# Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV

> **NIH NIH U01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $825,434

## Abstract

Abstract/Project Summary
Cardiovascular disease (CVD) has emerged as an increasingly important cause of morbidity and mortality
among people living with HIV (PLWHIV).
Now that HIV is considered a manageable chronic disease, the
identification and treatment of comorbid medical conditions including CVD are increasingly the focus of
research and clinical attention. What is missing, however, is yet another critical component of care for
PLWHIV: integrated care for histories of trauma. Experiences of trauma increase the likelihood of HIV
infection as well as CVD risk, yet health care for PLWHIV is rarely coordinated to address these three
intersecting issues of HIV, CVD, and trauma, particularly among those disproportionately affected by HIV,
i.e., ethnic minority patients. Histories of trauma among PLWHIV are associated with inconsistent
treatment adherence and non-adherence, and trauma history alone is associated with poor CVD
outcomes. Failure to address trauma poses significant barriers to the adoption of CVD risk strategies
among PLWHIV.
Health systems that coordinate and integrate care across HIV and chronic conditions such
as CVD may provide the infrastructure needed to address the complex interplay of these conditions and their
therapies.
We have designed a novel blended, culturally-congruent, evidence-informed care model,
“Healing our Minds and Bodies” (HMB), to address patients' trauma histories and barriers to care, and to
prepare patients to engage in CVD risk reduction. Recognizing the need to ensure that PLWHIV receive CVD
guideline-concordant care, we have also identified implementation strategies to prepare providers and clinics
for addressing CVD risk among their HIV-positive patients. Therefore,
using a hybrid type II
effectiveness/implementation study design, the goal of this study is to increase both patient and
organizational readiness to address trauma and CVD risk among PLWHIV. The Specific Aims are: (1) to
assess and enhance organizational readiness for addressing trauma and CVD risk among ethnic minority
PLWHIV; specifically, a phased approach will drive the use of implementation strategies designed to educate,
monitor, and support providers and staff in adhering to CVD care guidelines; (2)
u
sing mixed methods, to (a)
evaluate the use and effectiveness of implementation strategies over time, and (b) identify barriers and
facilitators to organizational adoption of guidelines, provider adherence to guidelines, feasibility, and
sustainability; and (3) to evaluate the effect of HMB on cognitive-behavioral, emotional, and physical outcomes
among 260 PLWHIV, specifically patient activation, engagement in care, knowledge of CVD risk, adherence to
clinicians' recommendations, cardiovascular health, mental health symptoms, and satisfaction with care. W
e
will use the RE-AIM framework to guide the evaluation and the Replicating Effective Programs (REP)
Framework to guide the use of implementation strategies and the tailoring of the car...

## Key facts

- **NIH application ID:** 9983489
- **Project number:** 5U01HL142109-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** ARLEEN F. BROWN
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $825,434
- **Award type:** 5
- **Project period:** 2018-08-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9983489

## Citation

> US National Institutes of Health, RePORTER application 9983489, Enhancing patient and organizational readiness for cardiovascular risk reduction among ethnic minority patients living with HIV (5U01HL142109-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9983489. Licensed CC0.

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