Developing a Resilience-Enhancing Intervention to Improve COPD-Related Outcomes in People with COPD and HIV - PROJECT SUMMARY/ABSTRACT The overall objective of this K99/R00 application is to provide the training and research experiences necessary for Dr. Jun Yeong Byun to transition to an independent investigator and build a program of research developing, implementing, and testing behavioral interventions to improve health outcomes for people with chronic obstructive pulmonary disease (COPD) and HIV. COPD is a leading cause of morbidity and mortality, and its burden is disproportionately greater among people with HIV, who develop disease earlier, experience more frequent exacerbations, and report higher levels of depression and poorer quality of life. Surprisingly, in the absence of curative treatment for COPD, few behavioral strategies exist to support people with COPD and HIV in managing their symptoms and preventing disease progression. Behavioral interventions focused on improving resilience, defined as the capacity to adapt to and recover from adversity, offer a promising, scalable pathway to improving health. Preliminary evidence from Dr. Byun and others suggests that resilience moderates the relationship between respiratory and depressive symptoms in people with COPD and HIV, underscoring its potential as an intervention target. The research objective of this K99/R00 is to adapt and pilot test the Relaxation Response Resiliency Program (3RP), a structured, evidence-based intervention that integrates relaxation training, cognitive-behavioral strategies, and positive psychology. Although the 3RP has demonstrated efficacy across populations with chronic diseases, including HIV, it has not been adapted for the unique challenges of COPD in people with HIV. In the K99 phase (Aim 1), Dr. Byun will conduct qualitative interviews with people with COPD and HIV and healthcare providers to identify barriers, facilitators, priorities, and recommendations for adapting the 3RP. In the R00 phase (Aim 2), we will iteratively refine the adapted 3RP using an open pilot study design, and in Aim 3, we will evaluate the feasibility, acceptability, and preliminary impact of the adapted 3RP via a pilot randomized controlled trial. This work will generate essential preliminary data and an intervention protocol directly supporting a fully powered R01 efficacy trial. The training objectives of this K99/R00 are to provide Dr. Byun with advanced expertise in resilience research, qualitative research methodologies, and behavioral intervention adaptation and pilot testing, while strengthening professional skills in grant writing and leadership. The proposed training will occur within a highly supportive research environment at the University of Alabama at Birmingham, with mentorship from experts in HIV, COPD, behavioral interventions, and implementation science. The expected outcomes are a rigorously adapted, resilience-enhancing intervention and the research capacity to sustain an independent, NIH-funded program. This work directly aligns with NIH’s HIV research priorities to address HIV-associated comorbidities.
