iTransition: Developing and Pilot Testing a Multilevel Technology-Based Intervention to Support Youth Living with HIV from Adolescent to Adult Care

iTransition：开发和试点测试基于技术的多层次干预措施，以支持艾滋病毒感染者从青少年到成人护理

• 批准号: 10004717
• 负责人: Sophia A. Hussen
• 金额: $ 27.98万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10004717
• 关键词: Address; Adherence; Adolescent; Adolescent and Young Adult; Adoption; Adult; Age; Appointment; Caring; Cellular Phone; Childhood; Clinic; Clinical; Communication; Computerized Medical Record; Continuity of Patient Care; Control Groups; Data; Development; Disease Management; Ensure; Epidemic; Evaluation; Evidence based intervention; Face; Future; Goals; HIV; HIV Infections; Health Personnel; Healthcare; Incidence; Individual; Internet; Intervention; Interview; Link; Measures; Medical; Methods; Morbidity - disease rate; NIH Office of AIDS Research; Outcome; Participant; Patients; Philadelphia; Preparation; Prevention; Procedures; Process; Protocols documentation; Provider; Public Health; Randomized Controlled Trials; Research Priority; Site; Standardization; Structure; Surveys; Technology; Testing; Training; United States; Viral; Viral Load result; Work; Youth; age group; barrier to care; base; care coordination; care providers; clinical care; clinical practice; cohort; comparison group; design; efficacy testing; experience; group intervention; health care settings; health disparity; implementation trial; improved; individual patient; iterative design; mHealth; medication compliance; member; mobile computing; mortality; multidisciplinary; novel; patient-clinician communication; pilot trial; prospective; retention rate; social cognitive theory; success; therapy design; therapy development; uptake; usability; web platform; web site

ABSTRACT Youth between the ages 13 and 24 are disproportionately represented in the United States HIV epidemic; in 2015, 22% of HIV infections occurred within this age group. Youth living with HIV (YLH) face significant barriers to care engagement across all stages of the HIV Care Continuum. The transition from pediatric/adolescent to adult-oriented care settings can be especially disruptive. Yet, there are no evidence- based interventions shown to improve healthcare transition (HCT) clinical outcomes for YLH. We propose to develop and pilot iTransition, a mobile website-based intervention for YLH and their providers to improve HCT at the patient, provider, and clinic levels. To maximize the cultural and developmental congruence of the intervention we will convene a Design Team that includes YLH and healthcare providers, who will inform the development of the intervention content and delivery strategies. Using an iterative design and development process, we will develop tailored content and activities that align with YLH-specific HCT needs. After developing the intervention, we will employ established usability testing procedures to collect preliminary data from our Design Team on the proposed intervention's design and acceptability. Providers on the Design Team will also be trained as “Transition Champions, encouraging and facilitating uptake of the intervention in their respective clinics. Recommended changes will be added to the intervention prior to launching an implementation trial based at pediatric/adolescent and adult-oriented HIV clinical care sites in Atlanta and Philadelphia. The trial will use a mixed-methods approach to assess intervention feasibility and acceptability for YLH (N=50) and provider (N=20) participants. We will also compare clinical outcomes of YLH in the iTransition intervention group (N=50) over the 12-month period around HCT, to outcomes of a historical comparison group (N=50), in order to gather preliminary efficacy data to inform a subsequent application. Specific Aims include: (1) To develop iTransition, an mHealth intervention designed to improve care engagement throughout HCT by targeting YLH, pediatric/adolescent providers' and adult providers' needs; and (2) To conduct a pilot trial of iTransition with 50 YLH and 20 providers, in order to collect data on feasibility, acceptability, and preliminary efficacy for improving HCT. Future directions include a fully powered RCT to test the efficacy of iTransition for improving post-HCT care continuum outcomes for YLH.

抽象的 在美国，13至24岁之间的青年在美国艾滋病毒流行中不成比例地交往） 2015年，艾滋病毒感染的22％发生在该年龄组内。 在Hib Care连续的所有阶段的关怀障碍 小儿/青少年到成人的护理环境可能尤其是破坏性的。 我们提出的基于改善医疗保健转变（HCT）临床结果的干预措施 开发和驾驶ITransition，这是一种基于移动网站的YLH及其提供商的间隔，以改善HCT 在患者，提供者和诊所水平上。 间隔我们将召集一个包括YLH和医疗保健提供者在内的设计团队，他们将告知 开发干预内容和交付策略。 过程，我们将开发量身定制的内容和与YLH特定的HCT需求保持一致的活动。 制定干预措施，我们将估计测试程序以收集初步数据 我们的设计团队在设计团队中提供的干预设计和可接受性。 还将被培训为“过渡冠军，鼓励和促进对他们的干预的吸收 推荐的临时诊所将在启动之前添加 基于亚特兰大的儿科/青少年和成人艾滋病毒临床护理网站的实施试验 费城。 YLH（n = 50）和提供商（n = 20）参与者。 在HCT附近的12个月期间，干预组（n = 50），与历史比较组的结果 （n = 50），以收集原始功效数据以告知后续申请。 （1）开发Itransition，这是一种旨在改善护理参与度的MHealth Itransition 针对YLH，儿科/青少年提供者和成人提供者的需求； 拥有50 YLH和20个提供商的ITRANSITION，以收集有关饮食性的数据 改善HCT的功效。 改善YLH的HCT后护理连续性结果。