For people living with HIV and AIDS (PLWHA), life stress often undermines quality of life and interferes with medical care. Stress management interventions seek to help PLWHA to cope more adaptively with life stressors. Recently, mindfulness-based interventions have been implemented in the context of chronic illness. Mindfulness training (MT) involves teaching people to focus their attention on both internal (e.g., sensations, thoughts, emotions), and external (e.g., sounds) events unfolding in the present, in a non-judgmental way. Overall, extant studies of MT in the context of HIV disease provide some evidence of benefit. However, many of these studies have been limited methodologically by small sample sizes, low numbers of female participants, non-random assignment, inadequate comparison conditions, and relatively short follow-ups.
Given these feasibility challenges, researchers were interested in exploring the adaptation of MT to the unique needs of PLWHA. This study, authored by Dr. Rochelle K. Rosen, assistant professor of behavioral and social sciences, sought to explore telephone delivery as a potentially more feasible approach of MT. The team used an innovative 360° qualitative inquiry to seek input regarding telephone-delivery of MT for PLWHA in advance of a planned intervention trial. They also sought input on a time- and attention-matched control. Ultimately, this research aimed to inform both the intervention adaptation and the planned trial.
Twenty-five HIV patients, providers and advocates, were recruited to five focus groups. A semi-structured research agenda was developed to guide focus group discussions consistent with recommendations for adapting an intervention using qualitative research. Focus groups were led by a trained qualitative facilitator. Topics that were prioritized included (1) implementation of a mindfulness intervention (e.g., prior knowledge and/or understanding of mindfulness, ways to “market” the intervention, ways to adapt the intervention for PLWHA), (2) development of a health coaching (control) condition, and (3) determining how to deliver these interventions by telephone (e.g., patterns of telephone use and telephone-based intervention delivery).
Results indicated that participants understood the construct of mindfulness and recognized its potential benefits for stress management and improving medication adherence. Patients preferred the term “mindfulness” to meditation. Telephone-delivery appealed to all patients but several challenges were raised. Topics for the control intervention included nutrition, sleep, and aging. The 360° approach allowed three groups (patients, providers, advocates) to influence intervention development.
“Telephone-Delivered Mindfulness Training for People Living with HIV: A Qualitative 360° Inquiry” was published in August in Aids and Behavior.