Research towards implementing technology-based prevention with positives

研究以积极的方式实施基于技术的预防

基本信息

批准号：
9193655
负责人：
Stephanie Lynn Marhefka
金额：
$ 18.95万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-10 至 2018-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9193655
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Adopted Adoption Anti-Retroviral Agents Area Behavior Therapy Behavioral Car Phone Caring Case Manager Characteristics Client Communities Computers County Data Devices Diagnosis Effectiveness Ensure Florida Follow-Up Studies Funding Future Geographic Locations HIV HIV Seropositivity Health Personnel Internet Intervention Interview Knowledge Link Medical Methods Modeling Participant Patients Perception Persons Pharmaceutical Preparations Phase Prevention Privacy Probability Provider Public Health Readiness Recruitment Activity Research Services Sexually Transmitted Diseases Shapes Structure Surveys System Technology Testing Text Thinking Time Translational Research United States National Institutes of Health Videoconferencing antiretroviral therapy base cost cost effective cost effectiveness demographics eHealth evidence base implementation research implementation science improved innovation programs public health relevance research study rural underserved scale up sex risk skills willingness

项目摘要

DESCRIPTION (provided by applicant): Despite increased access to antiretroviral (ARV) drugs and behavioral interventions, HIV remains a public health problem worldwide. Access to interventions is oftentimes limited, especially for people living with HIV (PLH) living in the rura and underserved areas. Providing Internet or mobile text-message based interventions can increase reach and there is increasing evidence of cost-effectiveness. However, data are scarce on PLH's access to technology and the acceptability of such interventions. It is also important to get the perspective of the health care providers who provide services to PLH to ensure that technology-based, or ehealth, prevention with [HIV] positives interventions (henceforth, ePWPIs) can fit with existing systems for reaching PLH clients. Aim 1 is to determine the extent to which PLH in Florida have the technical capacity (i.e., device access) to participate in technology-based, or eHealth, prevention with (HIV) positives interventions (henceforth, ePWPIs) via their own devices. This will be done with a statewide survey (approximate N=17656) of English and Spanish-speaking PLH in Florida via Ryan White case managers, as well as a more in-depth assessment with a subset of the statewide survey participants. Aim 2 is to describe PLH's willingness to adopt ePWPIs via their own devices and how adoption may vary based on participant (e.g., demographics, technology readiness), technology (e.g., text, app, video-chat), and intervention characteristics (i.e., perceptions of usefulness, cost, relative advantage). We will do this through an exploratory sequential mixed methods follow-up study with a sub-set of participants from the statewide assessment. Findings from 30 qualitative, in-person PLH interviews (Phase 2a) about willingness to adopt ePWPIs will inform an in-depth primarily quantitative assessment (N=400 PLH) regarding access, use, and willingness to adopt ePWPIs, guided in part by an adapted Technology Readiness and Acceptance Model (TRAM35). Aim 3 is to examine key stakeholder (i.e., medical care providers and ASO staff) perceptions of fit between ePWPIs and their existing systems for reaching clients and delivering programs, and identify potential ePWPI implementation strategies to maximize fit. This will be done via semi-structured interviews. The study is innovative as it is guided by the consolidated framework for implementation research (CFIR) and the TRAM. Findings will be critical in shaping the scientific agenda regarding ePWPIs and will lead to subsequent R01 applications, including a R01 trial that tests effectiveness of an approach that matches ePWPIs to geographical areas and subpopulations, employing implementation strategies that emerged from this R21.

描述（由申请人提供）：尽管抗逆转录病毒 (ARV) 药物和行为干预措施的获取有所增加，但艾滋病毒仍然是世界范围内的一个公共卫生问题，获得干预措施的机会往往有限，特别是对于生活在乡村和服务不足的艾滋病毒感染者 (PLH) 而言。提供基于互联网或移动短信的干预措施可以扩大影响范围，而且越来越多的证据表明，艾滋病患者获得技术的情况以及此类干预措施的可接受性方面的数据很少。同样重要的是，了解向 PLH 提供服务的医疗保健提供者的观点，以确保基于技术的或电子健康的预防措施（以下简称 ePWPI）能够适应现有系统，以覆盖 PLH 客户。 1 的目的是确定佛罗里达州的 PLH 在多大程度上拥有参与基于技术或电子医疗的 (HIV) 阳性干预措施的预防（即设备使用）（此后， ePWPI）将通过 Ryan White 案例经理对佛罗里达州的英语和西班牙语 PLH 进行全州范围内的调查（大约 N=17656），并对一部分人进行更深入的评估。目标 2 是描述 PLH 通过自己的设备采用 ePWPI 的意愿，以及采用情况如何根据参与者（例如人口统计、技术准备情况）、技术而变化。（例如文本、应用程序、视频聊天）和干预特征（即对有用性、成本、相对我们将通过一项探索性顺序混合方法后续研究来实现这一目标，其中来自 30 次定性面对面 PLH 访谈（第 2a 阶段）的调查结果将告诉我们采用 ePWPI 的意愿。关于获取、使用和采用 ePWPI 的意愿进行深入的主要定量评估 (N=400 PLH)，部分由改编的技术准备和接受模型 (TRAM35) 指导。目标 3 是检查主要利益相关者（即医疗保健提供者和 ASO 工作人员）对 ePWPI 与其现有系统之间的契合度的看法，以接触客户和交付计划，并确定潜在的 ePWPI 实施策略，以最大限度地提高契合度。这将通过半完成。该研究具有创新性，因为它以研究综合框架实施 (CFIR) 为指导，并且 TRAM 的研究结果对于制定有关 ePWPI 的科学议程至关重要，并将导致后续的 R01。应用程序，包括 R01 试验，该试验采用 R21 中提出的实施策略，测试将 ePWPI 与地理区域和亚人群相匹配的方法的有效性。

项目成果

期刊论文数量（3）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Social Determinants of Potential eHealth Engagement Among People Living with HIV Receiving Ryan White Case Management: Health Equity Implications from Project TECH.

接受 Ryan White 病例管理的艾滋病毒感染者潜在电子医疗参与的社会决定因素：技术项目对健康公平的影响。

DOI：
发表时间：
2020-05
期刊：
影响因子：
4.4
作者：
Marhefka, Stephanie L;Lockhart, Elizabeth;Turner, DeAnne;Wang, Wei;Dolcini, M Margaret;Baldwin, Julie A;Roig;Lescano, Celia M;Glueckauf, Robert L
通讯作者：
Glueckauf, Robert L

Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities.

基于种族、性别和性行为的交叉点了解艾滋病毒感染者的技术适应性：分析多种社会身份差异的公平方法。

DOI：
发表时间：
2021-08
期刊：
影响因子：
4.4
作者：
Lockhart, Elizabeth;Turner, DeAnne;Ficek, Joseph;Livingston, Taylor;Logan, Rachel G;Marhefka, Stephanie L
通讯作者：
Marhefka, Stephanie L

Achieve Research Continuity During Social Distancing by Rapidly Implementing Individual and Group Videoconferencing with Participants: Key Considerations, Best Practices, and Protocols.

通过快速实施与参与者的个人和团体视频会议，在保持社交距离期间实现研究连续性：关键考虑因素、最佳实践和协议。