Development of Real-Time Antiretroviral Therapy Adherence Intervention in Uganda
乌干达实时抗逆转录病毒治疗依从性干预的发展
基本信息
- 批准号:8666821
- 负责人:
- 金额:$ 25.96万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2013
- 资助国家:美国
- 起止时间:2013-06-01 至 2016-05-31
- 项目状态:已结题
- 来源:
- 关键词:AIDS/HIV problemAdherenceAfrica South of the SaharaAlcohol abuseBehaviorBehavioralBehavioral MechanismsBypassCaringClinicClinicalCognitiveCommunicationDetectionDevelopmentDevicesDoseDrug resistanceEarly InterventionEconomicsElectronicsEvaluationEvidence based interventionFaceFailureFamilyFoodFriendsGoalsHIVHealthHealth BenefitHealthcareHealthcare SystemsHourIndividualInformation SystemsInterruptionInterventionInterviewKenyaLeadLearningLinkMedicalMental DepressionMentorsMethodsMonitorNotificationParticipantPatient Self-ReportPatientsPharmaceutical PreparationsPlayPopulation ControlProcessPublic HealthRNARandomized Controlled TrialsRecruitment ActivityRegimenRelative (related person)ReportingResearchResearch InfrastructureResearch PersonnelResourcesRiskRoleRuralScheduleSignal TransductionSocial supportStagingSystemTestingTimeTransportationTreatment EfficacyTreatment FailureUgandaViralantiretroviral therapyarmbaseclinical practicecohortcostdesignexperienceimprovedinnovationmemberpillpreventpublic health relevanceresponsesocialstandard measuresuccesstherapy adherencetransmission processtreatment adherence
项目摘要
DESCRIPTION (provided by applicant): Significance: Despite early success with antiretroviral therapy (ART) in sub-Saharan Africa, structural and non-structural barriers commonly cause adherence challenges. Inability to overcome these barriers and sustain first line ART has significant implications individual and public health, as well as cost. The proposed study will use
SMS texting and existing social support networks to develop a real-time adherence intervention with minimal burden on healthcare systems. Innovation: The proposed study is innovative in 1) its use of real-time adherence monitoring and intervention, 2) targeted intervention based on an individual's adherence behavior, 3) engagement of social support networks for provision of individualized support, and 4) determination of mechanisms of effect of SMS and social support, thus making it possible to design and test evidence-based interventions. Approach: The proposed intervention is based on a conceptual framework in which SMS trigger social support for improved adherence, as well as directly overcome adherence barriers. In a cohort of HIV-infected individuals starting ART and monitored with Wisepill, we will serially test 1) daily SMS reminders, 2) weekly SMS reminders, 3) SMS reminders linked to real-time detection of missed doses, and 4) SMS reminders plus SMS notifications to members of their social support networks- both linked to real-time detection of missed doses. We will conduct qualitative interviews to learn the experiences of participants and members of their social support networks with each type of SMS. This staged approach in a single cohort will allow us to fully understand and compare the additive effects and acceptability of SMS-based interventions. We will also determine behavioral effect mechanisms, as well as compare the impact of each type of SMS with a control population receiving only Wisepill monitoring on adherence and HIV RNA. We propose the following aims: Aim 1. Develop an ART adherence intervention based on SMS reminders linked to real-time detection of missed doses, and assess its acceptability, feasibility and preliminary impact on adherence and HIV RNA suppression. Aim 2. Develop an ART adherence intervention based on social support linked to real-time adherence monitoring and assess its acceptability, feasibility and preliminary impact on adherence and HIV RNA suppression. Investigators: Dr. Haberer (PI) is the emerging academic leader of real-time ART adherence monitoring, particularly in resource-limited settings. Dr. Musiimenta provides key experience in mixed method evaluation of HIV/AIDS-related information systems in rural Uganda. Dr. Ware is a medical anthropologist with extensive experience conducting qualitative interviews on ART adherence behavior in sub-Saharan Africa. Dr. Bangsberg is an internationally recognized leader in adherence to ART and Dr. Haberer's primary mentor.
描述(由申请人提供): 意义:尽管抗逆转录病毒疗法(ART)在撒哈拉以南非洲地区取得了早期成功,但结构性和非结构性障碍通常会导致依从性挑战。无法克服这些障碍并维持一线抗逆转录病毒治疗会对个人和公共健康以及成本产生重大影响。拟议的研究将使用
短信和现有的社会支持网络可开发实时依从性干预措施,同时将医疗保健系统的负担降至最低。创新:本研究的创新之处在于:1)使用实时依从性监测和干预,2)基于个人依从性行为的有针对性的干预,3)利用社会支持网络提供个性化支持,4)确定短信和社会支持的影响机制,从而使设计和测试基于证据的干预措施成为可能。方法:拟议的干预措施基于一个概念框架,其中短信触发社会支持以提高依从性,并直接克服依从性障碍。在一组开始 ART 并使用 Wisepill 进行监测的 HIV 感染者中,我们将连续测试 1) 每日短信提醒,2) 每周短信提醒,3) 与实时检测错过剂量相关的短信提醒,以及 4) 短信提醒再加上向其社交支持网络成员发送短信通知——两者都与实时检测错过的剂量有关。我们将进行定性访谈,以了解参与者及其社会支持网络成员对每种短信的体验。这种在单个队列中分阶段进行的方法将使我们能够充分理解和比较基于短信的干预措施的附加效果和可接受性。我们还将确定行为影响机制,并将每种短信的影响与仅接受 Wisepill 监测的对照组人群的依从性和 HIV RNA 进行比较。我们提出以下目标: 目标 1. 开发基于与实时检测漏服剂量相关的短信提醒的 ART 依从性干预措施,并评估其可接受性、可行性以及对依从性和 HIV RNA 抑制的初步影响。 目标 2. 基于与实时依从性监测相关的社会支持,制定 ART 依从性干预措施,并评估其可接受性、可行性以及对依从性和 HIV RNA 抑制的初步影响。调查人员:Haberer 博士(PI)是实时 ART 依从性监测的新兴学术领导者,特别是在资源有限的环境中。 Musiimenta 博士提供了乌干达农村地区艾滋病毒/艾滋病相关信息系统混合方法评估的重要经验。 Ware 博士是一位医学人类学家,在对撒哈拉以南非洲地区的 ART 依从行为进行定性访谈方面拥有丰富的经验。 Bangsberg 博士是国际公认的坚持 ART 的领导者,也是 Haberer 博士的主要导师。
项目成果
期刊论文数量(0)
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会议论文数量(0)
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Jessica Elizabeth Haberer其他文献
Jessica Elizabeth Haberer的其他文献
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