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联合之声团体歌唱干预措施,以应对 COVID-19 大流行期间老年 HIV 感染者的孤独感和社会隔离问题:干预措施改编研究。

United Voices Group-Singing Intervention to Address Loneliness and Social Isolation Among Older People With HIV During the COVID-19 Pandemic: Intervention Adaption Study.

机构信息

University of California, San Francisco, San Francisco, CA, United States.

Indiana University, Indianapolis, IN, United States.

出版信息

JMIR Form Res. 2024 Oct 8;8:e60387. doi: 10.2196/60387.


DOI:10.2196/60387
PMID:39378071
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11496909/
Abstract

BACKGROUND: People living with HIV experience HIV stigma alongside a spectrum of aging-related health conditions that accelerate their vulnerability to the ill effects of loneliness and social isolation. Group-singing interventions are efficacious in improving psychosocial well-being among older people in the general population; however, the social curative effects of group singing have not been explored in relation to HIV stigma. By promoting group identification, bonding, and pride, group singing may reduce loneliness, social isolation, and other negative impacts of HIV stigma among older people living with HIV. Access to group-singing programs may be enhanced by technology. OBJECTIVE: While group singing has been extensively studied in older adults, group-singing interventions have not been adapted for older people living with HIV to target loneliness and social isolation in the context of HIV stigma. The objective of this study was to describe the systematic development of a group-singing intervention to reduce loneliness and social isolation among older people living with HIV. METHODS: In the San Francisco Bay Area between February 2019 and October 2019, we engaged older people living with HIV in a rigorous, 8-stage, community-engaged intervention adaptation process using the Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT) framework. On the basis of a formative assessment of the needs and preferences of older people living with HIV, we selected an evidence-based group-singing intervention for older adults and systematically adapted the intervention components by administering them to a community advisory council (n=13). RESULTS: The result was United Voices, a 12-week hybrid (web-based and in-person) group-singing intervention for older people living with HIV. United Voices comprises 12 web-based (ie, via Zoom [Zoom Video Communications]) rehearsals, web-based and in-person drop-in helpdesk sessions, and a professionally produced final concert recording. CONCLUSIONS: Through an iterative process and in consultation with stakeholders and topic experts, we refined and manualized United Voices and finalized the design of a pilot randomized controlled trial to evaluate the feasibility and acceptability of the intervention protocol and procedures. The findings provide insights into the barriers and facilitators involved in culturally tailoring interventions for older people living with HIV, implementing intervention adaptations within web-based environments, and the promise of developing hybrid music-based interventions for older adults with HIV.

摘要

背景:艾滋病毒感染者在经历艾滋病毒污名化的同时,还会出现一系列与衰老相关的健康状况,这些健康状况加速了他们受到孤独和社会隔离负面影响的脆弱性。群体歌唱干预在改善普通人群中老年人的社会心理福祉方面是有效的;然而,群体歌唱的社会治疗效果尚未在与艾滋病毒污名相关的问题上得到探索。通过促进群体认同、联系和自豪感,群体歌唱可以减少艾滋病毒感染者中老年人的孤独感、社会隔离感和其他艾滋病毒污名的负面影响。通过技术可以增强群体歌唱计划的可及性。

目的:虽然群体歌唱在老年人中已经得到了广泛的研究,但群体歌唱干预措施尚未针对艾滋病毒感染者进行调整,以针对艾滋病毒污名背景下的孤独感和社会隔离问题。本研究的目的是描述一种群体歌唱干预措施的系统开发过程,以减少艾滋病毒感染者中老年人的孤独感和社会隔离感。

方法:在 2019 年 2 月至 10 月期间,我们在旧金山湾区,使用评估、决策、适应、生产、主题专家、整合、培训和测试(ADAPT-ITT)框架,让 13 名社区顾问委员会成员参与到一个严格的 8 阶段、社区参与的干预措施适应过程中,了解艾滋病毒感染者的需求和偏好。

结果:最终结果是“联合之声”,这是一项针对艾滋病毒感染者中老年人的为期 12 周的混合(基于网络和面对面)群体歌唱干预措施。“联合之声”包括 12 次基于网络的(即通过 Zoom [Zoom Video Communications])排练、基于网络和面对面的求助台会议,以及专业制作的最终音乐会录音。

结论:通过一个迭代过程,并与利益相关者和主题专家协商,我们对“联合之声”进行了改进和规范,并最终确定了一项试点随机对照试验的设计,以评估干预方案和程序的可行性和可接受性。这些发现为文化上调整艾滋病毒感染者的干预措施、在网络环境中实施干预措施适应以及为艾滋病毒感染者中的老年人开发混合音乐干预措施提供了见解。

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本文引用的文献

[1]
Remote Evidence-Based Programs for Health Promotion to Support Older Adults During the COVID-19 Pandemic and Beyond: Mixed Methods Outcome Evaluation.

JMIR Aging. 2024-6-13

[2]
A systematic review and meta-analysis of 90 cohort studies of social isolation, loneliness and mortality.

Nat Hum Behav. 2023-8

[3]
Development of an Economic and Relationship-Strengthening Intervention for Alcohol Drinkers Living with HIV in Malawi.

AIDS Behav. 2023-7

[4]
A Case for Strengths-Based Approaches to Addressing Intersectional Stigma in HIV Research.

Am J Public Health. 2022-6

[5]
Sing4Health: Randomised controlled trial of the effects of a singing group program on the subjective and social well-being of older adults.

Appl Psychol Health Well Being. 2022-2

[6]
HIV Stigma Among a National Probability Sample of Adults with Diagnosed HIV-United States, 2018-2019.

AIDS Behav. 2022-1

[7]
Epigenetic Aging Biomarkers Associated With Cognitive Impairment in Older African American Adults With Human Immunodeficiency Virus (HIV).

Clin Infect Dis. 2021-12-6

[8]
Social Isolation Profiles and Older Adult Substance Use: A Latent Profile Analysis.

J Gerontol B Psychol Sci Soc Sci. 2022-5-5

[9]
Older Adults' Experiences With Using Technology for Socialization During the COVID-19 Pandemic: Cross-sectional Survey Study.

JMIR Aging. 2021-4-23

[10]
Epidemiology of HIV in the USA: epidemic burden, inequities, contexts, and responses.

Lancet. 2021-3-20

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