Optimizing Resilience and Coping in HIV Via Internet Delivery

Study Overview
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Brief Summary
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This is a feasibility/pilot test of a set of positive affect skills provided online to HIV positive people with elevated depressive symptoms - a Center for Epidemiological Studies Depression Scale D (CES-D) score > 10. The investigators will test the feasibility of recruitment, retention and acceptability of these skills in an online delivery format, determine feasibility and acceptability of daily emotion assessments via text messaging and assess efficacy of these skills for improving psychological well-being this population.

Official Title
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Optimizing Resilience and Coping in HIV Via Internet Delivery

Conditions
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HIV Disease, Depression, Affect, Psychological Stress

Intervention / Treatment
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* Behavioral: Intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: HIV + 18 or older Score of CES-D depression scale >10 Daily internet access Smart phone ownership Exclusion Criteria: -

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention<br>Participants receive a five week intervention providing the following activities: EMA: Ecological Momentary Assessment (EMA) of Emotion throughout the day. Intervention: Positive Events: Participants identify a positive event and then describe how they capitalized on this event. Gratitude: Participants identify one more more things that make them feel grateful. Mindfulness: Participants participate in a 30 minute guided mindfulness/meditation practice. Positive Reappraisal: Participants identify how they reappraised a negative event making it into a positive event. Personal Strengths: Participants identify one more more personal strengths. Attainable goals: Participants identify a short-term attainable goal. Participants will outline what they did that day to work toward attaining their week's goal. Acts of Kindness: Participants will identify one more more acts of kindness that they engaged in and how it made them feel. | Behavioral: Intervention<br>* Positive Affect Skills Training<br>|
| No Intervention: Emotion reporting and EMA notification<br>Participants report emotions and receive EMA (ecological momentary assessment) text messages on the same regular basis as intervention participants, but receive no interventions. EMA detail: Ecological Momentary Assessment (EMA) of Emotion throughout the day. We will assess current emotions via email or text message 4 times per day, 2 days per week (one randomly selected week/work day and one randomly selected weekend/non-work day) during the 8 week study period, for a total of 16 days of EMA reporting. Participants will be asked to rate how much they are currently feeling several positive and negative emotions that have been associated with mortality and health: happy, excited, content, appreciative, sad, worried, and fearful. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Acceptability of ORCHID content | We will track participation in both the self-report questionnaires as well as the intervention sessions (e.g., number of ORCHID sessions completed, amount of home practice completed). We will carefully track usage - noting when participants who leave the study drop out to determine if there are particular sessions that are less acceptable than others. | 5 weeks post enrollment. May be slightly more or less for intervention participants depending on time taken to complete online content. | 
| Retention of participants in online delivery format. | We will track, for each participant who completes a screening questionnaire, where they heard about the study and the proportion who go on to enroll. We will track retention - noting when participants drop out to determine if particular sessions or activities result in less retention than other areas. | 5 weeks post enrollment. May be slightly more or less for intervention participants depending on time taken to complete online content. | 
| Feasibility of an online delivery format. | We will follow up with participants who have significant missing data to determine areas in which the protocol is feasible and to highlight areas for improvements. We will summarize participant feedback regarding the protocol and will use this feedback to inform the subsequent proposals. | 5 weeks post enrollment. May be slightly more or less for intervention participants depending on time taken to complete online content. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Determine acceptability of multiple daily emotion assessments using text messaging. | To measure this outcome, we will first document if anyone declines participation due to the perceived burden of the Ecological Momentary Assessment (EMA) protocol. We will carefully document adherence to the protocol and the proportion of assessments that participants complete. In the follow-up interviews, we will have questions specific to the EMA protocol to elicit feedback and suggestions for improvement | 5 weeks post enrollment. May be slightly more or less for intervention participants depending on time taken to complete online content. |