Evaluating the acceptability and feasibility of a tele-delivered, mindfulness-based cognitive therapy intervention for African American women living with HIV/AIDs in Georgia
Hunter-Jones, Josalin J
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People living with HIV/AIDS experience depression at higher rates than the general population. According to current literature in this area, AAWLWHA tend to have elevated depressive symptoms and also tend to be “silent” about those experiences. Therefore, depression among this group tends to go undiagnosed and untreated. No known interventions specifically address depression among this group. There is a need for evidence-based contextualized interventions specifically addressing depression among HIV-seropositive African American women. Project UPLIFT (UPLIFT), a mindfulness-based cognitive therapy intervention, has been used for both the prevention and treatment of depression among people with epilepsy. The intervention is delivered by phone, cost-effective, and easily adapted for other chronic illness populations. This program provides a novel opportunity for adaptation and evaluation- assessing its potential for improving the mental health of AAWLWHA. This dissertation research involves 1) conducting qualitative data collection via focus groups with both cis- and transgender AAWLWHA in Georgia, and expert review, 2) adapting UPLIFT and related intervention materials, and 3) conducting open trials of UPLIFT with AAWLWHA in Georgia. The overall purpose of the project was to examine the intervention’s acceptability and feasibility with the target group. Minor modifications were made to UPLIFT following qualitative data analysis and information gained during expert review. These changes included modifying language, lowering the overall reading level of teaching content, the inclusion of additional screening criteria such as self-report of vision and hearing ability, modifying a mindfulness exercise, and assuring anonymity during UPLIFT phone sessions. Overall UPLIFT was found to be both acceptable and feasible for cisgender AAWLWHA. Cisgender women who participated in the UPLIFT trial had few to no concerns about the UPLIFT content, though there were concerns about session logistics unrelated to the UPLIFT intervention specifically. Contrastly, and despite high self-reported satisfaction with UPLIFT, process data revealed that the intervention might be less feasible in its current adapted form, for transgender AAWLWHA.