Improving the HIV Care Continuum for Youth in the Deep South through Mobile Health Technology

通过移动医疗技术改善南方腹地青年的艾滋病毒护理连续性

基本信息

批准号：
10409655
负责人：
Sayward Elizabeth Harrison
金额：
$ 14.33万
依托单位：
UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-05-10 至 2024-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10409655
关键词：
AIDS prevention Accounting Acquired Immunodeficiency Syndrome Address Adherence Adopted Behavior Behavioral Caring Clinic Visits Clinical Continuity of Patient Care Data Deep South Development Development Plans Effectiveness Enrollment Environment Epidemic Evaluation Face Focus Groups Funding Goals HIV HIV Infections HIV Seropositivity HIV prevention trials network Health Technology Healthcare Infection Intervention Interview Knowledge Lead Link Mentors Mentorship Methodology Mobile Health Application Modeling Monitor Motivation National Institute of Mental Health Notification Outcome Patients Persons Population Population Heterogeneity Process Provider Psyche structure Quasi-experiment Research Research Personnel Research Support Research Training Risk Risk Behaviors Scientist Self Efficacy Service delivery model South Carolina Structure System Testing Training Training Activity Transportation Treatment Efficacy United States Universities Viral Viral Load result Wireless Technology Work Youth adherence rate antiretroviral therapy barrier to care behavioral health behavioral health intervention care providers career career development design disparity reduction efficacy evaluation experience formative assessment improved improved outcome infancy innovation insight mHealth medication compliance novel pilot test pilot trial point of care primary outcome programs psychologic psychosocial research and development service organization skills social cognitive theory social culture success therapy adherence therapy design therapy development tool treatment as prevention trial design usability virtual

项目摘要

PROJECT SUMMARY/ABSTRACT Youth living with HIV (YLHIV) display elevated risk at every point of the Care Continuum. They face barriers to becoming engaged and retained in HIV care, show poor medication adherence, and thus often fail to achieve viral suppression. HIV-positive youth in the Deep South have particularly poor outcomes. South Carolina is one of nine states identified as “key drivers” of the US HIV epidemic, and HIV rates for youth in South Carolina have risen rapidly in recent years (68% increase in past 15 years). Tailored interventions are urgently needed to improve outcomes for this population. One promising approach is to reach YLHIV via mobile Health (mHealth) technology, yet limited efforts have sought to tailor mHealth interventions to the needs of YLHIV in the Deep South. Thus the scientific objective of this K01 is to identify barriers experienced by YLHIV in South Carolina and then use findings to develop and pilot-test an mHealth intervention designed to increase engagement/retention in care and ART adherence. The career development objective of this K01 is to obtain the mentoring and training needed for a successful, high impact career investigating innovative ways to reduce HIV disparities among youth in the Southern US. This application is supported by a rigorous, highly productive research environment at the University of South Carolina and by a distinguished team of mentors. Collectively, mentors have expertise in psychological, behavioral, and socio-cultural aspects of HIV in the Deep South; the development of culturally-tailored HIV interventions; the use of mHealth to improve outcomes for YLHIV; factors related to a successful HIV Care Continuum; and rigorous intervention methodologies to test and enhance psychosocial and behavioral health interventions. Training experiences will provide expertise in formative assessment for intervention development; application of mHealth technologies to the HIV Care Continuum; intervention adaptation and development; theater testing methodology; innovative trial designs for mHealth interventions; and statistical/analytic skills necessary to assess intervention fidelity, acceptability, efficacy, and mechanisms of action. Training progression is linked to three specific research aims. In Aim 1, we will examine barriers to engagement/ retention in care and medication adherence for YLHIV in South Carolina. We will then use these findings to develop a tailored mHealth intervention to improve Care Continuum outcomes for YLHIV in the Deep South (Aim 2) by integrating several promising mHealth strategies. In Aim 3, we will evaluate the feasibility, acceptability, and usability of the mHealth intervention with a six-month pilot trial with 40 YLHIV in South Carolina. The project is relevant to NIMH priorities as it will bring together key stakeholders including patients, providers, and researchers to produce a developmentally and culturally tailored behavioral health intervention that can optimize clinical outcomes. It also aims to use an innovative service delivery model (i.e., mHealth technology) with a diverse population (i.e., YLHIV in the Deep South) in order to overcome traditional shortcomings of mental and behavioral healthcare.

项目概要/摘要感染艾滋病毒的青少年 (YLHIV) 在护理连续体的每个阶段都表现出较高的风险，他们面临着障碍。参与并保留艾滋病毒护理，药物依从性差，因此往往无法实现南卡罗来纳州腹地的艾滋病病毒呈阳性的年轻人的结果尤其糟糕。被确定为美国艾滋病毒流行“关键驱动因素”的九个州之一，以及南卡罗来纳州青少年的艾滋病毒感染率近年来增长迅速（过去 15 年增长了 68%），迫切需要采取量身定制的干预措施。一种有希望的方法是通过移动医疗来接触 YLHIV。（移动医疗）技术，但努力根据 YLHIV 的需要制定移动医疗干预措施的努力有限因此，本 K01 的科学目标是确定 YLHIV 在南方所经历的障碍。 Carolina，然后利用研究结果来开发和试点测试移动医疗干预措施，旨在提高 K01 的职业发展目标是获得护理参与/保留和 ART 依从性。成功、高影响力的职业所需的指导和培训调查创新方法以减少美国南部青少年之间的艾滋病毒差异该申请得到了严格、高效的支持。南卡罗来纳大学的研究环境和杰出的导师团队共同努力，导师拥有南方腹地艾滋病毒心理、行为和社会文化方面的专业知识；制定适合文化的艾滋病毒干预措施；利用移动医疗改善 YLHIV 的治疗结果；与成功的艾滋病毒护理连续体相关的因素；以及严格的干预方法来测试和加强心理社会和行为健康干预措施。干预措施发展的形成性评估；移动医疗技术在艾滋病毒护理中的应用连续体；干预适应和开发；创新试验设计；移动医疗干预；以及评估干预保真度、可接受性所需的统计/分析技能，培训进展与目标 1 中的三个具体研究目标相关。将检查南卡罗来纳州 YLHIV 参与/保留护理和药物依从性的障碍。然后，我们将利用这些发现来制定量身定制的移动医疗干预措施，以改善护理连续性通过整合几种有前途的移动医疗战略，在南方腹地（目标 2）取得 YLHIV 成果。在目标 3 中，我们将通过为期六个月的试点来评估移动医疗干预的可行性、可接受性和可用性在南卡罗来纳州对 40 名 YLHIV 进行的试验与 NIMH 的优先事项相关，因为它将汇集关键的内容。包括患者、提供者和研究人员在内的利益相关者，以产生一个发展和文化的它还旨在使用创新的方法来优化临床结果。服务提供模式（即移动医疗技术）与多样化人群（即南方腹地的 YLHIV）以克服精神和行为保健的传统缺点。