Optimizing the efficiency and implementation of cash transfers to improve adherence to antiretroviral therapy: study protocol for a cluster randomized controlled trial.
Optimizing the efficiency and implementation of cash transfers to improve adherence to antiretroviral therapy: study protocol for a cluster randomized controlled trial.
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DOI：
10.1186/s13063-020-04899-7
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发表时间：
2020-11-23
期刊：
影响因子：
2.5
通讯作者：
McCoy S
中科院分区：
文献类型：
--
作者：
Packel L;Njau P;Fahey C;Ramadhani A;Dow WH;Jewell NP;McCoy S
每天对艾滋病毒进行抗逆转录病毒治疗是临床抑制该病毒的一种有效策略，具有提高生存率和大大降低传播风险的双重益处。然而，这种非常有效的干预尚未惠及所有可能受益的人。现金转移支付越来越被认为是一种有效的策略，可以激励行为改变，改善艾滋病毒护理和治疗结果，包括参与艾滋病毒护理和坚持抗逆转录病毒药物治疗。尽管现金转移方法有越来越多的证据基础和强大的理论基础，但关键问题仍然存在。为了解决这些问题并开始弥合现金转移支付方面的“知识差距”，我们的团队正在采用一种实施科学方法，反复开发一种基于激励的干预措施，以促进坦桑尼亚湖区艾滋病毒感染者（PLHIV）接受和坚持抗逆转录病毒治疗。我们将进行一项I型实施-有效性混合试验，以测试现金转移干预对HIV病毒抑制结果的有效性，同时研究移动医疗技术（mHealth）系统在现实世界实施的潜力。具体来说，我们的团队将把干预扩大到32个诊所，并招募1984名PLHIV患者(a)通过进行以诊所为随机化单位的集群随机对照试验来评估其有效性，并将12个月的病毒抑制作为主要结果；(b)评估在多个层面（患者、提供者、诊所）实施的挑战和成功。这项试验不仅将提供证据，证明现金转移支付在艾滋病毒护理和病毒抑制方面的实际有效性，而且还将提供证据，证明实施方面的挑战和成功，这些挑战和成功将促进或阻碍在坦桑尼亚内外更广泛地推广。ClinicalTrials.gov NCT04201353。2019年12月17日注册
Antiretroviral therapy (ART) for HIV, taken daily, is an effective strategy to clinically suppress the virus, providing the dual benefit of improved survival and vastly decreasing the risk of transmission. However, this highly effective intervention has not yet reached all who could benefit. Cash transfers are increasingly recognized as an effective strategy to motivate behavior change and improve HIV care and treatment outcomes, including engagement in HIV care and adherence to ART. Despite a growing evidence base and strong theoretical foundation for the cash transfer approach, key questions remain. To address these questions and begin to bridge the “know-do gap” with respect to cash transfers, our team is employing an implementation science approach to iterative development of an incentive-based intervention to promote ART uptake and adherence among people living with HIV (PLHIV) in the Lake Zone region, Tanzania. We will conduct a type I hybrid implementation–effectiveness trial to test the effectiveness of a cash transfer intervention on the outcome of HIV viral suppression, and concurrently examine the potential for real-world implementation with a mobile health technology (mHealth) system. Specifically, our team will expand the intervention to 32 clinics and enroll 1984 PLHIV to (a) evaluate its effectiveness by conducting a cluster randomized controlled trial with clinics as the unit of randomization and 12-month viral suppression as the primary outcome and (b) evaluate the implementation challenges and successes at multiple levels (patient, provider, clinic). This trial will provide evidence not only about the real-world effectiveness of cash transfers for retention in HIV care and viral suppression, but also on the implementation challenges and successes that will facilitate or hinder wider scale-up within Tanzania and beyond. ClinicalTrials.gov NCT04201353. Registered on December 17, 2019
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影响因子：
4.4
作者：
Galarraga, Omar;Genberg, Becky L.;Martin, Rosemarie A.;Laws, M. Barton;Wilson, Ira B.
通讯作者：
Wilson, Ira B.
影响因子：
2.9
作者：
de Walque D;Dow WH;Nathan R;Abdul R;Abilahi F;Gong E;Isdahl Z;Jamison J;Jullu B;Krishnan S;Majura A;Miguel E;Moncada J;Mtenga S;Mwanyangala MA;Packel L;Schachter J;Shirima K;Medlin CA
通讯作者：
Medlin CA
影响因子：
3.7
作者：
Handa S;Halpern CT;Pettifor A;Thirumurthy H
通讯作者：
Thirumurthy H
DOI：
10.1016/s2352-3018(19)30233-4
发表时间：
2019-10
期刊：
The lancet. HIV
影响因子：
--
作者：
Galárraga O;Sosa-Rubí SG
通讯作者：
Sosa-Rubí SG
影响因子：
1.5
作者：
Goldman, Jason D.;Cantrell, Ronald A.;Chi, Benjamin H.
通讯作者：
Chi, Benjamin H.