mLab App for Improving Uptake of rapid HIV self-testing and Linking Youth to Care

mLab 应用程序可提高艾滋病毒快速自我检测的采用率并将青少年与护理联系起来

• 批准号: 9755512
• 负责人: Robert Garofalo
• 金额: $ 82.92万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-03 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9755512
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Africa; Age; Algorithms; Awareness; Back; Biological Assay; Car Phone; Caring; Cellular Phone; Cessation of life; Continuity of Patient Care; Data; Data Collection; Death Rate; Detection; Development; Devices; Diagnosis; Diagnostic; Discrimination; Engineering; Enrollment; Epidemic; Evaluation; Feedback; Future; Gender; Goals; HIV; HIV Seropositivity; Health; Health Technology; Healthcare Systems; Home environment; Homophobia; Human immunodeficiency virus test; Image; Individual; Infection; Intervention; Lateral; Latino; Link; Malaria; Methods; Modeling; Monitor; New York City; Notification; Outcome; Perception; Persons; Preventive Intervention; Preventive care; Process; Public Health; Randomized; Reporting; Research; Risk; Scientist; Secure; Sensitivity and Specificity; Sex Orientation; Signal Transduction; Site; Socioeconomic Factors; Stigmatization; Technology; Test Result; Testing; Time; Treatment outcome; United States; Ursidae Family; Visual; Work; Youth; age group; arm; base; care outcomes; computer human interaction; cost; design; digital; disenfranchised population; ethnic minority population; follow-up; group intervention; health information technology; high risk; image processing; improved; improved outcome; innovation; iterative design; mHealth; member; mobile computing; multi-site trial; multidisciplinary; next generation; novel diagnostics; prevention service; racial minority; racism; response; sexual minority; smartphone Application; social; social stigma; standard of care; study population; testing services; tool; transgender women; transmission process; uptake; usability; user centered design; wireless fidelity; young man; young men who have sex with men

The number of youth living with HIV continues to rise, and they are disproportionately represented at each stage of the care continuum. Most relevant to this application, it is estimated that less than half of HIV-infected youth in the United States (US) have been diagnosed with HIV, and AIDS-related deaths among youth have increased over the past decade despite decreased death rates among all other age groups, pointing to the urgent need for increased testing among youth. Black and Latino youth are at increased risk of poor HIV-related outcomes and have disparate testing rates as compared to White youth. Mobile Health (mHealth) technology is a powerful and relevant tool which represents a promising approach for improving outcomes among youth living with HIV. Youth are avid adopters and heavy users of smartphones and digital technologies, and these technologies offer opportunities to tailor interventions to developmental stages and personal needs. Importantly, these technologies are capable of delivering interventions in real-time and in ecologic settings. This creates an opportunity to remotely reach youth through mobile and connected health approaches to strengthen their HIV care continuum engagement and treatment outcomes. In response, our study team has developed the mLab App, an innovative mobile and connected technology that combines HIV prevention information with push notifications/reminders to complete HIV testing and an automated image processing feature to provide accessible, objective, secure, and real-time feedback on home-based OraQuick (lateral flow assay) HIV test results. The mLab App also contains an innovative automated data collection and a results reporting feature. Findings from our preliminary work in New York City indicate that youth perceive the mLab App as useful, easy to use, and effective at improving health outcomes and intend to use the technology. Findings from our preliminary work in Africa support the sensitivity and specificity of the imaging algorithm for interpreting lateral flow assay results. Theoretically-guided by the Health Information Technology Usability Evaluation Model (Health-ITUEM), the proposed project will refine and test a next- generation diagnostic intervention delivered on a mobile platform to improve HIV testing and linkage-to-care outcomes among youth living with and at-risk for HIV. Well in line with the objectives of RFA-MH-18-606, we will conduct a careful, iterative process of technology refinement based on input from end users, experts, and our youth advisory board. We will then enroll 500 high-risk youth (age 17-29 years) in a 12-month RCT to assess differences in HIV testing rates and linkage to care between the intervention (mLab App) and control arm. Finally, we will analyze paradata, defined as auxiliary data that capture details about the process of interaction with the technology, to understand the effect of user engagement of the mLab App on improving HIV testing rates and linkage to care. Interventions delivered through mHealth technology represent a promising approach for improving outcomes among youth. Given the pervasiveness, low cost, and convenience of mobile technology, the mLab App holds promise to help achieve the goals of the National HIV/AIDS Strategy in the US by increasing the number of persons living with HIV who know their serostatus, decreasing HIV-related disparities, and ultimately reducing the risk of HIV transmission and acquisition.

感染艾滋病毒的青少年人数持续增加，并且他们在艾滋病毒感染的各个阶段所占的比例不成比例。 护理连续体。与此应用最相关的是，据估计，美国不到一半的艾滋病毒感染青年 过去十年，美国各州已被诊断出感染艾滋病毒，青少年中与艾滋病相关的死亡人数有所增加 尽管所有其他年龄组的死亡率均有所下降，但这表明迫切需要在青少年中增加检测。 黑人和拉丁裔青年与艾滋病毒相关的不良结果的风险增加，并且与黑人和拉丁裔青年相比，他们的检测率也不同 白人青年。移动医疗 (mHealth) 技术是一种强大且相关的工具，代表了一种有前途的方法 改善感染艾滋病毒的青少年的结果。年轻人是智能手机的狂热采用者和重度用户 数字技术，这些技术提供了根据发展阶段和需求定制干预措施的机会 个人需求。重要的是，这些技术能够实时、生态地提供干预措施。 设置。这创造了一个通过移动和互联健康方法远程接触年轻人的机会 加强他们的艾滋病毒护理持续参与和治疗结果。作为回应，我们的研究团队开发了 mLab App，一种创新的移动互联技术，将艾滋病毒预防信息与推送相结合 完成 HIV 检测的通知/提醒和自动图像处理功能，以提供可访问、 对家庭 OraQuick（侧流检测）HIV 检测结果进行客观、安全和实时的反馈。 mLab 应用程序 还包含创新的自动数据收集和结果报告功能。我们前期工作的结果 纽约市的年轻人认为 mLab 应用程序有用、易于使用且能有效改善健康 结果并打算使用该技术。我们在非洲的初步工作结果支持了敏感性和 用于解释侧流测定结果的成像算法的特异性。以健康为理论指导 信息技术可用性评估模型（健康-ITUEM），拟议的项目将完善和测试下一个- 在移动平台上提供一代诊断干预，以改善艾滋病毒检测和与护理结果的联系 感染艾滋病毒和有感染艾滋病毒风险的青少年。完全符合 RFA-MH-18-606 的目标，我们将进行 根据最终用户、专家和我们的青年顾问委员会的意见，进行仔细、迭代的技术完善过程。 然后，我们将招募 500 名高危青少年（17-29 岁）进行为期 12 个月的随机对照试验，以评估 HIV 检测率的差异 以及干预（mLab 应用程序）和控制臂之间的护理联系。最后，我们将分析paradata，定义为 辅助数据捕获有关与技术交互过程的详细信息，以了解用户的效果 mLab 应用程序参与提高艾滋病毒检测率和与护理的联系。干预措施通过 移动医疗技术是改善青少年健康状况的一种有前景的方法。鉴于其普遍性，低 成本和移动技术的便利性，mLab 应用程序有望帮助实现国家的目标 美国的艾滋病毒/艾滋病战略，增加了解其血清状况的艾滋病毒感染者人数，减少 与艾滋病毒相关的差异，最终降低艾滋病毒传播和感染的风险。