Women Focused Encounters for Resilience Independence Strength and Eudaimonia

NCT ID: NCT06216600

Last Updated: 2024-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

300 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-19

Study Completion Date

2028-05-31

Brief Summary

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The goal of this combination Type 1 hybrid and observational study is to evaluate the impact of a peer delivered intervention of acceptance and comittment therapy(ACT) + exercise + social support to address the substance (ab)use, violence, and AIDS/HIV (SAVA) to improve medication adherence for women living with HIV (WLWH). This intervention will be implemented by community based organizations that focus on WLWH across four counties. The main question it aims to answer are:

* Will peer provision of ACT, exercise, and social support improve medication adherence for WLWH?
* Will community based organizations be able to sustain the intervention after research is completed, and what changes will need to be made to sustain th eintervention.

Detailed Description

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In the U.S. women living with HIV (WLWH) are less likely to engage in HIV care, be on antiretroviral therapy (ART), and achieve sustained viral suppression compared to men. The Substance (Ab)use, Violence/trauma, and HIV/AIDS (SAVA) syndemic is proposed to primarily contribute to gender-based differences in HIV outcomes.To meaningful address SAVA requires interventions that focus on each epidemic and transdiagnostic processes (shared mediators) including mood (depression/anxiety), HIV stigma, and loneliness. The Women focused Encounters for Resilience, Independence, Strength, and Eudaimonia (WE RISE) intervention addresses SAVA by employing peer navigator (PN) delivered group-based acceptance and commitment therapy (ACT) + exercise + empathetic social support.

The goal of this proposal is to evaluate and implement WE RISE for WLWH across four sites in Ending the HIV Epidemic (EHE) jurisdictions (San Diego, CA; Charlotte, NC; Atlanta, GA and Los Angeles, CA). This study is guided by a study advisory board (SAB) of 12 women living with and/or otherwise affected by HIV.

At each site peers will be trained at the University of California San Diego (UCSD) to provide ACT, exercise and social support thorugh didactic and experiential experiences and a workbook that guides them through the intervention. WE RISE delivery will be monitored by experts at UCSD and peers provided feedback through 6 months to encourage the devleopment of mastery.

The first phase of WE RISE is a type 1 hybrid study that will involve randomizing participants 1:1 to the WE RISE intervention or a local curated list of resources that focus on providing HIV care, therapy, exercise and social support. All participants in this phase will undergo assessments (HIV adherence, trauma symptoms, substance use, depression, anxiety, loneliness and others) at weeks 0, 8 (end of interveniton), 24 and 48. All participants in this arm will also receive a Fitbit to track objective activity (e.g. step counts).

This phase will pursue the following Aims:

Aim 1: Evaluate short (week 8) and longer term (weeks 12, 24) effectiveness of WE RISE on HIV (↑ ART adherence, ↑ continuous viral suppression), trauma (↓ trauma symptoms), substance use (↓ days and amount of substance use) and transdiagnostic factors such as mood (↓depression, ↓anxiety), stigma and loneliness.

Aim 2: Document the WE RISE implementation process by characterizing reach, effectiveness, adoption, implementation and maintenance (RE-AIM) by site for 24 weeks.

Phase 2 of WE RISE is an observational study that will focus on sustainability of WE RISE once research funding is completed. We will encourage our partnering community based organizations to adapt WE RISE as they see fit to enable them to continue to provide the intervention. Participants will undergo the same assessment schedule as in phase 1. In this phase, the study team will continue to observe and document the intervention for adaptations made and persistence of intervention fidelity.

This phase will focus on Aim 3.

Aim 3: Transcreate alternate or additional IS that address site specific barriers and facilitators to optimize the effectiveness, maintenance and broader dissemination of WE RISE at 24 weeks while documenting the implementation process (RE-AIM) and site-specific adaptations using the Framework for Recording Adaptations and Modifications-Enhanced (FRAME) through 48 weeks.

Conditions

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HIV Infections Substance Use Trauma Medication Adherence

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Type 1 hybrid study randomizing particpants 1:1 to either WE RISE or control (list of resources). Followed by one arm observational study.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors
Study investigators and outcomes assessors will be blinded.

Study Groups

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WE RISE Intervention

Participants will undergo WE RISE intervention: twice a week for 8 week combination delivery of acceptance and commitment therapy + exercise + social suppot.

Group Type EXPERIMENTAL

Acceptance and Commitment Therapy (ACT)

Intervention Type BEHAVIORAL

Participants will undergo ACT in combination with exercise and social support.

Body weight circuit training

Intervention Type BEHAVIORAL

Participants will learn and undergo body weight circuit training in combination with ACT and social support.

Empathetic social support

Intervention Type BEHAVIORAL

Study participants will participate in empathetic social support

Control

Participants will receive standard of care which would be referrals to local opportunites for therapy, exercise and social support.

Group Type ACTIVE_COMPARATOR

Control - list of resources

Intervention Type OTHER

A local list of resources to access exercise, therapy and social support will be provided.

Observational

Observational study of participants undergoing WE RISE adapted for sustainability.

Group Type EXPERIMENTAL

Acceptance and Commitment Therapy (ACT)

Intervention Type BEHAVIORAL

Participants will undergo ACT in combination with exercise and social support.

Body weight circuit training

Intervention Type BEHAVIORAL

Participants will learn and undergo body weight circuit training in combination with ACT and social support.

Empathetic social support

Intervention Type BEHAVIORAL

Study participants will participate in empathetic social support

Interventions

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Acceptance and Commitment Therapy (ACT)

Participants will undergo ACT in combination with exercise and social support.

Intervention Type BEHAVIORAL

Body weight circuit training

Participants will learn and undergo body weight circuit training in combination with ACT and social support.

Intervention Type BEHAVIORAL

Empathetic social support

Study participants will participate in empathetic social support

Intervention Type BEHAVIORAL

Control - list of resources

A local list of resources to access exercise, therapy and social support will be provided.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Is female sex at birth (cis-women)
2. Able to read and understand English
3. Able to participate in a low intensity exercise program
4. HIV-seropositive
5. At risk substance use (any illegal or unprescribed drug), tobacco, marijuana or alcohol use (four or more drinks in one day or 8 or more in one week).
6. Reports missing more ART doses than previous months, or \> 5 in a month, or has a detectable HIV viral load
7. Experienced interpersonal violence
8. Able and willing to provide informed consent
9. Confirmed COVID-19 vaccinated x 2 or willingness to wear a mask during inperson interactions.

Exclusion Criteria

1. Unwilling to participate in video record sessions (used to evaluate the quality of the intervention)
2. Enrolled in hospice
3. Not willing or not able to comply with study advisory board group participation agreement.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Christie's Place

OTHER

Sponsor Role collaborator

By His Stripes Wellness Center

OTHER

Sponsor Role collaborator

Sister Love

OTHER

Sponsor Role collaborator

APLA Health

UNKNOWN

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

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Maile Young Karris

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Maile Karris, MD

Role: PRINCIPAL_INVESTIGATOR

UCSD

Locations

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UC San Diego AntiViral Research Center (AVRC)

San Diego, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Liliana Harkness

Role: CONTACT

Phone: 619-543-4753

Email: [email protected]

Helene Le

Role: CONTACT

Phone: 619-543-3116

Email: [email protected]

Facility Contacts

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Liliana Harkness

Role: primary

Emily Kvitek

Role: backup

Other Identifiers

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808061

Identifier Type: -

Identifier Source: org_study_id