Epic Allies: A smartphone app for ART uptake and adherence among YMSM

Epic Allies：一款促进 YMSM 接受和遵守 ART 的智能手机应用程序

基本信息

批准号：
8846522
负责人：
Lisa B Hightow-Weidman
金额：
$ 57.56万
依托单位：
CAKTUS CONSULTING GROUP, LLC
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-12-15 至 2016-12-14
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8846522
关键词：
AIDS/HIV problem Accounting Address Adherence Adolescent Medicine Trials Network Adult Affect Affective Age Alcohols Ally Anti-Retroviral Agents Award Behavior Behavior Therapy Car Phone Caring Cellular Phone Chronic Disease Clinic Clinic Visits Clinical Communication Consult Data Diagnosis Drug usage Effectiveness Engineering Ensure Evaluation Exercise Face Family Friends Funding HIV HIV Infections HIV diagnosis Health Benefit Health Care Costs Health Promotion Imagery Individual Insurance Carriers Intervention Interview Knowledge Lead Learning Life Measures Mechanics Medical Mental Depression Modality Newly Diagnosed Outcome Outcome Measure Ownership Patients Phase Process Provider Public Health Randomized Controlled Trials Recruitment Activity Regimen Risk Sampling Self Management Site Small Business Innovation Research Grant Social Network Social isolation Social support Target Populations Technology Testing Time United States United States National Institutes of Health Viral Viral Load result Work Youth aged antiretroviral therapy arm base behavior change behavioral outcome effective intervention experience follow-up improved medication compliance meetings men men who have sex with men new technology novel patient population primary outcome prototype psychologic public health relevance secondary infection sex skills social theories therapy adherence tool uptake usability young men who have sex with men

项目摘要

DESCRIPTION (provided by applicant): Men who have sex with men (MSM) account for nearly two-thirds of all new HIV infections in the United States (US) and young MSM (YMSM) are the only risk group experiencing an increase in HIV incidence.1,2 After diagnosis, many YMSM do not enter medical care, get prescribed antiretroviral therapy (ART), adhere to ART regimens or achieve viral suppression. Novel theory-based interventions that optimize engagement in care, ART uptake and ART adherence for HIV+ YMSM are urgently needed to achieve both individual and public health benefits. Our study will evaluate the efficacy Epic Allies, a theory-based mobile phone application (app) that utilizes game mechanics and social networking features to improve engagement in care, ART uptake, ART adherence and viral suppression rates among HIV+ YMSM. Social networking technologies enhance support and reduce social isolation,3-5 while game mechanics engage users to motivate and sustain behavior change. High mobile phone ownership among YMSM supports using intervention tools based in these familiar, available technologies. The app addresses the most common engagement and adherence barriers among youth is tailored for the target population and is customizable for individual users. Epic Allies targets HIV+ YMSM aged 16-24, who are new to care (naive) or non-adherent to ART. Funded by the National Institutes of Health, through a Phase I SBIR application we worked with programmers and designers at Caktus Consulting Group to develop and test the Epic Allies prototype and found it acceptable among a sample of HIV+ YMSM. Our current Phase II proposal has 3 aims: Aim 1: Refine Epic Allies for use in a clinic-based trial and expand the scope of the developed app to address engagement in care and ART uptake. Enhancements to the social networking features of the app will be made to ensure the communication and support needs of youth who are not currently on ART and those new to care are met. To inform these changes, we will conduct in-depth usability interviews with 8-10 YMSM not currently on ART and new to care. Aim 2: Test Epic Allies app among 300 HIV+ YMSM recruited from 14 Adolescent Trials Network (ATN) sites. We will conduct a 2-arm randomized controlled trial with measures at baseline 3, 6 and 12 months. Primary outcome measures will include engagement in care, ART uptake, medication adherence and viral load suppression. Aim 3: Conduct a process evaluation of Epic Allies including intervention acceptability, impact and long-term sustainability. Qualitative in-depth exit interviews (n=30) wil evaluate Epic Allies' acceptability with the target population and its potential to improve engagement in care, uptake of ART and adherence. This project has high public health impact as it will address the current gap in scientific knowledge regarding how to best assist YMSM who are newly diagnosed with HIV and those who have adherence difficulties in order to improve medical, psychological, and public health outcomes. Moreover, the creation of a novel technology based adherence tool could be easily adapted for other highly prevalent and costly chronic diseases.

描述（由申请人提供）：在美国 (US)，男男性行为者 (MSM) 占所有新增艾滋病毒感染者的近三分之二，而年轻的男男性行为者 (YMSM) 是艾滋病毒感染率上升的唯一危险群体1,2 诊断后，许多 YMSM 没有接受医疗护理、接受抗逆转录病毒治疗 (ART)、坚持 ART 治疗方案或实现基于理论的新型干预措施，以优化护理参与度和 ART 吸收。为了实现个人和公共健康利益，迫切需要 HIV+ YMSM 的 ART 坚持，我们的研究将评估 Epic Allies 的功效，Epic Allies 是一款基于理论的手机应用程序 (app)，利用游戏机制和社交网络功能来提高护理参与度。 HIV+ YMSM 中的 ART 接受率、ART 坚持率和病毒抑制率社交网络技术增强了支持并减少了社会隔离，3-5 而游戏机制则利用基于干预工具的方式吸引用户激励和维持 YMSM 中的高手机拥有率。在这些该应用程序解决了年轻人中最常见的参与和依从障碍，专为目标人群量身定制，并可针对 16-24 岁的 HIV+ YMSM、新护理（新手）或非护理人员进行定制。 - 遵循 ART，由美国国立卫生研究院资助，通过第一阶段 SBIR 应用程序，我们与 Caktus Consulting Group 的程序员和设计师合作开发和测试 Epic Allies 原型，并发现它在样本中是可以接受的。 HIV+ YMSM。我们当前的第二阶段提案有 3 个目标：目标 1：完善 Epic Allies 以用于基于临床的试验，并扩大开发的应用程序的范围，以解决护理参与和 ART 的社交网络功能的增强。该应用程序将确保满足目前未接受 ART 的青少年和刚开始接受护理的青少年的沟通和支持需求。为了了解这些变化，我们将与目前未接受 ART 的 8-10 YMSM 进行深入的可用性访谈。 ART 和护理新目标 2：在从 14 个青少年试验网络 (ATN) 站点招募的 300 名 HIV+ YMSM 中测试 Epic Allies 应用程序，我们将在初级阶段进行 2 组随机对照试验。结果衡量标准将包括护理参与、抗逆转录病毒疗法的采用、药物依从性和病毒载量抑制。目标 3：对 Epic Allies 进行过程评估，包括干预措施的可接受性、影响和长期可持续性。定性深入的退出访谈 (n=30) 将评估 Epic Allies 对目标人群的接受程度及其提高护理参与度、ART 接受率和依从性的潜力。该项目具有很高的公共卫生影响，因为它将解决当前的差距。关于如何最好地帮助新诊断出艾滋病毒感染者和有依从困难的人的科学知识，以改善医疗、心理和公共卫生结果此外，基于新技术的依从性工具的创建可以很容易地适应。其他高度流行且昂贵的慢性疾病。