Development and pilot testing of a mobile health application to improve HIV prevention and substance use treatment service access among women involved in the carceral system

开发并试点测试移动医疗应用程序，以改善监狱系统中妇女的艾滋病毒预防和药物滥用治疗服务的获取

• 批准号: 10619999
• 负责人: Sarah B Bass
• 金额: $ 25.21万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10619999
• 关键词: AIDS prevention; Access to Information; Address; Adherence; Advocate; Attitude; Bass; Behavior; COVID-19 pandemic; Communication; Communities; Community Health; Community Healthcare; Complex; Counseling; Data; Decision Making; Demographic Factors; Development; Discrimination; Enhancement Technology; Feedback; Gender; General Population; HIV; HIV Infections; HIV risk; Health Personnel; Health Services; Healthcare; Hepatitis C virus; High Risk Woman; Imprisonment; Individual; Intervention; Intervention Studies; Interview; Jail; Knowledge; Link; Maps; Marketing; Medical; Mental Health; Methods; Minority Women; Mobile Health Application; Modality; Modeling; Needle Sharing; Overdose; Participant; Patient Self-Report; Patients; Pennsylvania; Perception; Pharmaceutical Preparations; Philadelphia; Pilot Projects; Poverty; Prevention strategy; Provider; Randomized; Research; Research Design; Resources; Risk; Route; Self Assessment; Services; Shapes; Structure; Substance Use Disorder; Surveys; System; Techniques; Technology; Testing; Transact; Unsafe Sex; Woman; Women' s Group; Work; acceptability and feasibility; barrier to care; behavioral health; care providers; eHealth; ethnic disparity; ethnic minority; experience; follow-up; formative assessment; health care availability; health care delivery; high risk; implementation framework; implementation science; improved; injection drug use; innovation; interest; mHealth; marginalization; medication for opioid use disorder; men; methadone patient; mobile application; mobile computing; multidisciplinary; novel; opioid use disorder; overdose risk; patient navigation; peer; peer support; pilot test; pilot trial; pre-exposure prophylaxis; preventive intervention; primary outcome; programs; prototype; racial disparity; racial minority; racism; secondary outcome; service organization; sex; smartphone based assessment; social; social stigma; sociocultural determinant; substance abuse treatment; substance use; substance use treatment; therapy development; three-dimensional visualization; tool; treatment services; underserved community; uptake; usability; vector; web app

Project Summary Women involved with the carceral system are more at risk of HIV infection, substance use disorders, and overdose than their community-based counterparts. Pre-exposure prophylaxis (PrEP) has emerged as a powerful HIV-prevention tool and in combination with Medication for Opioid Use Disorder (MOUD) could significantly impact HIV and overdose risk. Patient navigation holds strong potential to address multifactorial and complex barriers to PrEP and substance use treatment linkage and uptake for women involved in the carceral system. In tandem with patient navigation, eHealth has the potential to improve healthcare engagement for this group of women. As a multidisciplinary team with expertise in HIV-prevention implementation science research, technology enhanced, gender-responsive, and behavioral health focused (substance use, mental health and HIV prevention) interventions, and intervention development for individuals involved in the carceral system, we propose to examine the potential impact of using a technology-based adjunct to an existing navigation program to improve linkage to PrEP and MOUD for women leaving carceral settings in Philadelphia (PA). Intervention development and study design will be guided by our team’s pilot and on-going research, and the EPIS Implementation Framework. Study aims are to: 1) Assess women involved in the carceral systems’ perceptions of PrEP and MOUD and potential barriers to initiation and adherence; 2) Develop the PA-Links web-based app and assess usability and acceptability; and 3) Pilot the intervention to assess for promise of efficacy in engaging women involved in the carceral systems in PrEP and MOUD by integrating PA-Links into existing patient navigation. A survey of women involved in the carceral system and perceptual mapping analyses will be used in Aim 1 to guide proto-type app development and user testing in Aim 2. In Aim 3, we will examine the primary outcome of PrEP and MOUD service linkage and secondary outcomes such as PrEP and MOUD prescription/initiation, PrEP and MOUD adherence/persistence, perceptions and knowledge, and acceptability of the intervention. A Community Advisory Board will inform all aspects of the proposed study. This pilot study will significantly contribute to the field of HIV and substance abuse treatment by examining the potential impact of using technology based, tailored, gender-responsive interventions in adjunct with existing navigation in an urban, community-based health center. Study results will provide crucial information for a subsequent R01 proposal to rigorously evaluate an urgently needed HIV prevention intervention developed specifically to meet the unique cultural and social needs of high-risk women.

项目摘要 涉及术系统的妇女更容易受到艾滋病毒感染，药物使用障碍和 服用过量比他们的社区同行。暴露前预防（PREP）已成为 强大的HIV预防工具，并结合阿片类药物使用障碍（MOUD）的药物 显着影响艾滋病毒和过量的风险。患者导航具有解决多因素的强大潜力 与参与该女性的准备和物质使用治疗连接和吸收的复杂障碍 carceral系统。在与患者导航的同时，eHealth有可能改善医疗保健 这组妇女的订婚。作为具有艾滋病毒预防专业知识的多学科团队 实施科学研究，技术增强，性别响应和行为健康的重点 （药物使用，心理健康和艾滋病毒预防）干预措施，并为个人开发干预措施 参与Carceral System，我们建议研究使用基于技术的潜在影响 现有导航计划的兼职，以改善与妇女离开Carceral 费城（PA）的设置。干预开发和研究设计将由我们团队的飞行员和 正在进行的研究和EPIC实施框架。研究目的是：1）评估参与的妇女 Carceral Systems对PrEP和MOUD的看法以及对主动性和依从性的潜在障碍； 2） 开发基于Web的PA链接应用程序以及评估可用性和可接受性； 3）试点干预措施 评估效率的承诺，参与参与PREP和MOUD的妇女参与carceral Systems 将PA链接集成到现有的患者导航中。一项对参与汽车系统的妇女的调查和 AIM 1将使用感知映射分析来指导AIM中的原型应用程序开发和用户测试 2。在AIM 3中，我们将研究PrEP和MOUD服务连锁和次要结果的主要结果 例如准备和穆德处方/启动，准备和穆德坚持/持久性，感知和 干预的知识和可接受性。社区顾问委员会将为 拟议的研究。这项试点研究将通过 检查使用基于技术的，量身定制的性别响应性干预措施的潜在影响 在一个城市，社区健康中心的现有导航。研究结果将提供至关重要的 随后的R01提案的信息，以严格评估急需的艾滋病毒预防 干预专门为满足高风险妇女的独特文化和社会需求而开发。