Health Unit, RAND Corporation.
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School.
Cultur Divers Ethnic Minor Psychol. 2018 Oct;24(4):541-551. doi: 10.1037/cdp0000205. Epub 2018 Jun 14.
Discrimination is associated with worse health. Although interventions have been developed to improve coping with general stressors and chronic illness, no literature to date has reported the development and testing of an intervention specifically to address coping with discrimination. We examined the feasibility, acceptability, and preliminary effects of Still Climbin', a pilot intervention created to improve coping with discrimination experienced by HIV-positive Black sexual minority men, who face significant HIV-related disparities.
Still Climbin' was culturally tailored using community stakeholder input and formative qualitative research. Still Climbin' consists of 8 weekly group sessions and a graduation session, based on principles of cognitive behavior therapy. Sixty-four HIV-positive Black sexual minority men were recruited from community venues; 38 were randomized to the intervention and 26 to a wait-list control group. Participants completed assessments at baseline and 3- and 6-months postbaseline. Intervention participants completed postsession feedback forms.
Repeated-measures regressions indicated significant intervention effects on improved coping in response to discrimination, including functional (problem-solving) coping [b (SE) = 0.39 (0.19), p = .04], humor [b (SE) = 0.48 (0.22), p = .03], and cognitive/emotional debriefing [b (SE) = 0.30 (0.14), p = .04], a culturally relevant form of coping that includes self-protective strategies (e.g., strategic avoidance of certain places or people). Intervention participants rated the sessions positively in response to closed- and open-ended questions.
Still Climbin' was feasible and acceptable to participants, and showed promise for improving coping with discrimination, which ultimately can lead to better health outcomes and reduced disparities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
歧视与健康状况恶化有关。尽管已经开发出干预措施来改善应对一般压力源和慢性疾病的能力，但迄今为止，尚无文献报道专门针对应对歧视的干预措施的开发和测试。我们检查了 Still Climbin'的可行性、可接受性和初步效果，这是一种针对感染艾滋病毒的黑人男同性恋者的试点干预措施，他们面临着与艾滋病毒相关的巨大差异。
Still Climbin' 是根据社区利益相关者的投入和形成性定性研究进行文化调整的。Still Climbin' 由 8 个每周小组会议和一个毕业会议组成，基于认知行为疗法的原则。从社区场所招募了 64 名感染艾滋病毒的黑人男同性恋者；其中 38 名被随机分配到干预组，26 名被分配到等待名单对照组。参与者在基线和基线后 3 个月和 6 个月进行评估。干预组的参与者完成了课后反馈表。
重复测量回归表明，干预对应对歧视的应对能力有显著影响，包括功能性（解决问题）应对[ b（SE）= 0.39（0.19），p =.04]、幽默[b（SE）= 0.48（0.22），p =.03]和认知/情绪疏泄[b（SE）= 0.30（0.14），p =.04]，这是一种文化相关的应对方式，包括自我保护策略（例如，有策略地避免某些地方或人）。干预组参与者在对封闭式和开放式问题的回答中对课程给予了积极评价。
Still Climbin' 对参与者来说是可行和可接受的，并显示出改善应对歧视的潜力，这最终可以导致更好的健康结果和减少差异。（PsycINFO 数据库记录（c）2018 APA，保留所有权利）。
