mLab App for Improving Uptake of rapid HIV self-testing and Linking Youth to Care

mLab 应用程序可提高艾滋病毒快速自我检测的采用率并将青少年与护理联系起来

• 批准号: 10160957
• 负责人: Robert Garofalo
• 金额: $ 81.58万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-03 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10160957
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Africa; Age; Algorithms; Awareness; Back; Car Phone; Caring; Cellular Phone; Cessation of life; Continuity of Patient Care; Data; Data Collection; Death Rate; Detection; Development; Devices; Diagnosis; Diagnostic; Discrimination; Engineering; Enrollment; Epidemic; Evaluation; Feedback; Future; Gender; Goals; HIV; HIV Seropositivity; Health; Health Technology; Healthcare Systems; Home; Homophobia; Human immunodeficiency virus test; Image; Individual; Infection; Intervention; Lateral; Latino; Link; Malaria; Methods; Modeling; Monitor; New York City; Notification; Outcome; Perception; Persons; Preventive care; Process; Public Health; Randomized; Reporting; Research; Risk; Scientist; Secure; Sensitivity and Specificity; Sex Orientation; Signal Transduction; Site; Socioeconomic Factors; Stigmatization; Technology; Test Result; Testing; Time; Treatment outcome; United States; Ursidae Family; Visual; Work; Youth; acceptability and feasibility; age group; arm; base; care outcomes; computer human interaction; connected health; cost; design; digital; disenfranchised population; efficacious intervention; efficacy evaluation; ethnic minority population; follow-up; group intervention; health information technology; high risk; image processing; improved; improved outcome; innovation; iterative design; lateral flow assay; mHealth; member; mobile computing; multi-site trial; multidisciplinary; next generation; novel diagnostics; prevention service; preventive intervention; racial minority; racism; response; self testing; sexual minority; smartphone Application; social; social factors; social stigma; standard of care; study population; testing services; tool; transgender women; transmission process; uptake; usability; user centered design; wireless fidelity; young man; young men who have sex with men

The number of youth living with HIV continues to rise, and they are disproportionately represented at each stage of the care continuum. Most relevant to this application, it is estimated that less than half of HIV-infected youth in the United States (US) have been diagnosed with HIV, and AIDS-related deaths among youth have increased over the past decade despite decreased death rates among all other age groups, pointing to the urgent need for increased testing among youth. Black and Latino youth are at increased risk of poor HIV-related outcomes and have disparate testing rates as compared to White youth. Mobile Health (mHealth) technology is a powerful and relevant tool which represents a promising approach for improving outcomes among youth living with HIV. Youth are avid adopters and heavy users of smartphones and digital technologies, and these technologies offer opportunities to tailor interventions to developmental stages and personal needs. Importantly, these technologies are capable of delivering interventions in real-time and in ecologic settings. This creates an opportunity to remotely reach youth through mobile and connected health approaches to strengthen their HIV care continuum engagement and treatment outcomes. In response, our study team has developed the mLab App, an innovative mobile and connected technology that combines HIV prevention information with push notifications/reminders to complete HIV testing and an automated image processing feature to provide accessible, objective, secure, and real-time feedback on home-based OraQuick (lateral flow assay) HIV test results. The mLab App also contains an innovative automated data collection and a results reporting feature. Findings from our preliminary work in New York City indicate that youth perceive the mLab App as useful, easy to use, and effective at improving health outcomes and intend to use the technology. Findings from our preliminary work in Africa support the sensitivity and specificity of the imaging algorithm for interpreting lateral flow assay results. Theoretically-guided by the Health Information Technology Usability Evaluation Model (Health-ITUEM), the proposed project will refine and test a next- generation diagnostic intervention delivered on a mobile platform to improve HIV testing and linkage-to-care outcomes among youth living with and at-risk for HIV. Well in line with the objectives of RFA-MH-18-606, we will conduct a careful, iterative process of technology refinement based on input from end users, experts, and our youth advisory board. We will then enroll 500 high-risk youth (age 17-29 years) in a 12-month RCT to assess differences in HIV testing rates and linkage to care between the intervention (mLab App) and control arm. Finally, we will analyze paradata, defined as auxiliary data that capture details about the process of interaction with the technology, to understand the effect of user engagement of the mLab App on improving HIV testing rates and linkage to care. Interventions delivered through mHealth technology represent a promising approach for improving outcomes among youth. Given the pervasiveness, low cost, and convenience of mobile technology, the mLab App holds promise to help achieve the goals of the National HIV/AIDS Strategy in the US by increasing the number of persons living with HIV who know their serostatus, decreasing HIV-related disparities, and ultimately reducing the risk of HIV transmission and acquisition.

艾滋病毒感染的青年人数继续增加，在 关心连续体。与该应用程序最相关，据估计，曼联不到一半的HIV感染青年 在过去的十年中 尽管所有其他年龄段的死亡率都降低，但指出迫切需要增加青少年的测试。 黑人和拉丁裔青年的风险增加了与HIV相关结果不佳的风险，并且与相比的测试率不同 白人青年。移动健康（MHealth）技术是一种强大且相关的工具，代表了一种有前途的方法 用于改善艾滋病毒青年的结果。年轻人是狂热的采用者和智能手机的重型用户 数字技术和这些技术为开发阶段的干预提供了机会 个人需求。重要的是，这些技术能够实时进行干预措施 设置。这创造了通过移动和连接的健康方法远程吸引青年的机会 加强他们的艾滋病毒护理连续性参与和治疗结果。作为回应，我们的学习团队开发了 MLAB应用程序，一种创新的移动和互联技术，将艾滋病毒预防信息与PUSH相结合 通知/提醒以完成HIV测试和自动图像处理功能，以提供可访问的 对基于家庭的Oraquick（横向流量测定）HIV测试结果的目标，安全和实时反馈。 MLAB应用 还包含创新的自动数据收集和结果报告功能。我们初步工作的发现 在纽约市，年轻人认为MLAB应用程序是有用的，易于使用的，并且有效地改善了健康 结果并打算使用该技术。我们在非洲初步工作中的发现支持敏感性和 成像算法的特异性用于解释横向流量测定结果。理论上由健康引导 信息技术可用性评估模型（卫生学院），拟议的项目将完善并测试下一步 在移动平台上提供的一代诊断干预措施，以改善HIV测试和连接到保健结果 在与艾滋病毒的年轻人和危险中的青年中。与RFA-MH-18-18-606的目标一致，我们将进行 根据最终用户，专家和我们的青年顾问委员会的意见，谨慎地迭代技术精致过程。 然后，我们将在12个月的RCT中注册500名高风险青年（17-29岁），以评估HIV测试率的差异 与干预措施（MLAB应用程序）和控制臂之间的护理联系。最后，我们将分析Paradata，定义为 辅助数据捕获有关与技术交互过程的详细信息，以了解用户的效果 MLAB应用程序参与改善HIV测试率和与CARE的联系。进行干预措施 MHealth技术是改善青年结果的有前途的方法。考虑到普遍性，低 MLAB应用程序的成本和便利性，有望帮助实现国家的目标 通过增加与艾滋病毒的人数，了解他们的血清，减少艾滋病毒/艾滋病策略 与HIV相关的差异，并最终降低了HIV传播和获取的风险。