Adaptive Antiretroviral Therapy Adherence Interventions for Youth Living With HIV Through Text Message and Cell Phone Support With and Without Incentives: Protocol for a Sequential Multiple Assignment Randomized Trial (SMART)
Adaptive Antiretroviral Therapy Adherence Interventions for Youth Living With HIV Through Text Message and Cell Phone Support With and Without Incentives: Protocol for a Sequential Multiple Assignment Randomized Trial (SMART)
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DOI：
10.2196/11183
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发表时间：
2018-12-01
影响因子：
1.7
通讯作者：
Parsons, Jeffrey T.
中科院分区：
文献类型：
--
作者：
Belzer, Marvin E.;MacDonell, Karen Kolmodin;Parsons, Jeffrey T.
背景资料：2016年，13至24岁的青年艾滋病毒感染者（YLH）占新诊断艾滋病毒的五分之一以上（21%），但只有27%的YLH受到病毒抑制。YLH已被证明是抗逆转录病毒治疗（ART）的依从性差，但是，有有限的研究调查如何增加坚持YLH。移动的健康（mHealth）干预措施可能是一个有前途的方式做到这一点。目的：本研究（ATN [青少年试验网络] 144 SMART）的目的是比较适应性干预措施，可以增加ART坚持在15至24岁的YLH。这包括移动健康倡议、逐步减少干预措施和使用激励措施。将确定在提供激励措施之前在没有激励措施的情况下对干预措施进行排序的成本效益，以及由于抑制病毒载量而节省的社会成本。该方案是由Naar等人在本期中描述的ATN扩展计划的一部分。方法：本研究采用序贯多重分配随机试验设计。大约190名参与者正在招募、登记并随机分配到手机支持或短信支持。两个干预组都接受了3个月的干预，然后根据对干预的反应进行第二次随机分组。应答者测试逐渐减少他们的干预，和无应答者测试接收incentivers.Results：本研究的数据收集预计将于2018年8月开始，并持续到2020.Conclusions：这是一项创新的研究，特别是在人口，干预类型，注重成本效益和招聘方面。这项研究可能特别有效地提高YLH的依从性，同时降低长期的个人和社会成本。
Background: Youth living with HIV (YLH) aged 13 to 24 years made up over a fifth (21%) of new HIV diagnoses in 2016, yet only 27% of YLH are virally suppressed. YLH have been shown to be poorly adherent to antiretroviral therapy (ART); however, there has been limited research investigating how to increase adherence in YLH. Mobile health (mHealth) interventions may be one promising way to do this.Objective: This study (ATN [Adolescent Trials Network] 144 SMART) aimed to compare adaptive interventions that could increase ART adherence in YLH aged 15 to 24 years. This includes mHealth initiatives, the tapering of interventions, and the use of incentives. Cost-effectiveness of sequencing the interventions without incentives before providing incentives and the savings on societal costs due to suppressed viral loads will be determined. This protocol is part of the ATN Scale It Up program described in this issue by Naar et al.Methods: This study uses a Sequential Multiple Assignment Randomized Trial design. Approximately 190 participants are being recruited, enrolled, and randomized to either cell phone support or text message support. Both intervention groups receive 3 months of intervention, followed by a second randomization based on response to the intervention. Responders test tapering their intervention, and nonresponders test receiving incentives.Results: Data collection for this study is projected to begin in August 2018 and last until June 2020.Conclusions: This is an innovative study, particularly in terms of population, intervention types, focus on cost-effectiveness, and recruitment. This study could be particularly effective in improving adherence in YLH while reducing long-term individual and societal costs.