HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial
HealthCall delivered via smartphone to reduce co-occurring drug and alcohol use in HIV-infected adults: A randomized pilot trial
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DOI：
10.1016/j.jsat.2017.09.013
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发表时间：
2017-12-01
影响因子：
3.9
通讯作者：
Hasin, Deborah
中科院分区：
文献类型：
--
作者：
Aharonovich, Efrat;Stohl, Malka;Hasin, Deborah
目的：艾滋病毒感染者同时吸毒和酗酒与药物依从性差和缺乏病毒抑制有关。 HealthCall 是简短动机访谈 (MI) 的技术增强版，涉及简短的日常自我监控、积极强化和个性化反馈。这项针对 HIV 感染者的随机试点研究调查了通过适用于智能手机技术的 MI + HealthCall 减少非注射药物和酒精使用的可行性和功效。 设计：对城市、主要是少数族裔社区的 HIV 感染者成年人样本进行资格筛选：过去 30 天使用非注射药物（>= 4 天使用快克/可卡因、甲基苯丙胺或海洛因）以及 暴饮暴食（>= 1 天喝 4+ 标准饮料）。符合资格的人被随机分为两组：仅 MI（n = 21）和 MI + HealthCall-S（n = 21）。训练有素的辅导员在基线时提供了简短的 MI。药物和酒精使用评估在基线、30 天和 60 天（治疗结束）时完成。来自过去 30 天时间线追踪 (TLFB) 的主要结果包括 (1) 使用主要药物的总天数 (NumDU) (2) 使用主要药物的总量（每天花费的美元金额；QuantU）、(3) 总饮酒天数 (NumDD) 和 (4) 每天平均饮酒次数 (QuantDD)。可行性由 HealthCall 使用率、患者满意度调查问卷（1-5 级，5 为最佳）和保留率来确定。结果：HealthCall 的中位每日使用率为 95%，患者满意度非常好 (4.5)，保留率很高 (93%)。到治疗结束时，两个治疗组均减少了药物和酒精的使用，其中在 QuantU (p = 0.01) 和 NumDU (p = 0.046) 中，MI+ Healthcall-S 的减少量显着大于仅使用 MI 的药物和酒精使用量。 MI + Healthcall 组中饮酒量和频率减少的 P 值为 0.09-0.11。结论：这项概念验证随机试验表明，智能手机上的 HealthCall 对于城市、少数民族 HIV 感染者来说是一种高度可行的干预措施，并表明在减少同时发生的药物和酒精使用方面有效。结果表明，可以通过交互式移动技术来加强短暂的行为干预，以解决干扰艾滋病毒护理、药物依从性以及最终病毒抑制的复杂的酒精和药物使用模式。有必要进行更大规模的随机试验来复制和扩展目前的结果。 (C) 2017 Elsevier Inc. 保留所有权利。
Aims: Co-occurrence of drug and alcohol use among people living with HIV is linked to poor medication adherence and lack of viral suppression. HealthCall, a technological enhancement of brief Motivational Interviewing (MI), involves brief daily self-monitoring, positive reinforcement, and personalized feedback. This randomized pilot study among people living with HIV investigated the feasibility and efficacy of reducing non-injection drug and alcohol use with MI + HealthCall as adapted for smartphone technology.Design: An urban, largely-minority community sample of adults living with HIV were screened for eligibility: last 30 day use of non-injection drugs (>= 4 days of crack/cocaine, methamphetamine, or heroin use) and binge drinking (>= 1 day of 4+ standard drinks). Those eligible were randomized to one of two groups: MI-only (n = 21) and MI + HealthCall-S (n = 21). Trained counselors delivered the brief MI at baseline. Drug and alcohol use assessments were completed at baseline, 30 and 60 days (end of treatment). Primary outcomes derived from a Timeline Follow Back (TLFB) of the past 30 days included (1) total number of days used primary drug (NumDU) (2) total quantity of primary drug used (dollar amount spent per day; QuantU), (3) total number of drinking days (NumDD) and (4) mean number of drinks per day (QuantDD). Feasibility was determined by HealthCall use rates, patient satisfaction questionnaire (1-5 scale, 5 being best), and retention.Findings: The median daily use rate for HealthCall was 95%, patient satisfaction was excellent (4.5) and retention was high (93%). Both treatment groups reduced drug and alcohol use by end of treatment, with MI+ Healthcall-S showing significantly greater reductions than MI-only in QuantU (p = 0.01) and NumDU (p = 0.046). P-values for reductions in alcohol quantity and frequency in the MI + Healthcall group were 0.09-0.11.Conclusions: This proof-of-concept randomized trial indicates that HealthCall on the smartphone is a highly feasible intervention in urban, minority individuals with HIV, and suggests efficacy in reducing co-occurring drug and alcohol use. Results suggest opportunities for brief behavioral intervention that may be enhanced through interactive mobile technology to address complex alcohol and drug use patterns that interfere with HIV care, medication adherence and ultimately, viral suppression. A larger randomized trial is warranted to replicate and extend present results. (C) 2017 Elsevier Inc. All rights reserved.