Role of Resilience in the Psychological Recovery of Women With Acute Myocardial Infarction.

Background Psychological well-being is important among individuals with myocardial infarction (MI) given the clear links between stress, depression, and adverse cardiovascular outcomes. Stress and depressive disorders are more prevalent in women than men after MI. Resilience may protect against stress and depressive disorders after a traumatic event. Longitudinal data are lacking in populations post MI. We examined the role of resilience in the psychological recovery of women post MI, over time. Methods and Results We analyzed a sample from a longitudinal observational multicenter study (United States, Canada) of women post MI, between 2016 and 2020. Perceived stress (Perceived Stress Scale-4 [PSS-4]) and depressive symptoms (Patient Health Questionnaire-2 [PHQ-2]) were assessed at baseline (time of MI) and 2 months post MI. Demographics, clinical characteristics, and resilience (Brief Resilience Scale [BRS]) were collected at baseline. Low and normal/high resilience groups were established as per published cutoffs (BRS scores <3 or ≥3). Mixed-effects modeling was used to examine associations between resilience and psychological recovery over 2 months. The sample included 449 women, mean (SD) age, 62.2 (13.2) years, of whom 61.1% identified as non-Hispanic White, 18.5% as non-Hispanic Black, and 15.4% as Hispanic/Latina. Twenty-three percent had low resilience. The low resilience group had significantly higher PSS-4 and PHQ-2 scores than the normal/high resilience group at all time points. In adjusted models, both groups showed a decrease in PSS-4 scores over time. Conclusions In a diverse cohort of women post MI, higher resilience is associated with better psychological recovery over time. Future work should focus on developing strategies to strengthen resilience and improve psychological well-being for women with MI. Registration URL: https://clinicaltrials.gov/ct2/show/NCT02905357; Unique identifier: NCT02905357.

Participatory Design of a Web-Based HIV Oral Self-Testing Infographic Experiment (HOTIE) for Emerging Adult Sexual Minority Men of Color: A Mixed Methods Randomized Control Trial.

Health communication is a key health promotion approach for translating research findings into actionable information. The purpose of this study was to use participatory design to create and then test the usability and comprehension of an HIV self-testing infographic in a sample of 322 emerging adult, sexual minority men of color. Our study objectives addressed three challenges to HIV self-testing: (1) correct usage of the test stick, (2) understanding the number of minutes to wait before reading the result, and (3) how to correctly interpret a negative or a positive HIV result. This study was a two-phase, sequential, mixed methods, pilot, online, randomized controlled trial. Results suggested a significant mean difference between the control and intervention groups on HIV self-testing knowledge, with the control group outperforming the intervention group. However, two-thirds or better of the participants in the intervention group were able to comprehend the three critical steps to HIV self-testing. This was a promising finding that has resulted in the authors' development of additional recommendations for using participatory design for visual aid development in HIV prevention research. Participatory design of an HIV self-testing infographic is a rigorous approach, as a health communication strategy, to address public health priorities.

Purely Behavioral: A Scoping Review of Nonpharmacological Behavioral and Lifestyle Interventions to Prevent Cardiovascular Disease in Persons Living With HIV.

ABSTRACT: Cardiovascular disease (CVD) is the leading cause of death in the United States, accounting for 900,000 deaths annually. People living with HIV are at a higher risk of developing CVD. We conducted a scoping review guided by the Joanna Briggs Institute Manual for Evidence Synthesis. In July 2020, six databases were searched: PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Web of Science, Embase, and The Cochrane Central Register of Controlled Trials, as well as reference lists of relevant studies and key journals. Our review identified 18 studies that addressed nonpharmacological behavioral interventions into the following: physical activity (n = 6), weight loss (n = 2), dietary interventions (n = 1), and multicomponent interventions (n = 9). In the past 10 years, there has been an increased emphasis on nonpharmacological behavioral approaches, including the incorporation of multicomponent interventions, to reduce cardiovascular risk in people living with HIV. The extant literature is limited by underrepresentation of geographic regions and populations that disproportionately experience CVD.