A mobile phone intervention using a relational human talking Avatar to promote multiple stages of the HIV Care Continuum in African American MSM

使用关系型人类说话头像进行手机干预，以促进非裔美国 MSM 的艾滋病毒护理连续体的多个阶段

• 批准号: 10318520
• 负责人: Mark S Dworkin
• 金额: $ 74.24万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-02-11 至 2023-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10318520
• 关键词: Adherence; Affect; Age; Anti-Retroviral Agents; Appointment; Awareness; Behavior; Behavioral; Car Phone; Caregivers; Caring; Case Manager; Chicago; Cities; Clinic; Collaborations; Continuity of Patient Care; Control Groups; Data; Development; Disease; Empathy; Failure; Feedback; Female; Focus Groups; Food Safety; Frequencies; Funding; HIV; HIV Infections; HIV Seropositivity; Health; Hearing; Home; Human; Individual; Intervention; Knowledge; Measures; Medical center; Mississippi; Modeling; Motivation; Outcome; Participant; Patients; Persons; Pharmaceutical Preparations; Pilot Projects; Population; Prevention Research; Privacy; Privatization; Public Health; Randomized; Randomized Controlled Clinical Trials; Risk; Self Efficacy; Source; Telephone; Testing; Therapeutic; United States National Institutes of Health; Universities; Viral; Viral Load result; Work; antiretroviral therapy; attentional control; base; black men who have sex with men; care providers; clinical care; efficacy testing; follow-up; health literacy; improved; improved outcome; infection rate; innovation; intervention participants; literacy; medication compliance; men; men who have sex with men; mortality; phrases; response; scale up; skills; social stigma; theories; therapy adherence; transmission process; treatment research; wireless sensor

ABSTRACT: HIV-positive African American men who have sex with men (AAMSM) have the lowest percentage of retention in care and are less likely to have viral suppression, an outcome that relies on antiretroviral therapy (ART) adherence. This proposal focuses on an innovative theory-driven intervention aimed at helping to improve outcomes for AAMSM targeting 3 stages of the HIV Care Continuum, (1) retention, (2) adherence to antiretroviral medication, and (3) viral suppression. My Personal Health Guide is an innovative talking relational human Avatar mobile phone application to engage HIV-positive AAMSM in adherence and retention in care. Development of this app was informed by the Information Motivation Behavioral Skills Model that focuses on feedback between information and motivation that affect one's behavioral skills, behaviors, and desired health outcomes. In the privacy of the user's home or anywhere they have their phone, the Avatar can encourage healthy behavior, acknowledge stigma and speak with empathy, audibly teach persons with low literacy, employ credible culturally appropriate phrasing, and invite the user to hear advice and motivational stories of other HIV-positive people and their caregivers. A pilot study in HIV- positive AAMSM ages 18-34 years demonstrated acceptability, enthusiasm for the app, and preliminary efficacy. As part of a collaboration between UIC, Emory University, and the University of Mississippi Medical Center, we propose to test the efficacy of the My Personal Health Guide Avatar application for young HIV- positive AAMSM. In this 5-year study, the application will be refined based on pilot data (Aim 1) and then 250 HIV-positive AAMSM between the ages of 18-34 years with detectable viral load at baseline will be randomized to the My Personal Health Guide Avatar application or a food safety Avatar application control intervention for a 6-month period (Aim 2). Wirelessly monitored ART adherence will be collected for 1-month at baseline and then wirelessly monitored ART adherence, viral load, and clinic appointment data will be collected throughout the 6-month follow-up period. We hypothesize that participants in the My Personal Health Guide intervention will demonstrate significant improvements in ART adherence, viral load, and retention in care during the follow- up period compared to control participants. We will also identify mobile phone application functions that are associated with improvement in adherence in order to inform refinement of the application (Aim 3). We hypothesize that more frequent use of Avatar information functions that included motivational messages will be associated with improved ART adherence. This proposal is innovative in that it launches a new direction in prevention and treatment research for young AAMSM, a population at increased risk for therapeutic failure and poor retention in care, by using a relational talking human Avatar in a mobile phone to overcome the impact of stigma and literacy on engagement with clinical care. If the My Personal Health Guide intervention is demonstrated to be effective, it may be quickly scaled up for wide-scale dissemination.

摘要：与男性发生性关系的艾滋病毒阳性非洲裔美国男性（AAMSM）最低 保留保留率的百分比较小，抑制病毒的可能性较小，这是依赖的结果 抗逆转录病毒疗法（ART）依从性。该提案重点是创新的理论驱动干预措施 旨在帮助改善针对3个艾滋病毒护理连续体的AAMSM的结果，（1）保留， （2）遵守抗逆转录病毒药物，以及（3）病毒抑制。我的个人健康指南是 创新的会话关系人类阿凡达移动电话应用程序，以吸引HIV阳性AAMSM 依从性和保留率。该应用程序的开发是通过信息动机告知的 行为技能模型的重点是影响一个人的信息和动机之间的反馈 行为技巧，行为和所需的健康成果。在用户房屋的隐私或他们的任何地方 拥有他们的手机，化身可以鼓励健康的行为，承认污名并以同理心交谈， 可以听到识字率低的人，采用可靠的文化措辞，并邀请用户 听取其他HIV阳性人士及其护理人员的建议和励志故事。 HIV的试点研究 18-34岁的积极AAMSM表现出可接受性，对应用的热情和初步 功效。作为UIC，埃默里大学和密西西比大学医学的合作的一部分 中心，我们建议测试《我的个人健康指南》对年轻艾滋病毒申请的效力 - 阳性AAMSM。在这项为期5年的研究中，该应用将根据试点数据（AIM 1）进行完善，然后是250 在基线时可检测到的病毒载荷的18-34岁年龄段的HIV阳性AAMSM将随机分配 对于我的个人健康指南的化身申请或食品安全头像应用程序控制干预措施 6个月（目标2）。无线监控的艺术依从性将在基线和 然后将收集无线监控的艺术依从性，病毒载荷和诊所预约数据 6个月的随访期。我们假设我的个人健康指南干预参与者 将在以下过程中显示出艺术依从性，病毒载荷和保留率的显着改善 - 与对照参与者相比，UP期间。我们还将确定手机应用程序功能 与依从性的改善相关，以告知应用程序的完善（AIM 3）。我们 假设更频繁地使用包含动机消息的阿凡达信息功能 与改善的艺术依从性有关。该建议具有创新性，因为它在 针对年轻AAMSM的预防和治疗研究，患有治疗衰竭风险的人口增加 通过在手机中使用关系的人类化身来克服护理的保留率不佳 关于参与临床护理的污名和识字率。如果我的个人健康指南干预是 证明是有效的，可以迅速扩大规模以进行大规模传播。