Mobile Health Intervention to Increase HIV Self Testing and Linkage to Services for High-Risk Men in China

移动健康干预措施旨在加强中国高危男性的艾滋病毒自我检测和服务联系

基本信息

批准号：
10747137
负责人：
DON OPERARIO
金额：
$ 51.79万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-04-01 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10747137
关键词：
2 arm randomized control trial AIDS prevention Adherence Age Behavioral Behavioral Mechanisms Behavioral Model Caring Characteristics China Cities Clinic Communication Consolidated Framework for Implementation Research Continuity of Patient Care Control Groups Coping Skills Country Cultural Sensitivity Data Development Disclosure Early Diagnosis Education Excision Goals Grant HIV HIV Infections HIV Seronegativity HIV Seropositivity HIV diagnosis HIV risk Health Health Promotion Health Services High Prevalence Human immunodeficiency virus test Individual Infection Intervention Link Maps Measures Mediation Motivation National Institute of Mental Health Outcome Participant Persons Photography Pilot Projects Population Prevention Privatization Process Professional counselor Qualitative Evaluations Qualitative Research Research Resource-limited setting Risk Risk Reduction Science Secure Self Efficacy Services Site Strategic Planning Test Result Testing Time Treatment Efficacy United States National Institutes of Health Visual Work behavior change behavior test care outcomes care systems cost effectiveness evaluation effectiveness testing effectiveness/implementation hybrid efficacy evaluation follow-up high risk men home test hybrid type 1 design implementation evaluation implementation intervention improved informant innovation intervention effect mHealth men who have sex with men minority stress mobile application pilot test prevention service primary outcome recruit same sex behavior scale up secondary outcome self testing sexual risk behavior social stigma testing services testing uptake theories translational approach transmission process treatment services uptake user centered design willingness

项目摘要

PROJECT SUMMARY The overarching goal of this R01 application (PA-18-278: Innovations in HIV Testing, Adherence, and Retention to Optimize HIV Care Continuum Outcomes) is to advance the science of mobile health approaches to increase uptake of repeat HIV self-testing (HST) and linkage to HIV-related care with populations that underperform on these steps of the HIV care continuum. We propose an intervention entitled “WeTest- WeLink” that builds on years of formative work with MSM in China (R34MH106349), demonstrating promising effects from a pilot RCT and strong indication of intervention acceptability, feasibility, and cultural sensitivity. The intervention uses the “WeChat” mobile app platform, which offers multiple features built into the app that facilitate health information delivery and communication channels (e.g., capacity for private texts, group chats, video sharing, GPS, instant messaging, real-time audio and visual communication). Guided by the Information- Motivation-Behavioral (IMB) model and Minority Stress Theory, we will employ a user-centered design process to refine and expand app features to support repeat HST uptake, behavioral risk reduction, stigma coping strategies, and self-efficacy to link to HIV care. We will use an Effectiveness-Implementation Hybrid Type 1 design consisting of a three site, 2-arm RCT to test HST and linkage to HIV related care outcomes as well as qualitative research to examine implementation and scalability. We will recruit 1,800 HIV negative MSM in three cities with HIV high-prevalence among MSM – Chengdu (9%), Suzhou (13%), Wuhan (11%) – allocated to the intervention (access to the WeTest-WeLink app) or control group (education about HST and passive referral to HIV care for individuals who test HIV positive). We will assess participants at 6-, 12-, and 18 months to measure intervention effects on primary outcomes: repeated use of HST (including photographic confirmation) and linkage to care for individuals who test HIV-positive. Secondary outcomes include sexual risk behaviors and use of HIV prevention services, and we will conduct mediation analysis to examine theoretical mechanisms of behavior change. We will qualitatively assess intervention-related process characteristics that enable and/or impede implementation and scalability informed by the Consolidated Framework for Implementation Research (CFIR). This project will provide the first known evidence for a mobile health approach to optimize both HIV testing and linkage to care as part of a single intervention continuum with MSM. Such findings can be crucial for optimizing the care cascade in populations that underutilize HIV services, such as MSM in China and elsewhere in the world where HIV testing and linkage to care services are sub-optimal.

项目概要此 R01 应用程序的总体目标（PA-18-278：HIV 检测、依从性和 Retention to Optimize HIV Care Continuum Outcomes）旨在推进移动医疗方法的科学性提高艾滋病毒重复自检 (HST) 的采用率以及与艾滋病毒相关护理与以下人群的联系：在艾滋病毒护理连续体的这些步骤上表现不佳，我们提出了一项题为“WeTest-”的干预措施。 WeLink”建立在与中国 MSM 多年的形成性合作 (R34MH106349) 的基础上，展示了前景广阔试点随机对照试验的效果以及干预可接受性、可行性和文化敏感性的强烈指示。干预使用“微信”移动应用程序平台，该平台提供了内置于应用程序中的多种功能，促进健康信息传递和沟通渠道（例如私人文本、群聊、视频共享、GPS、即时消息、实时音频和视频通信）。动机行为（IMB）模型和少数压力理论，我们将采用以用户为中心的设计流程完善和扩展应用程序功能，以支持重复 HST 吸收、行为风险降低、耻辱应对我们将使用有效性-实施混合型 1 型策略和自我效能感。设计包括三中心、两臂 RCT，用于测试 HST 以及与 HIV 相关护理结果的联系以及我们将招募 1,800 名 HIV 阴性 MSM 进行定性研究，以检验其实施情况和可扩展性。男男性接触者艾滋病病毒感染率高的三个城市——成都（9%）、苏州（13%）、武汉（11%）——分配干预组（访问 WeTest-WeLink 应用程序）或对照组（有关 HST 和被动学习的教育）我们将在 6 个月、12 个月和 18 个月时对参与者进行评估。衡量干预措施对主要结果的影响：重复使用 HST（包括摄影确认）以及与艾滋病毒检测呈阳性的个体的护理的联系次要结果包括性风险。 HIV预防服务的行为和使用，我们将进行中介分析，从理论上检验我们将定性评估与干预相关的过程特征促进和/或阻碍综合框架所告知的实施和可扩展性实施研究（CFIR）。该项目将为移动健康提供第一个已知的证据。优化 HIV 检测和护理联系的方法，作为 MSM 单一干预连续体的一部分。这些发现对于优化未充分利用艾滋病毒服务的人群的护理级联至关重要，例如在中国和世界其他地方，男男性行为者的艾滋病毒检测和护理服务的联系并不理想。