mHealth for ART adherence by HIV+ African Americans age 45 & older

移动医疗促进 45 岁非洲裔美国人艾滋病毒依从性治疗

基本信息

批准号：
9233205
负责人：
Patricia Flynn Weitzman
金额：
$ 39.49万
依托单位：
ENVIRONMENT AND HEALTH GROUP, INC.
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-04-18 至 2018-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9233205
关键词：
AIDS/HIV problem Address Adherence Adult Affect African American Age Aging Back Behavioral Boston Car Phone Centers for Disease Control and Prevention (U.S.)Clinic Cognitive aging Collaborations Communication Counseling Data Effectiveness Elderly Environment Feeling Goals HIV HIV Infections HIV Seropositivity HIV diagnosis Health Health education Holidays Immune system Impaired cognition Individual Intake Intervention Marketing Measures Mediator of activation protein Medication Management Memory Memory impairment Modeling Morbidity - disease rate Motivation National Institute of Drug Abuse Not Hispanic or Latino Outcome Participant Patient Self-Report Patients Pharmaceutical Preparations Pharmacists Pharmacy facility Phase Play Population Primary Health Care Provider Psychological reinforcement Psychology Psychosocial Assessment and Care Randomized Controlled Trials Reporting Research Role Self Efficacy Services Stress Testing Text Time Viral Visual Vulnerable Populations age group aged allostatic load antiretroviral therapy base behavioral economics commercialization cost disparity reduction evidence base experience functional disability health disparity improved mHealth medication compliance mortality negative affect pill prevent primary outcome psychologic public health relevance response smoking cessation therapy adherence tool

项目摘要

DESCRIPTION (provided by applicant): Environment and Health Group (EHG), Inc., in collaboration with a number of Boston MA and Columbia SC based organizations, seeks to enhance, test, and commercialize an individually-tailored, culturally-sensitive, positive-psychology and behavioral-economics based, mobile health intervention to promote ART adherence, increase ART self-efficacy and reduce feelings of stress burden among HIV positive African Americans age 45 and older. African Americans represent a growing portion (41%) of people living with HIV (CDC, 2012; 2014); by 2015, those age 50+ will account for half of all cases of HIV/AIDS in the U.S. (NIDA, 2012). Poor ART adherence contributes to disparities in HIV/AIDS outcomes among older African Americans. The proposed project is based on EHG's previous research with HIV+, age 50 years and older, African American adults. That research revealed personalized pill reminder text messages with positive-psychology based motivational and educational messages are effective at addressing two major barriers to ART adherence in this group: 1) memory deficits resulting from the combined effects of HIV, cognitive aging, and increased allostatic load, and 2) low motivation due to lack of ART self efficacy and negative affect. Findings showed significant improvement in ART adherence scores and marginally significant improvement in ART self- efficacy scores. While affect scores did not change, qualitative findings showed the intervention helped reduce feelings of stress burden. Supporting ART adherence is key to reducing health disparities among HIV+ African Americans. Doing so for those, age 45 and older-who are most vulnerable to cumulative, age-accelerating effects of HIV infection and allostatic load-is urgent, which is why we are lowering the age cut-off from 50 to 45 in Phase II. To date, no ART adherence support intervention has been developed for this highly-vulnerable group. The Phase II project will enhance the existing mobile intervention by offering: 1) a two-way communication capability through which participants can: i) indicate "pill taken" in response to pill reminders, and ii) receive a positive visual icon as behavioral-economics based reinforcement for "pill taken" responses; 2) live, real-time pharmacist counseling and medication support; and, 3) the addition of opt-in smoking cessation educational and motivational texts. Overall aims are to: 1) expand mhealth intervention to incorporate new Phase II features; 2) evaluate effectiveness in an RCT of HIV+ African Americans age 45 and older; and 3) prepare marketing and commercialization plans. Our long-term goal is to increase ART adherence, thus decreasing health disparities, among HIV+, African-Americans, age 45+.

描述（由申请人提供）：环境与健康集团（EHG），Inc。与许多基于基于基于的波士顿的波士顿MA和基于基于哥伦比亚SC的Boston MA和基于基于哥伦比亚的SC敏感的，积极的心理学和行为经济学，基于移动健康干预措施，以促进艺术依从性，增加艺术自我效能感并减少45岁及以上的非洲人的艾滋病毒阳性人士的感觉压力负担。艾滋病毒（CDC，2014年）到2015年；在美国，所有艾滋病毒/艾滋病的艾滋病都将为50岁以上（NIDA，2012年）基于EHG的基于50岁的Yeaars和年龄较大INRT的自我效能分数略有改善，有助于减轻45岁及以上的压力负担。到迄今为止的45阶段。 ii）作为基于行为经济学的积极图标，以实现“服用”的反应； TO：1）评估45岁及45岁的艾滋病毒的RCT的有效性； 45+。