A Telemedicine and mHealth Intervention for Reducing Alcohol Consumption among People Living with HIV/AIDS.

用于减少艾滋病毒/艾滋病患者饮酒量的远程医疗和移动健康干预措施。

基本信息

批准号：
10261369
负责人：
Carolyn Lauckner
金额：
$ 16.89万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-15 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10261369
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Age Alcohol consumption Alcohols Attitude Behavior Therapy Behavioral Bluetooth Caring Cellular Phone Client Clinic Clinical Clinical Data Cognitive Therapy Collection Communication Counseling Data Data Analyses Databases Disease Drug usage Educational workshop Effectiveness Ethnic Origin Evaluation Feedback Foundations Funding Gender General Population Goals HIV Health Health Insurance Portability and Accountability Act Highly Active Antiretroviral Therapy Improve Access Individual Interdisciplinary Study Intervention Intoxication Link Literature Measures Medical Mental Depression Mentors Methods Modernization Monitor National Institute on Alcohol Abuse and Alcoholism Outcome Outcomes Research Participant Patient Self-Report Patients Persons Pharmaceutical Preparations Prevention Process Professional counselor Public Health Questionnaires Race Randomized Randomized Controlled Trials Reading Recording of previous events Regimen Reporting Research Research Design Research Personnel Resources Secure Social support Survival Rate Technology Telemedicine Telephone Testing Time Training Transportation Travel Universities Validity of Self Report Videoconferencing Viral Visit Voice Waiting Lists Wireless Technology alcohol abuse therapy alcohol availability alcohol intervention alcohol monitoring alcohol related problem alcohol research alcohol testing base brief intervention cocaine use dosage drinking efficacy trial follow-up heroin use improved improved outcome innovation intervention effect intervention participants mHealth medication compliance meetings member motivational enhancement therapy new technology pilot trial problem drinker programs recruit reduced alcohol use response rural area skills telehealth therapy adherence therapy design tool treatment response urban area usability

项目摘要

Project Summary/Abstract With advances in treatment, people living with HIV/AIDS (PLWHA) have greatly improved survival rates and medical outcomes. However, despite the increased availability of highly-active antiretroviral therapy, many PLWHA fail to take their medication as directed. This reduces their chances of achieving viral suppression and is thus a crucial component of the HIV/AIDS treatment cascade. To improve the outcomes of PLWHA and address the low levels of viral suppression observed nationwide, it is essential to examine factors that are likely to decrease medication adherence. One such factor is alcohol consumption, which has been shown to have a significant and large effect on whether or not individuals follow their medication regimen. The primary objective of this research is to develop and test an alcohol reduction intervention for PLWHA. Based on collaborators’ previous research and prior literature, this eight-week intervention, titled Tracking and Reducing Alcohol Consumption (TRAC), will be delivered entirely using technology. Counselors will meet with patients using videoconferencing in partnership with the Georgia Department of Public Health’s Telehealth Network, as well as via phone-based conversations. This technology-based delivery will be highly accessible to patients in both rural and urban areas of Georgia, as it requires only two in-person visits to a local health department office for videoconferencing sessions. As a supplement to the intervention, participants will also engage in self-monitoring of alcohol consumption and medication adherence through mobile questionnaires and Bluetooth-enabled breathalyzers. The use of mobile breathalyzers represents an innovative application of modern technologies and has potential to improve the validity of self-reported alcohol consumption. Overall, the TRAC intervention will be developed and tested in two stages: an open trial (N=10) exploring acceptance and usability, and a small randomized pilot trial (N=60) assessing feasibility and evidence for efficacy in regard to reducing alcohol consumption, increasing medication adherence, and improving medical outcomes. I aim to receive comprehensive training to support this line of research related to reducing alcohol consumption among PLWHA. As part of my training plan, five mentors who specialize in HIV/AIDS, alcohol, intervention design, telemedicine, and advanced data analysis will provide guidance through directed readings, regular meetings, and feedback on research design. These mentors are located at the University of Georgia and Yale University. Both universities will provide me with access to extensive intellectual resources and partnering organizations who can aid in my research, including the Georgia Department of Public Health, Yale’s Center for Interdisciplinary Research on AIDS, and the NIAAA Consortia for HIV/AIDS and Alcohol-Related Research Trials. I will also participate in courses and workshops related to clinical data analysis, HIV/AIDS research, and behavioral intervention design. This training will provide me with the foundation needed to meet my long-term goal of conducting an externally-funded program of research in HIV/AIDS and alcohol and drug use.

项目摘要/摘要随着治疗的进步，艾滋病毒/艾滋病（PLWHA）的人的生存率大大提高，并且医疗结果。然而，尽管高度活跃抗逆转录病毒疗法的可用性增加了 PLWHA无法按照指示服药。这减少了他们实现病毒抑制和因此，是HIV/AIDS治疗级联的关键组成部分。改善PLWHA的结果和解决全国观察到的病毒抑制的低水平，必须检查可能是可能的因素降低药物依从性。这样一个因素是饮酒，该因素已被证明具有对个人是否遵循其药物治疗方案的重大影响。这项研究的主要目的是开发和测试PLWHA的饮酒干预措施。根据合作者的先前研究和先前的文献，这项为期八周的干预措施，标题为“跟踪”和减少饮酒（TRAC）将完全使用技术交付。辅导员将与与佐治亚州公共卫生部远程医疗合作使用视频会议的患者网络以及通过基于电话的对话。这种基于技术的交付将高度使用佐治亚州粗糙和城市地区的患者，因为它仅需要两次面对当地健康的访问部门视频会议办公室。作为干预的补充，参与者也将通过移动问卷进行饮酒和药物依从性的自我监控和支持蓝牙的Braathalyzer。移动braathalyzers的使用代表了现代技术，有可能提高自我报告的酒精消耗的有效性。全面的， TRAC干预将在两个阶段开发和测试：开放试验（n = 10）探索接受和可用性，以及一项小型的随机试验试验（n = 60），评估可行性和证据减少饮酒，增加药物依从性并改善医疗结果。我的目标是接受全面的培训，以支持与减少饮酒有关的这一研究在plwha中。作为我培训计划的一部分，五位专门从事艾滋病毒/艾滋病，酒精，干预的导师设计，远程医疗和高级数据分析将通过定期读数，常规读数提供指导会议和研究设计的反馈。这些导师位于佐治亚大学和耶鲁大学大学。两所大学都将为我提供广泛的智力资源和合作的机会可以协助我的研究的组织，包括乔治亚州公共卫生部，耶鲁大学中心用于艾滋病的跨学科研究以及NIAAA艾滋病毒/艾滋病和酒精有关的研究试验。我还将参加与临床数据分析，艾滋病毒/艾滋病研究以及行为干预设计。这项培训将为我提供长期满足所需的基础在艾滋病毒/艾滋病，酒精和吸毒的研究计划中进行外部资助的计划。