Mobile Augmented Screening Tool to Increase Adolescent HIV Testing and Linkage to Care

移动增强筛查工具可增加青少年艾滋病毒检测和与护理的联系

基本信息

批准号：
9678036
负责人：
Ian David Aronson
金额：
$ 47.73万
依托单位：
DIGITAL HEALTH EMPOWERMENT, INC.
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-05-19 至 2020-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9678036
关键词：
AIDS prevention Accident and Emergency department Address Adolescent Adolescent and Young Adult African American Age Appointment Area Behavioral Caring Centers for Disease Control and Prevention (U.S.)Child Client Clinic Clinical Clinical Trials Counseling Data Data Collection Development Doctor of Philosophy Education Emergency Department patient Emergency department visit Evaluation Face Feedback Fright Funding Gender Goals Grant HIV HIV Infections HIV Seropositivity HIV risk Health Health Personnel Health care facility High Prevalence Hospitals Human immunodeficiency virus test Infection Insurance Insurance Carriers Intervention Interview Knowledge Laws Lead Measures Minority Modeling Motivation New York City Outcome Paper Participant Patients Phase Population Preparation Prevention Prevention education Primary Health Care Privacy Privatization Prophylactic treatment Provider Public Health Race Randomized Randomized Controlled Trials Research Research Assistant Risk Screening procedure Sex Orientation Small Business Technology Transfer Research Stigmatization Tablet Computer Tablets Technology Testing Text Text Messaging Time TimeLine United States National Institutes of Health Universities Woman Work Youth aged base care providers cost design digital effectiveness trial emerging adult experience follow-up health empowerment improved intervention participants maltreatment men programs randomized trial recruit response school health screening secondary outcome sexual minority sexually active adolescent skills social cognitive theory social stigma software development statistics success therapy development tool treatment as usual treatment group

项目摘要

ABSTRACT Adolescents face increased HIV risk, infrequent testing, inconsistent linkage to care, and a lack of prevention related knowledge. We propose to address this by completing and evaluating the Mobile Augmented Screening (MAS) tool to increase youth HIV testing via a tablet-based intervention in clinical settings, and then use text messages to facilitate linkage to care for those who test positive, and deliver ongoing prevention education via text message to those who test negative. Many adolescents and young adults at greatest risk for HIV are unlikely to have access to primary care, and therefore have limited access to HIV testing and prevention education. When young people are offered testing, many decline because they believe (perhaps incorrectly) they are not at risk or because they fear being stigmatized. Our proposed MAS will enable care providers to privately and discretely offer routine HIV testing and counseling, including prevention education, to high need, diverse adolescent and young adult populations at a low cost. Further, because federal law requires public and private insurers to cover routine HIV testing, healthcare providers who use our proposed MAS to test an increased number of youth can potentially generate significant additional revenue through increased insurance reimbursements. The MAS will consist of 3 components. A tablet-based intervention including a brief video (approximately 5 minutes) designed to increase adolescent HIV testing, automated text-messages to facilitate linkage to care for those who test positive, and text-based education for those who test negative or decline testing. Our team has created multiple NIH-funded interventions to increase HIV testing among patients in high volume, urban emergency departments (EDs). Patients, including youth who initially declined testing, cited the privacy and clarity of our technology-based approach as reasons they ultimately agreed to test for HIV. During the Phase I grant period we conducted formative research with young ED patients, and then created the video portion of the MAS. Preliminary evaluations indicate the video was highly acceptable, led to significant knowledge increases, and encouraged testing. We now plan an effectiveness trial during the Phase II period. Digital Health Empowerment is a minority and woman owned SBC. Principals So-Young Oh and Ian David Aronson, Ph.D. have more than 10 years experience developing technology products together, including video- based health interventions and other digital content, for commercial, non-profit, and university clients. We seek to build upon this expertise, along with the initial success of our Phase I work, to: complete full intervention development; and evaluate the product through a randomized controlled trial with ED patients aged 13 – 24 (N=350), as well as qualitative interviews with a subset of young patients (n=40) and ED staff (n=10).

抽象的青少年面临艾滋病毒风险增加、检测不频繁、与护理的联系不一致以及缺乏预防措施我们建议通过完成和评估移动增强筛查来解决这个问题。 (MAS) 工具，通过在临床环境中基于平板电脑的干预来增加青少年艾滋病毒检测，然后使用文本信息，以促进与护理测试呈阳性的人的联系，并通过以下方式提供持续的预防教育向测试结果呈阴性的人发送短信。许多感染艾滋病毒风险最高的青少年和年轻人不太可能获得初级保健，并且因此，获得艾滋病毒检测和预防教育的机会有限。许多人拒绝是因为他们相信（也许是错误的）他们没有面临风险，或者因为他们害怕被我们提议的 MAS 将使护理提供者能够私下和离散地提供常规 HIV 检测。向高需求、多样化的青少年和青年群体提供咨询，包括预防教育此外，由于联邦法律要求公共和私人保险公司承保常规艾滋病毒检测，使用我们提议的 MAS 来测试更多青少年的医疗保健提供者可能会产生通过增加保险报销获得大量额外收入。 MAS 将由 3 个部分组成，基于平板电脑的干预包括一段简短的视频（大约 5 个）。分钟）旨在增加青少年艾滋病毒检测，自动短信以促进与护理人员的联系对测试呈阳性的人进行教育，对测试呈阴性或拒绝测试的人进行基于文本的教育。我们的团队制定了多项由 NIH 资助的干预措施，以增加高危患者的 HIV 检测城市急诊科（ED）的患者，包括最初拒绝检测的青少年，引用了这一说法。我们基于技术的方法的隐私性和清晰度是他们最终同意进行艾滋病毒检测的原因。在第一阶段资助期间，我们对年轻的 ED 患者进行了形成性研究，然后制作了视频初步评估部分表明该视频高度可接受，带来了重要的知识增加，并鼓励在第二阶段进行测试。 Digital Health Empowerment 是一家少数族裔、女性拥有的 SBC，其负责人 So-Young Oh 和 Ian David。 Aronson 博士拥有 10 多年共同开发技术产品的经验，包括视频基于健康干预措施和其他数字内容，面向商业、非营利和大学客户。凭借我们的专业知识以及我们第一阶段工作的初步成功，以：完成全面干预开发；并通过针对 13 至 24 岁 ED 患者的随机对照试验来评估该产品 (N=350)，以及对一部分年轻患者 (n=40) 和 ED 工作人员 (n=10) 的定性访谈。