Effectiveness and implementation of text messaging to improve HIV testing in sexual and gender minority adolescents

短信改善性少数青少年艾滋病毒检测的有效性和实施

基本信息

批准号：
10403150
负责人：
Kathryn Rose Macapagal
金额：
$ 79.95万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-05 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10403150
关键词：
AIDS prevention Accounting Address Adolescent Adoption Adult Affect Age Attention Behavioral Bisexual Caring Centers for Disease Control and Prevention (U.S.)Clinic Communities Computer software Consensus Consolidated Framework for Implementation Research Continuity of Patient Care Development Devices Effectiveness Ensure Eye Focus Groups Gays Gender Generations Goals HIV HIV Infections HIV Seropositivity HIV risk Health Personnel Human immunodeficiency virus test Hybrids Incidence Infection Intervention Intervention Trial Interview Left Mediator of activation protein Minority Modeling Modernization Motivation Outcome Population Prevention Prevention Research Prevention program Process Provider Public Health Randomized Randomized Controlled Trials Recommendation Reporting Research Resources Risk Risk Reduction Behavior Science Self Efficacy Service provision Sexual and Gender Minorities Strategic Planning Surveys Technology Teenagers Test Result Testing Text Messaging Time Unsafe Sex Update Youth active method age group aged antiretroviral therapy arm base behavior change behavior test boys cisgender design digital digital health digital intervention effective intervention effectiveness outcome effectiveness testing follow-up girls group intervention healthy lifestyle high school hybrid type 1 trial implementation barriers implementation science improved innovation minority children pre-exposure prophylaxis preference prevent preventive intervention primary outcome programs prospective recruit scale up screening secondary outcome sexual minority male sexual minority youth sexually active adolescent skills social media software development success therapy design tool transgender transmission process treatment arm uptake

AIDS prevention Accounting Address Adolescent Adoption Adult Affect Age Attention Behavioral Bisexual Caring Centers for Disease Control and Prevention (U.S.)Clinic Communities Computer software Consensus Consolidated Framework for Implementation Research Continuity of Patient Care Development Devices Effectiveness Ensure Eye Focus Groups Gays Gender Generations Goals HIV HIV Infections HIV Seropositivity HIV risk Health Personnel Human immunodeficiency virus test Hybrids Incidence Infection Intervention Intervention Trial Interview Left Mediator of activation protein Minority Modeling Modernization Motivation Outcome Population Prevention Prevention Research Prevention program Process Provider Public Health Randomized Randomized Controlled Trials Recommendation Reporting Research Resources Risk Risk Reduction Behavior Science Self Efficacy Service provision Sexual and Gender Minorities Strategic Planning Surveys Technology Teenagers Test Result Testing Text Messaging Time Unsafe Sex Update Youth active method age group aged antiretroviral therapy arm base behavior change behavior test boys cisgender design digital digital health digital intervention effective intervention effectiveness outcome effectiveness testing follow-up girls group intervention healthy lifestyle high school hybrid type 1 trial implementation barriers implementation science improved innovation minority children pre-exposure prophylaxis preference prevent preventive intervention primary outcome programs prospective recruit scale up screening secondary outcome sexual minority male sexual minority youth sexually active adolescent skills social media software development success therapy design tool transgender transmission process treatment arm uptake

