared to nonrural people living with HIV. In addition, compared to younger people living with HIV, older people living with HIV face numerous challenges to maintaining health and well-being. However, few interventions have targeted health or quality-of-life outcomes in rural older people living with HIV. OBJECTIVE: This randomized controlled trial will evaluate the efficacy of 2 remotely delivered interventions-supportive-expressive peer social support groups and strengths-based case management-to improve viral suppression, medication adherence, quality of life, and depressive symptoms in people living with HIV aged >50 years in rural counties in the southern United States. METHODS: We will enroll 352 rural older (aged >50 y) people living with HIV and test the interventions using a 2 (social support groups: yes or no) × 2 (strengths-based case management: yes or no) factorial design. Supportive-expressive peer social support groups aim to increase social support and lower HIV stigma, thereby improving HIV health outcomes and quality of life. Trained facilitators will deliver the 8 weekly sessions with a set curriculum to groups of 8 to 12 participants via videoconference. Strengths-based case management is an individual-level, individually tailored intervention delivered by trained staff. Over 5 sessions, the participant-staff duo selects a barrier impacting HIV care or quality of life and identifies short-term goals to overcome the barrier, focusing on the process of incremental problem-solving while recognizing accomplishments. We will assess HIV viral load-using participant-collected dried blood spot samples-at baseline and 8 and 12 months after the intervention. Using surveys, we will assess adherence, quality of life, depressive symptoms, and secondary outcomes at baseline and 4, 8, and 12 months after the intervention. We hypothesize that participants randomly assigned to each intervention will be more likely to be virally suppressed and adherent to antiretroviral therapy and have higher quality of life and fewer depressive symptoms at follow-up than those not assigned to each intervention. Secondary hypotheses are that, compared to those not receiving each intervention, participants in each intervention will report greater social support, self-efficacy, and likelihood of accessing needed services; less loneliness and internalized HIV stigma; and fewer structural barriers. Data will be analyzed using generalized linear mixed models. RESULTS: Funded in April 2023, the study began enrollment in April 2024, with 177 participants having given consent by July 2025. Data collection will run through 2027 followed by analysis and publication by 2028. CONCLUSIONS: This study will evaluate 2 remotely delivered interventions for rural older people living with HIV for their effects on HIV health outcomes, quality of life, and depressive symptoms. If effective, these scalable interventions could improve outcomes for this growing population. TRIAL REGISTRATION: ClinicalTrials.gov NCT06269081; https://www.clinicaltrials.gov/study/NCT06269081. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/71429.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,065 | 0,056 |
| Méta-épidémiologie (sens strict) | 0,011 | 0,006 |
| Méta-épidémiologie (sens large) | 0,021 | 0,012 |
| Bibliométrie | 0,005 | 0,006 |
| Études des sciences et des technologies | 0,007 | 0,007 |
| Communication savante | 0,007 | 0,007 |
| Science ouverte | 0,006 | 0,004 |
| Intégrité de la recherche | 0,013 | 0,016 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,095 | 0,017 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».