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

• 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
• 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

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.

项目摘要/摘要 艾滋病毒（YLHIV）的年轻人在护理连续体的每个点表现出较高的风险。他们面临障碍 要参与并保留在艾滋病毒护理中，表现出较差的药物依从性，因此常常无法实现 病毒抑制。南方深处的艾滋病毒阳性青年的结果特别差。南卡罗来纳州是 九个州之一被确定为美国艾滋病毒流行的“关键驱动力”，南卡罗来纳州青年的艾滋病毒率 近年来，迅速增长（过去15年增长了68％）。迫切需要量身定制的干预措施 改善该人群的结果。一种有希望的方法是通过移动健康达到YLHIV （MHealth）技术，但有限的努力却感觉到为YLHIV的需求量身定制了MHealth的干预措施 深南方。该K01的科学目标是确定YLHIV在南方的障碍 卡罗来纳州，然后使用调查结果来开发和试验旨在增加的MHealth干预措施 参与/保留护理和艺术依从性。这个K01的职业发展目标是获得 成功，高影响力职业所需的心理和培训，调查了减少创新的方法 美国南部青年的艾滋病毒差异。该应用程序由严格，高效的严格的支持 南卡罗来纳大学和杰出的导师团队的研究环境。共同 导师在深南部的艾滋病毒的心理，行为和社会文化方面具有专业知识；这 发展文化定制的艾滋病毒干预措施；使用MHealth改善YLHIV的结果； 与成功的HIV护理连续体有关的因素；和严格的干预方法进行测试和 增强社会心理和行为健康干预措施。培训经验将提供专业知识 干预开发的形成性评估； MHealth Technologies在艾滋病毒护理中的应用 连续；干预适应和发展；剧院测试方法；创新的试验设计 用于MHealth干预措施；以及评估干预保真度，可接受性，所必需的统计/分析技能 功效和作用机制。培训进程与三个特定的研究目的有关。在AIM 1中，我们 将检查南卡罗来纳州YLHIV的护理和药物依从性的参与/保留障碍。 然后，我们将使用这些发现来开发量身定制的MHealth干预措施，以改善护理连续性 YLHIV在深南地区的结果（AIM 2）通过整合了几种有希望的MHealth策略。在AIM 3中， 我们将通过六个月的飞行员评估MHealth干预的可行性，可接受性和可用性 在南卡罗来纳州与40 YLHIV的审判。该项目与NIMH的优先事项有关，因为它将汇集密钥 利益相关者在内 量身定制的行为健康干预措施，可以优化临床结果。它还旨在使用创新 服务交付模型（即MHealth技术），其中有潜水员的人口（即深南部的YLHIV） 为了克服传统的心理和行为医疗保健缺点。