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项目摘要

Project Summary Adolescent sexual minority males, transgender girls, and gender diverse teens (ASMM/TGD; ages 13-18) are disproportionately affected by HIV, accounting for 79% of new infections among this age group. Although CDC and USPTF recommend HIV screening among teens, testing rates among ASMM/TGD are very low (1 in 4 ASMM; <1 in 10 TGD). Increasing HIV testing in ASMM/TGD is critical in mitigating transmission rates and in linkage to care for those who test positive. Despite this alarming public health issue, few developmentally tailored HIV prevention interventions exist for ASMM/TGD, and to date, no CDC best-evidence interventions for this group are focused on increasing HIV testing as a primary outcome. G2G was a 6-week text message-based HIV risk behavior reduction program originally designed for ASMM. Active treatment arm content focused on providing HIV prevention information, increasing HIV prevention motivation, and increasing HIV prevention self- efficacy relative to an information-only healthy lifestyle control arm. The G2G pilot RCT showed adolescents in the active treatment arm were >3x more likely to report being tested for HIV at follow-up versus those in the control arm, even though only a minority of messages focused on testing. We propose to update G2G with the latest HIV prevention and testing science, make content inclusive of TGD, and test its effectiveness on the outcome of validated HIV testing (e.g., photo of test result). Moreover, widespread adoption of digital HIV prevention programs has lagged due to lack of attention to implementation throughout software development, intervention design, and testing. For instance, who should implement digital HIV prevention/testing interventions for teens (e.g., direct-to-consumer, clinics) remains an open question, and involving potential implementers in the development process can ensure intervention success; best practices for updating content and technology for digital HIV prevention/testing programs to prevent their obsolescence are lacking; and there is a lack of consensus on how best to reach SGM adolescents for such programs. We propose a Hybrid Type 1 trial that will establish G2G effectiveness and identify best practices for implementing digital HIV prevention/testing for teens via three specific aims. In Aim 1 we will collaborate with a youth advisory council to add content reflecting our increased emphasis on HIV testing and update gender inclusivity and cultural relevance of existing content. With prospective implementers’ input, we will also modernize the G2G software platform with an eye toward implementation. In Aim 2 we will test G2G effectiveness on HIV testing in a nationwide randomized controlled trial with 360 ASMM/TGD aged 13-18. Finally, Aim 3 will convene a experts in ASMM/TGD youth research and service provision to identify and achieve consensus in processes of, requirements for, and barriers/facilitators to reaching and engaging ASMM/TGD for HIV testing/prevention. The goal of Aim 3 is to inform, develop, and disseminate concrete tools to ensure HIV prevention programs reach ASMM/TGD. The panel will also recommend potential implementation models and adaptations needed to scale up G2G in real world settings.

项目摘要青少年性少数男性，跨性别女孩和性别不同的青少年（ASMM/TGD； 13-18岁）受艾滋病毒的影响不成比例，占该年龄组新感染的79％。虽然CDC USPTF建议在青少年中进行艾滋病毒筛查，ASMM/TGD的测试率很低（四分之一 asmm; <10 tgd中的1个）。在ASMM/TGD中增加HIV测试对于缓解传输速率和在与那些测试阳性的人保持联系。尽管这个令人震惊的公共卫生问题，但很少有量身定制的为ASMM/TGD存在HIV预防干预措施，迄今为止，没有CDC最佳证据干预措施小组的重点是增加HIV测试作为主要结果。 G2G是一个为期6周的基于短信的艾滋病毒降低风险行为的计划最初是为ASMM设计的。主动治疗臂内容的重点提供预防艾滋病毒的信息，增加艾滋病毒预防动机以及增加艾滋病毒预防自我相对于仅信息健康的生活方式控制部门的功效。 G2G飞行员RCT在主动治疗臂报告在随访中对HIV进行测试的可能性更高。控制臂，即使只有少数信息专注于测试。我们建议用最新的HIV预防和测试科学，使内容包括TGD，并测试其在经过验证的HIV测试的结果（例如，测试结果的照片）。此外，通过数字艾滋病毒的宽度采用预防计划落后于整个软件开发中对实施的关注，干预设计和测试。例如，谁应该实施预防数字艾滋病毒/测试干预措施对于青少年（例如，直接面向消费者，诊所）仍然是一个悬而未决的问题，并参与了潜在的实施者开发过程可以确保干预成功；更新内容和技术的最佳实践为了预防数字艾滋病毒/测试计划，以防止其过时；而且缺乏关于如何最好地与SGM青少年有关此类计划的共识。我们提出了一项混合型1试验，该试验将建立G2G有效性并确定针对青少年实施数字艾滋病毒预防/测试的最佳实践通过三个特定目标。在AIM 1中，我们将与青年咨询委员会合作，以添加反映我们的内容对艾滋病毒测试和更新现有内容的性别包容性和文化相关性的强调越来越重视。和潜在的实施者的意见，我们还将对G2G软件平台进行现代化，以注重执行。在AIM 2中，我们将在全国范围内的随机控制中测试G2G对HIV测试的有效性 360 ASMM/TGD年龄13-18岁。最后，AIM 3将召集ASMM/TGD青年研究专家服务规定以识别和达成在对过程，要求和障碍的过程中的共识，达到和参与ASMM/TGD进行HIV测试/预防。目标3的目标是告知，开发和传播混凝土工具，以确保预防艾滋病毒计划达到ASMM/TGD。面板也将建议在现实世界中规模扩大G2G所需的潜在实施模型和改编。