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Adaptive Challenges, Adaptive Work, and Adaptive Leadership Among Women Living With HIV in the Southern United
Donald E Bailey1, Courtney Caiola, Adaora A Adimora
1Donald E. Bailey, Jr., PhD, RN, FAAN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Courtney Caiola, PhD, MPH, RN, CNE, is an Assistant Professor, East Carolina University, School of Nursing, Greenville, North Carolina, USA. Adaora A. Adimora, MD, MPH, is a Sarah Graham Kenan Distinguished Professor of Medicine, School of Medicine, and Professor of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Catalina Ramirez, MPH, CCRP, is a Clinical Research Director, School of Medicine, and Project Director, Women's Interagency HIV Study, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. Lauren Holt, MSN, RN, is a PhD Student, Duke University School of Nursing, Durham, North Carolina, USA. Ragan Johnson, DNP, FNP-BC, CNE, is an Assistant Professor, Duke University School of Nursing, Durham, North Carolina, USA. Amie Koch, DNP, FNP-C, RN, ACHPN, is an Assistant Professor, Duke University School of Nursing, and Palliative Care and Hospice Family Nurse Practitioner, Transitions LifeCare, and a COVID Nurse Practitioner, Lincoln Community Health Clinic, Durham, North Carolina, USA. Kara McGee, DMS, MSPH, PA-C, AAHIVS, is an Assistant Professor, Duke University School of Nursing, Durham, North Carolina, USA. Jacquelyn M. McMillian-Bohler, PhD, CNM, CNE, is an Assistant Professor, Duke University School of Nursing, Durham, North Carolina, USA. Schenita D. Randolph, PhD, MPH, RN, is an Associate Professor, Duke University School of Nursing, Durham, North Carolina, USA. Tiarney D. Ritchwood, PhD, is an Assistant Professor, Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, USA. Michael V. Relf, PhD, RN, AACRN, ACNS-BC, ANEF, FAAN, is Associate Dean for Global and Community Health Affairs, Duke University School of Nursing, and an Associate Professor, Duke Global Health Institute, Durham, North Carolina, USA.
Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions.
Women living with HIV have a higher burden of non-AIDS comorbidities and prevalence of chronic conditions. The Adaptive Leadership Framework for Chronic Illness clarifies living with complex health challenges by delineating the technical work of health care providers as well as the adaptive work and leadership behaviors of patients and their providers. We conducted a descriptive, qualitative study of women residing in the Southern United States who were participating in the Women's Interagency HIV Study in North Carolina. Twenty-two participants (mean age = 52.2 years; 90.9% self-identifying as Black or African American) completed semi-structured qualitative interviews. We identified adaptive challenges (e.g., affective and disclosure challenges) and adaptive work and leadership behaviors. Women learned skills to care for their health and support their families and to work with their providers to manage their care. Findings support the importance of identifying leadership behaviors for the purpose of developing person-centered interventions.
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