A Mobile Health Application for Engagement in Care among Youth Living with HIV

用于参与艾滋病毒青少年护理的移动健康应用程序

基本信息

批准号：
9404104
负责人：
Parya Saberi
金额：
$ 27.74万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-15 至 2020-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9404104
关键词：
AIDS/HIV problem Address Adherence Adolescent Medicine Trials Network Age Android Area Awareness Behavioral CD4 Lymphocyte Count California Car Phone Caring Cessation of life Clinical Communities Complex Computers Continuity of Patient Care Data Data Analyses Databases Development Focus Groups Growth HIV HIV Infections HIV diagnosis Health Health Communication Health Personnel Healthcare Healthy People 2020 Human Immunologics Incidence Individual Information Services Internet Intervention Interview Laboratories Link Measures Mentored Patient-Oriented Research Career Development Award Methods Modeling Morbidity - disease rate Motivation Outcome Participant Patients Pharmacy facility Plasma Population Primary Health Care Provider Public Health RNA Randomized Research Resources Risk San Francisco System Target Populations Techniques Technology Testing Text Treatment outcome United States National Institutes of Health Universities Viral Waiting Lists Work Youth age group antiretroviral therapy base cost data integration design efficacy testing experience field study follow-up health application health care delivery health care quality health disparity health equity health information technology improved innovation mHealth mortality novel physical conditioning population health psychosocial randomized trial response skills social tailored health care theories therapy adherence transmission process virology young adult

项目摘要

Abstract/Project Summary: In the US, fewer than 6% of all youth living with HIV (YLWH) achieve HIV viral suppression. This health disparity extends to the entire HIV care continuum in that there is a strong association between younger age and later HIV diagnosis, lower engagement in care, lower levels of antiretroviral therapy (ART) adherence, and worse HIV clinical outcomes. In response to this critical public health dilemma and aligned with the National Institute of Health's High Priority Topics of Research (i.e., “to reduce health disparities in the incidence of new HIV infections or in treatment outcomes of those living with HIV/AIDS”), our research team proposes to develop a novel mobile health application (“app”) to improve engagement in health care and ART adherence and to pilot test this mobile health app in 18-29 year-old YLWH. The aims of our study are to: Aim 1: Build on our theory-guided model and formative work to complete the development of our novel personalized mobile health app, WYZ (pronounced “wise”), for improved HIV clinical outcomes among YLWH. Our research team will work with the University of California, San Francisco's Information Services Unit to complete the development of WYZ using an iterative Human-Centered Design approach. This will be done by adding data integration with pharmacy and laboratory databases, creation of an Android-compatible version of the app based on our in-progress iOS version, refinement based on user-experience data from field testing, and qualitative interviews with the primary care providers of the youth participating in the field testing. Aim 2: Conduct a pilot randomized trial to assess the feasibility, acceptability, and preliminary clinical impact (i.e., adherence, plasma HIV RNA, and CD4+ cell count) of the use of WYZ among YLWH and their HCPs. Aim 2 consists of two sub-aims: 2a. Examine feasibility and acceptability of the use of WYZ based on defined metrics, acceptability through qualitative exit interviews, and preliminary clinical impact by virologic/immunologic outcomes with participants randomized to the intervention versus the wait-list control. 2b. Assess the acceptability of WYZ by participants' HCPs through individual qualitative interviews. We hypothesize that our mobile health app will be feasible and acceptable and will result in improved HIV clinical outcomes. Our study is significant because it has the potential to improve engagement in care, ART adherence, and clinical outcomes among YLWH. Our study is innovative because we will employ a novel suite of technology-based methods to improve information, motivation, and behavioral skills in YLWH. Upon completion, we will be ready to test the efficacy of this app in a subsequent large-scale RCT among this population that is disproportionately impacted by HIV and at elevated risk for poor clinical outcomes.

摘要/项目摘要：在美国，只有不到 6% 的艾滋病毒感染者 (YLWH) 能够实现艾滋病毒病毒抑制。差异延伸到整个艾滋病毒护理连续体，因为年龄较小之间存在密切联系以及后来的艾滋病毒诊断、护理参与度较低、抗逆转录病毒治疗 (ART) 依从性水平较低，以及不断恶化的艾滋病毒临床结果是为了应对这一严重的公共卫生困境，并与国家政策保持一致。卫生研究所的高优先级研究主题（即“减少新冠肺炎发病率方面的健康差距”） “艾滋病毒感染或艾滋病毒/艾滋病患者的治疗结果”），我们的研究团队建议开发一款新颖的移动健康应用程序（“应用程序”），以提高医疗保健的参与度和 ART 的依从性并在 18-29 岁的 YLWH 中试点测试这款移动健康应用程序，我们的研究目的是：目标 1：以我们的理论指导模型和形成工作为基础，完成小说的开发个性化移动健康应用程序 WYZ（发音为“wise”），用于改善 YLWH 中的 HIV 临床结果。我们的研究团队将与加州大学旧金山分校信息服务部门合作使用以人为本的迭代设计方法完成 WYZ 的开发。添加与药房和实验室数据库的数据集成，创建 Android 兼容版本该应用程序基于我们正在开发的 iOS 版本，根据现场测试的用户体验数据进行改进，对参与现场测试的青少年的初级保健提供者进行定性访谈。目标 2：进行试点随机试验，评估可行性、可接受性和初步临床影响（即依从性、血浆 HIV RNA 和 CD4+ 细胞计数）YLWH 及其 HCP 中使用 WYZ 的情况。目标 2 由两个子目标组成： 2a. 根据定义的指标检查使用 WYZ 的可行性和可接受性，通过定性退出访谈以及参与者的病毒学/免疫学结果的初步临床影响随机分配到干预组与等待名单对照组。 2b. 通过个人定性访谈评估参与者的 HCP 对 WYZ 的可接受性。我们探索了我们的移动健康应用程序将是可行和可接受的，并将导致改善我们的研究具有重要意义，因为它有可能改善护理参与度， YLWH 的 ART 依从性和临床结果我们的研究具有创新性，因为我们将采用一种新颖的方法。一套基于技术的方法，用于提高 YLWH 的信息、动机和行为技能。完成后，我们将准备在后续的大规模 RCT 中测试该应用程序的功效受艾滋病毒影响尤为严重且临床结果不佳风险较高的人群。