Implementation of an mHealth App to Promote Engagement During HIV Care and Viral Load Suppression in Johannesburg, South Africa (iThemba Life): Pilot Technical Feasibility and Acceptability Study.
Implementation of an mHealth App to Promote Engagement During HIV Care and Viral Load Suppression in Johannesburg, South Africa (iThemba Life): Pilot Technical Feasibility and Acceptability Study.
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DOI：
10.2196/26033
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发表时间：
2022-02-02
影响因子：
2.2
通讯作者：
Stevens W
中科院分区：
文献类型：
--
作者：
Lalla-Edward ST;Mashabane N;Stewart-Isherwood L;Scott L;Fyvie K;Duncan D;Haile B;Chugh K;Zhou Y;Reimers J;Pan M;Venkatraman M;Stevens W
南非拥有世界上最大的艾滋病治疗项目。保留护理和药物依从性仍然存在问题，需要创新解决方案来改善艾滋病毒护理。移动技术的日益普及和使用可以支持艾滋病毒感染者取得积极的临床结果。iThemba Life是一款移动健康应用程序，根据南非卫生专业人员和患者的意见设计，通过获取医疗结果促进人们参与艾滋病毒护理。本研究旨在测试通过应用程序接收HIV病毒载量（VL）结果的可行性和可接受性，并比较研究参与者使用应用程序前后HIV病毒载量（VL）结果返回时间。采用方便抽样的方法，从约翰内斯堡的2个卫生机构招募进行常规VL静脉切开术的成年人。签署同意后，将应用程序下载到他们的Android智能手机上，进行静脉切开术，并通过手机扫描样本条形码以链接样本和应用程序。参与者收到结果可用性通知，并登录到应用程序查看结果，他们的解释和建议的行动。总的来说，750人被筛选为500名参与者。750例中，113例（15.1%）未能通过资格筛选。21.5%（137/637）的学生因智能手机技术限制而无法注册。结果发布到92.2%（461/500）的参与者的手机上。App技术问题和实验室操作问题限制了发布结果的数量。大约78.1%（360/461）的结果在应用程序中被查看。从通知可用性到查看结果的平均时间为15.5小时（0.6；范围为0-150天）。用户从抽血到收到结果的周转时间为6天（范围1-167天），而应用程序使用前为56天（范围10-430天；P< 0.001）。总体而言，4%（20/500）的参与者获得了非抑制结果（VL浓度为1000拷贝/mL）。未抑制结果的周转时间为7天，而应用程序使用前为37.5天（P< 0.001）。从样本收集到结果交付的时间，被抑制和未被抑制的用户在使用应用程序之前和之后的差异具有统计学意义。在20名参与者中，12名（60%）在研究期间返回进行确认性VL。应用程序用户从未抑制VL到确认性VL的时间为106天，而应用程序使用前为203天（P<.001）。总体而言，52.4%（262/500）的参与者完成了离职调查；23.2%（58/250）的人报告在查看VL结果时遇到了挑战。此外，58%（35/60）的受访者表示，他们在他人的技术帮助下克服了挑战，97.3%（255/262）的受访者希望继续使用该应用程序获取VL结果。尽管一些参与者的智能手机接入有限，但使用iThemba Life进行VL测试的结果还是很受欢迎。应用程序用户收到结果的时间比应用程序之前快10倍，如果他们的VL为1000份/mL，则快5倍。这种增加的通知速度使得参与者想要继续使用iThemba Life。
South Africa has the largest HIV treatment program worldwide. Retention in care and medication adherence remain problematic necessitating innovative solutions for improving HIV care. The increasing availability and use of mobile technology can support positive clinical outcomes for persons living with HIV. iThemba Life is a mobile health app designed with input from South African health professionals and patients, promoting engagement with HIV care through access to medical results. This study aimed to test the feasibility and acceptability of receiving HIV viral load (VL) results through the app and compare the time to HIV VL result return for study participants before and after app use. Using convenience sampling, adults having routine VL phlebotomy were recruited from 2 Johannesburg health facilities. After signed consent, the app was downloaded on their Android smartphones, phlebotomy was performed, and the sample barcode was scanned through their phone to link the sample and app. Participants received a notification of the result availability and logged into the app to view results, their explanation and recommended action. Overall, 750 people were screened to enroll 500 participants. Of 750, 113 (15.1%) failed eligibility screening. 21.5% (137/637) had smartphone technical limitations preventing enrollment. Results were released to 92.2% (461/500) of participants’ phones. App technical issues and laboratory operational issues limited the number of released results. Approximately 78.1% (360/461) results were viewed in the app. Median time from notification of availability to result viewed being 15.5 hours (0.6; range 0-150 days). Turnaround time from phlebotomy to the result being received was 6 (range 1-167) days for users versus 56 days (range 10-430 days; P<.001) before app use. Overall, 4% (20/500) of participants received unsuppressed results (VL>1000 copies/mL). Turnaround time for unsuppressed results was 7 days for participants versus 37.5 days before app use (P<.001). The difference before and after app use in the suppressed and unsuppressed users for time from sample collection to result delivery was statistically significant. Of 20 participants, 12 (60%) returned for a confirmatory VL during the study period. The time from an unsuppressed VL to a confirmatory VL was 106 days for app users versus 203 days before app use (P<.001). Overall, 52.4% (262/500) of participants completed an exit survey; 23.2% (58/250) reported challenges in viewing their VL results. Moreover, 58% (35/60) reported that they overcame challenges with technical assistance from others, and 97.3% (255/262) wanted to continue using the app for VL results. Using iThemba Life for VL results was well-received despite limited smartphone access for some participants. App users received results 10 times sooner than before the app and 5 times sooner if their VL >1000 copies/mL. This increased notification speed led to participants wanting to continue using iThemba Life.
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影响因子：
8.1
作者：
Skinner D;Delobelle P;Pappin M;Pieterse D;Esterhuizen TM;Barron P;Dudley L
通讯作者：
Dudley L
通过手机应用改善与艾滋病毒护理的联系：随机对照试验。
影响因子：
5
作者：
Venter W;Coleman J;Chan VL;Shubber Z;Phatsoane M;Gorgens M;Stewart-Isherwood L;Carmona S;Fraser-Hurt N
通讯作者：
Fraser-Hurt N
影响因子：
5
作者：
Fischer, Alex Emilio;Sebidi, Jane;Lalla-Edward, Samanta Tresha
通讯作者：
Lalla-Edward, Samanta Tresha
影响因子：
5
作者：
Venter, Willem Daniel Francois;Fischer, Alex;Fraser-Hurt, Nicole
通讯作者：
Fraser-Hurt, Nicole
影响因子：
1.7
作者：
Gous, Natasha;Fischer, Alex E.;Lalla-Edward, Samanta T.
通讯作者：
Lalla-Edward, Samanta T.