Developing a Two-way SMS Platform to Prevent and Treat Wasting Among HIV-infected and HIV-exposed Uninfected Children

开发双向短信平台来预防和治疗艾滋病毒感染者和暴露于艾滋病毒的未感染儿童的消瘦

• 批准号: 10537094
• 负责人: Arianna Rubin Means
• 金额: $ 19.58万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-17 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10537094
• 关键词: 2 year old; Address; Age; Age-Months; Behavioral; Breast Feeding; Caregivers; Caring; Cessation of life; Child; Child Care; Child Health; Childhood; Clinic; Complementary Feeding; Complex; Consumption; Cost Analysis; Developmental Delay Disorders; Diagnosis; Diet; Early identification; Education; Educational Intervention; Effectiveness; Enrollment; Exclusive Breastfeeding; Exposure to; Failure; Family; Feeds; Food; Frequencies; Grant; Guidelines; HIV; HIV Infections; HIV diagnosis; HIV-exposed uninfected infant; Health Personnel; Health system; Healthcare; Healthcare Systems; Height; Home; Hospitalization; Incidence; Individual; Infant; Infection; Intention; Intervention; Iron; Kenya; Knowledge; Life; Malnutrition; Measures; Medical; Methods; Monitor; Morbidity - disease rate; Mothers; Nutritional; Nutritional Support; Opportunistic Infections; Outcome; Pathway interactions; Phase; Population; Predisposition; Prevalence; Prevention; Process; Qualifying; Randomized; Randomized Clinical Trials; Recovery; Reporting; Risk; Services; Surveys; System; Techniques; Testing; Text Messaging; Time; Trust; Underweight; Upper arm; Weight; adverse outcome; arm; behavioral outcome; care seeking; care systems; caregiver education; clinical care; cost effective; cost effective intervention; cost effectiveness; design; dietary; effectiveness testing; empowered; feeding; follow-up; health care availability; health care service; high risk; implementation outcomes; improved; improved outcome; incremental cost-effectiveness; intervention delivery; mHealth; maternal outcome; medical complication; mortality; novel; phase III trial; prevent; programs; randomized trial; response; social stigma; standard of care; vaccine response; wasting

PROJECT SUMMARY/ABSTRACT Twenty-five percent of children with HIV-infection have childhood wasting (low weight-for-height or low mid-upper arm circumference, and HIV-exposed uninfected (HEU) children are twice as likely to be underweight as comparable HIV-unexposed children. Wasting is known to promote morbidity, HIV-progression, and mortality among these children. Improving wasting prevention and treatment for children and in early infant diagnosis and HIV-care programs could not only improve the child health outcomes of these children, but also substantially lower the global burden of childhood wasting. This proposal will develop a novel two-way short message service (SMS) platform that targets key barriers to improving nutritional care for HEU and HIV-infected children. This intervention will combine a maternally administered malnutrition monitoring system (MAMMS) with infant and young child education (IYCF) delivered by SMS. After developing the intervention using participatory design methods, we will complete a proof-of- concept quasi-experimental trial of MAMMS-IYCF in the R21. If the R21 milestones are meet, we will use the R33 to conduct a randomized trial testing the effectiveness of MAMMS-IYCF at reduced the incidence wasting, and the duration of wasting treatment. During this trial we will also assess the cost and cost-effectiveness of MAMMS-IYCF, and to better understand which barriers are being successfully addressed by intervention we will measure its effect on key attitudinal and behavioral outcomes including trust in the healthcare system, intention to seek if a child becomes wasted, and IYCF knowledge. This trial will generate the evidence necessary to integrate MAMMS-IYCF interventions into existing HIV-mHealth programs across the globe, and improve the outcomes of children in early infant diagnosis and HIV-care services while also substantially lowering the global burden of childhood wasting.

项目概要/摘要 25% 的 HIV 感染儿童患有童年消瘦症（身高体重比偏低或中上偏低） 臂围和暴露于艾滋病毒的未感染儿童 (HEU) 体重不足的可能性是 未接触艾滋病毒的儿童具有可比性。众所周知，消瘦会增加发病率、艾滋病毒进展和死亡率 在这些孩子之中。改善儿童消瘦预防和治疗以及婴儿早期诊断和治疗 艾滋病毒护理计划不仅可以改善这些儿童的健康状况，而且可以大大改善儿童的健康状况。 减轻全球儿童消瘦的负担。 该提案将开发一种新颖的双向短信服务 (SMS) 平台，针对主要障碍 改善 HEU 和艾滋病毒感染儿童的营养护理。这项干预措施将结合产妇 实施营养不良监测系统（MAMMS）和婴幼儿教育（IYCF） 通过短信。使用参与式设计方法开发干预措施后，我们将完成一个证明- R21 中 MAMMS-IYCF 的概念准实验试验。如果达到 R21 里程碑，我们将使用 R33 进行一项随机试验，测试 MAMMS-IYCF 在减少消瘦发生率方面的有效性， 以及消瘦治疗的持续时间。在此试验期间，我们还将评估成本和成本效益 MAMMS-IYCF，为了更好地了解哪些障碍正在通过干预成功解决，我们将 衡量其对关键态度和行为结果的影响，包括对医疗保健系统的信任、意图 寻求孩子是否消瘦，以及IYCF知识。该试验将产生必要的证据 将 MAMMS-IYCF 干预措施纳入全球现有的 HIV-mHealth 项目，并改善 儿童早期诊断和艾滋病毒护理服务的结果，同时也大大降低了全球 童年消瘦的负担。