Peer MODELS: (Managing a Community-based HIV, Diabetes, and pain intervention that Encourages healthy Living and provides Support), for PWH and T2D in the setting of chronic pain

Kristen Allen-Watts, Ph.D.
University of Alabama at Birmingham

This project focuses on improving patient reported outcomes (e.g., physical activity, functional status, quality of life) for people living with HIV (PWH) and diabetes in the setting of chronic pain. This research is important because: 1) few investigators have examined the similarities and complex duality of condition specific self-management behaviors for co-morbid HIV and diabetes, which, left untreated, increases risk of morbidity and mortality from cardiovascular disease; and 2) there are no interventions that simultaneously address the dual diagnosis of HIV and diabetes in the context of chronic pain, which acts as a barrier to self-management and increases the risk of mood or anxiety disorders, physical and emotional disability, and other poor health outcomes. Therefore, the development of this theory-based intervention, Peer MODELS: (Managing a COmmunity-based HIV, Diabetes, and pain intervention that Encourages healthy Living and provides Support), for PWH and diabetes in the setting of chronic pain can provide foundational knowledge in understanding the unique self-management needs of PWH, diabetes, and chronic pain and better inform researchers and clinicians on best practices for managing the burden of co-morbidities in PWH.

This sequential explanatory study design is guided by principles of the Cognitive Behavioral Theory and constructs from the Anderson’s Sociobehavioral Model of Health Services Utilization. We will use intervention mapping to systematically develop a peer-led, cognitive behavioral therapy (CBT) intervention for PWH and diabetes in the setting of chronic pain by leveraging the pre-existing and well-established data from the CFAR Network of Integrated Clinical Systems (CNICS) to analyze data collected by CNICS to 1) identify the prevalence of co-morbid diabetes and pain among PHW; and 2) identify factors associated with dual prevalence of diabetes and pain in PWH. Sequentially, we will recruit and interview study participants by utilizing resources from the UAB HIV Research and Informatics Service Center (RISC) at the UAB HIV clinic to further understand 1) facilitators and barriers as well as 2) perceptions, attitudes, and beliefs about the co-occurrence of diabetes, HIV, and pain. Lastly, we will meet with the Patient Advisory Board at the CFAR and trusted members of Connection Health to elicit feedback to develop an engaged CBT intervention for PWH and diabetes in the setting of chronic pain.