A Smartphone Game to Increase Engagement in Care among African Adolescents Living with HIV

一款提高非洲艾滋病毒青少年护理参与度的智能手机游戏

基本信息

批准号：
10718335
负责人：
S KATE WINSKELL
金额：
$ 32.44万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-02 至 2026-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10718335
关键词：
Active Learning Address Adherence Adolescence Adolescent Adult Africa Africa South of the Sahara African Age Attitude Behavior Therapy Behavioral Caregivers Caring Cellular Phone Clinical Communication Continuity of Patient Care Country Data Data Collection Development Disclosure Education Electronics Emotional Environment Epidemiology Evidence based practice Female Funding Future Goals HIV Health Human Resources Individual Infection Intervention Kenya Knowledge Life Life Expectancy Managed Care Mediating Mediator Medical Research Mental Health Modeling Morbidity - disease rate Motivation Outcome Perinatal Persons Pharmaceutical Preparations Pilot Projects Population Randomized, Controlled Trials Reproductive Health Research Research Institute Resources Risk Sampling Self Care Self Efficacy Sexual Health Social Behavior Social support Structure Target Populations Technology Telephone Testing Time United States National Institutes of Health Universities Vertical Disease Transmission Viral Viral Load result Vulnerable Populations Youth adolescent health outcomes aged antiretroviral therapy base behavior influence care systems coping cost cost effective design digital efficacy trial experience feasibility testing global health handheld mobile device improved intervention effect mHealth male medication compliance mortality multidisciplinary mutual learning pedagogy poor health outcome preadolescence prevent response safety assessment safety testing scaffold sexual risk taking skills social social cognitive theory social stigma theories transmission process treatment arm unintended pregnancy uptake usability virtual

项目摘要

Project Summary: The goal of the study is to contribute to efforts to improve health outcomes for adolescents living with HIV (ALHIV) in sub-Saharan Africa, a population of high demographic, clinical and epidemiological importance. We aim to advance this goal by creating and testing in Kisumu, Kenya, a smartphone game-based intervention for ALHIV aged 15-18 (MyLife). It will focus on increasing adherence to antiretroviral therapy (ART) and addressing sexual and reproductive health needs. It will be informed by socio-behavioral, communication and pedagogical theories, evidence-based practice, and unique research on young Africans’ narratives about HIV. It will be designed to increase ALHIV knowledge, motivation, skills, and resources to facilitate: (1) increased autonomy in treatment management and self-care; (2) mental health and strategies for addressing stigma; (3) social support including via dialogue with caregivers and disclosure to others; and (4) sexual risk avoidance and reduction. The increasing availability of smartphones in Africa provides unprecedented opportunities to deliver culturally relevant narrative-based behavioral interventions for ALHIV that incorporate digital resources to support adherence such as medication and refill trackers and reminders. Such interventions require little personnel to implement, have high entertainment and motivation appeal, and incorporate automated data collection to support theory-building. By allowing players to experience real agency in a virtual and safe environment, well-designed games offer a level of experiential learning unparalleled by most other interventions. The proposed project has the following aims: (1) (R21) To design, develop, and conduct usability, acceptability, and safety testing of a theory-based smartphone game for ALHIV ages 15-18 focused on increasing and sustaining engagement in HIV care and sexual risk avoidance and reduction, with iterative input from the target population; (2) (R33) Via a cluster-randomized controlled trial with a sample of 120 ALHIV ages 15-18 in Kisumu to conduct comprehensive feasibility testing and determine whether the game influences behavioral mediators of engagement in care and sexual risk avoidance and reduction (including knowledge, attitudes, behavioral intentions, and self-efficacy); and (3) (R21/R33) To strengthen the capacity of the established multidisciplinary team to conduct mHealth, specifically serious games for health, research in sSA. Our Secondary Aims are: (1) To provide preliminary data on the game’s impact on viral load, engagement in care, and sexual risk avoidance and reduction. (2) Through analysis of outcome data and game paradata, to identify the game components and theoretical constructs that mediated intervention effects. The proposed intervention holds promise to be highly scalable, cost-effective, and culturally adaptable to other settings. By advancing the evidence and theory base, addressing challenges to uptake through motivating pedagogy, assessing safety for a vulnerable population, attending to potential future dissemination, and building capacity for mHealth research in sub-Saharan Africa, the study shows promise to advance global mHealth.

项目摘要：该研究的目标是为改善青少年的健康状况做出贡献撒哈拉以南非洲地区的艾滋病毒 (ALHIV) 感染者是一个人口、临床和流行病学人口较多的地区我们的目标是通过在肯尼亚基苏木创建和测试一款基于智能手机游戏的游戏来推进这一目标。针对 15-18 岁 ALHIV 的干预 (MyLife) 重点是提高抗逆转录病毒治疗 (ART) 的依从性。它将通过社会行为、沟通来解决性和生殖健康需求。和教学理论、循证实践以及对非洲年轻人关于艾滋病毒叙述的独特研究。它将旨在增加 ALHIV 知识、动机、技能和资源，以促进：(1) 增加治疗管理和自我护理的自主权；(2) 心理健康和解决耻辱的策略；社会支持，包括通过与护理人员对话和向他人披露；(4) 避免性风险；非洲智能手机的普及提供了前所未有的机会。针对 ALHIV 的文化相关的基于叙事的行为干预措施，将数字资源纳入支持依从性，例如药物和补充跟踪器和提醒。人员实施，具有较高的娱乐性和激励吸引力，并整合自动化数据通过让玩家在虚拟和安全的环境中体验真实的代理来支持理论构建。在良好的环境中，精心设计的游戏提供了大多数其他干预措施无法比拟的体验式学习水平。拟议项目有以下目标： (1) (R21) 设计、开发和进行可用性，针对 15-18 岁 ALHIV 患者的基于理论的智能手机游戏的可接受性和安全性测试，重点是提高持续参与艾滋病毒护理以及避免和减少性风险，并听取来自各方的反复投入 (2) (R33) 通过一项整群随机对照试验，样本为 120 名 15-18 岁的 ALHIV 患者基苏木将进行全面的可行性测试并确定游戏是否影响行为参与护理以及避免和减少性风险的中介因素（包括知识、态度、 (3) (R21/R33) 加强现有机构的能力多学科团队在 sSA 我们的中学开展移动健康研究，特别是严肃的健康游戏。目的是：(1) 提供有关游戏对病毒载量、护理参与度和性行为影响的初步数据 (2)通过分析结果数据和比赛参数，识别比赛介导干预效果的成分和理论结构。拟议的干预措施有望具有高度可扩展性、成本效益和文化适应性通过推进证据和理论基础，通过激励解决吸收挑战。教育学，评估弱势群体的安全，关注未来潜在的传播，以及建立该研究显示了撒哈拉以南非洲移动医疗研究能力，有望推动全球移动医疗的发展。