CareConekta: study protocol for a randomized controlled trial of a mobile health intervention to improve engagement in postpartum HIV care in South Africa
CareConekta: study protocol for a randomized controlled trial of a mobile health intervention to improve engagement in postpartum HIV care in South Africa
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DOI：
10.1186/s13063-020-4190-x
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发表时间：
2020-03-12
期刊：
影响因子：
2.5
通讯作者：
Myer, Landon
中科院分区：
文献类型：
--
作者：
Clouse, Kate;Phillips, Tamsin K.;Myer, Landon
南非是世界上最大的抗逆转录病毒治疗项目的所在地，但事实证明，在该国和整个更广泛的地区，艾滋病毒护理连续体的持续参与沿着具有挑战性。人口流动在南非很常见，但在描述这种流动及其对艾滋病毒护理的影响方面存在重要的研究空白。众所周知，南非的产后妇女及其婴儿在分娩后退出艾滋病毒护理的风险很高，而且经常移动的。方法在2017年，我们开发了一个测试版的智能手机应用程序（应用程序）- CareConekta -检测用户的智能手机位置，以允许移动性的前瞻性表征。现在，我们将调整和测试CareConekta，以进行有关流动性的基本形成工作，并评估干预措施-CareConekta应用程序加上文本通知和电话和/或WhatsApp消息-以促进在流动期间参与艾滋病毒护理。在为期3年的项目期间，我们的第一个目标是评估使用CareConekta作为干预措施的可行性，可接受性和初步疗效，以改善艾滋病毒护理的参与。我们的第二个目标是描述南非妇女在围产期的流动性及其对参与艾滋病毒护理的影响。我们将招募200名感染艾滋病毒并在南非开普敦的Gugulethu助产士产科单位接受护理的合格孕妇。讨论这项工作将提供关键信息的流动性在围产期和参与艾滋病毒护理的影响。与此同时，我们将对一项干预措施进行试点测试，以提高参与度，并对结果进行严格评估。如果成功的话，CareConekta作为一种研究和服务工具提供了巨大的潜力，可以在多个地理区域，研究环境和患者人群中进行调整和评估。
Background South Africa is home to the world's largest antiretroviral therapy program but sustaining engagement along the HIV care continuum has proven challenging in the country and throughout the wider region. Population mobility is common in South Africa, but there are important research gaps in describing this mobility and its impact on engagement in HIV care. Postpartum women and their infants in South Africa are known to be at high risk of dropping out of HIV care after delivery and are frequently mobile. Methods In 2017, we developed a beta version of a smartphone application (app) - CareConekta - that detects a user's smartphone location to allow for prospective characterization of mobility. Now we will adapt and test CareConekta to conduct essential formative work on mobility and evaluate an intervention - the CareConekta app plus text notifications and phone calls and/or WhatsApp messages - to facilitate engagement in HIV care during times of mobility. During the 3-year project period, our first objective is to evaluate the feasibility, acceptability, and initial efficacy of using CareConekta as an intervention to improve engagement in HIV care. Our second objective is to characterize mobility among South African women during the peripartum period and its impact on engagement in HIV care. We will enroll 200 eligible pregnant women living with HIV and receiving care at the Gugulethu Midwife Obstetric Unit in Cape Town, South Africa. Discussion This work will provide critical information about mobility during the peripartum period and the impact on engagement in HIV care. Simultaneously, we will pilot test an intervention to improve engagement with rigorously assessed outcomes. If successful, CareConekta offers tremendous potential as a research and service tool that can be adapted and evaluated in multiple geographic regions, study contexts, and patient populations.