Awards for 2023-2024:
General Grant - Yors Garcia, Mariana Tellez, Guillermo Aldana and Sandra Liliana Valderrama
Effectiveness of ACT on quality of life, depression, and adherence in people living with HIV
Lay Summary:
The purpose of this project is to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on depression, quality of life, and medication adherence in people living with HIV/AIDS (PLWHA). PLWHA faces numerous behavioral, mental health, and social challenges associated with their illness. For example, 22% to 61% of PLWHA report symptoms of depression (Du et al., 2023). Depression has been associated with a significant decrease in health-related quality of life (HRQoL; Cooper et al., 2017). Improvements in quality of life for PLWHA reduce the risk for probable infections associated with HIV and improves medication adherence to antiretroviral therapy (ART; Miners et al., 2014). ACT is a process-based intervention that has demonstrated significant improvements in multiple mental health disorders (Gloster et al., 2020), yet the empirical evidence is very limited in increasing health indicators in PLWHA (Moitra et al., 2015; Skinta et al., 2015). Therefore, the main goal of this project is to advance the CBS research in ACT with PLWHA and investigate the impact of ACT in underexplored areas such as depression, quality of life and treatment adherence and evaluate the maintenance of health gains after the end of the intervention. A pretest-posttest design with a waiting list control group will be implemented in this study. A total of 50 HIV/AIDS positive participants will be randomly assigned to two groups, treatment and waiting list control groups. Depression, psychological flexibility, HRQoL and medication adherence measurements will be administered at pretest, posttest, and at 1- and 3-months follow-up. Participants in the treatment group will receive seven ACT sessions covering topics such as acceptance, values, mindfulness and defusion. We expect the treatment group to show significant improvements in the four outcome measures and demonstrate maintenance over time compared to the waiting list group.
General Grant - Jennifer Krafft and Natalie Tadros
Reframing health behavior change: A randomized controlled trial of an RFT-informed values intervention for health
Lay Summary:
Clarification of personal values is a core motivational process in acceptance and commitment therapy (ACT). Values theoretically provide a stable and inexhaustible source of positive reinforcement. Both basic and applied research have demonstrated that values clarification is generally effective at increasing motivation and improving well-being. However, from a process-based framework, it is important not just to know that values clarification is beneficial, but how values clarification can be targeted most efficiently and when values clarification is most likely to be useful. Given the high prevalence and severe impact of lifestyle-related health problems, health behavior change is one area in which enhancing motivation is particularly important. Linking specific health behaviors to personal values through relational framing should theoretically both
increase motivation and make motivation more stable.
Thus, this randomized controlled trial will evaluate the impact of values clarification, implemented over 4 weeks through daily writing exercises in a prototype mobile app, relative to a control intervention that engages in daily writing exercises focused on self-reflection. In order to clarify how to most effectively engage values clarification, we will test the impact of values clarification prompts that employ distinct relational frames (hierarchical, conditional, distinction, and deictic). Participants will be 64 individuals who are interested in improving their health through behavior change and have regular internet access. We hypothesize that using a prototype mobile app focused on values clarification will improve motivation and facilitate health behavior change, and that values clarification will be particularly useful (relative to self-reflection) in the context of stressors or negative affect. This study is consistent with the aims of process-based intervention science, as it both examines a treatment process from a multilevel perspective (i.e., an applied intervention informed by RFT) and explicitly evaluates the contexts in which values clarification is linked to positive outcomes.
Inclusive Science Grant - Miriam N. Mukasa, Joseph Mugarura, Rosco Kasujja and Michael Levin
Cultural adaptation of the ACT Guide for anxiety treatment among college students in Uganda
Lay Summary:
Throughout the world, college/university is a right of passage transition time that comes with great responsibilities, higher academic achievement expectations and change. This can be an especially stressful time for individuals and as a result there are increased levels of stress and anxiety reported. Acceptance and Commitment Therapy (ACT) is an evidence based transdiagnostic intervention that has been proven helpful in the treatment of several disorders including depression and anxiety. There are several gaps in mental health access in sub–Saharan Africa due to shortage of mental health practitioners among other barriers. There is a call for digital mental health programs to address the challenges in providing mental health to the population. To minimize training burden and maximize effectiveness, the ACT guide has been designed as an intervention that offers a single session for anyone with mental distress to access online with an option to get long-term support.
The proposed study aims to contextually adapt the ACT Guide and explore its acceptability amongst Ugandan college students. Using a mixed method design we intend to recruit a total of 100 participants using purposive sampling. Data will be collected using focus group discussions
and surveys.