Developing an mHealth Intervention that Leverages Social Networks to Improve ART Adherence among HIV-Infected Adolescents in South Africa

项目摘要/摘要 拟议的导师研究科学家发展奖(K01)将为穆拉瓦博士提供 培训和指导成为一名独立的行为科学家，专注于发展和 对减少艾滋病相关发病率和死亡率的创新多层次干预措施的评价 有限的设置。这项拟议的研究的目标是确定与社交网络层面相关的因素 随着开普敦围产期感染艾滋病毒的青少年坚持抗逆转录病毒疗法(ART)， 南非，并利用这些信息开发和试点移动健康(MHealth)干预措施，以 通过参与这些人群的社交网络来促进对艺术的坚持。这款K01将提供 为穆拉瓦博士实现以下科学培训目标提供必要的支持：(1)获取调查员- 具备设计、执行和评估临床试验的技能，(2)积累移动健康干预方面的专业知识 发展、部署和评估；(3)丰富分析以自我为中心和 纵向社会网络数据，以及(4)熟练掌握针对青少年的行为改变理论 以及突出南非文化背景的概念。其他专业培训目标 包括扩大在低资源环境下进行跨文化研究的道德行为的培训 培养一般的职业发展技能。为了支持这些目标，穆拉瓦博士有一个指导团队领导 凯瑟琳·西科马博士，南方艾滋病毒行为试验开发和评估专家 非洲背景。共同导师和顾问将提供与艾滋病毒相关的mHealth开发方面的专业知识 针对青少年的干预(Lisa Hightow-Weidman博士)，使用社会网络分析来了解 青少年行为(詹姆斯·穆迪博士)，南非青少年精神健康(杰奎琳·霍尔博士)， 以及定量方法(约瑟夫·埃格尔博士)和定性方法(梅丽莎·瓦特博士)。培训目标将 通过包括一对一会议、教学/培训、指导的全面培训计划来满足 定向阅读、研讨会/实验室会议和科学会议。通过培训计划获得的技能将 通过执行补充性研究计划将其付诸实施。拟议的研究将是 在目标1数据中，对一群围产期感染艾滋病毒的青少年进行了调查，年龄在12-14岁之间，参加了 开普敦青少年抗逆转录病毒队列(CTAAC)的子研究。目标1是分析以自我为中心的社交 来自CTAAC参与者(n=100)的网络数据，以确定社交网络层面之间的关系 因素(结构和功能特征)和艺术坚持。目标2是迭代地定制一个 移动健康干预，利用社交网络在这一人群中促进抗逆转录病毒治疗的坚持。目标3是 对50名CTAAC青少年进行mHealth干预的试点测试，以a)评估其可行性和可接受性，并 B)探索对艺术依从性和社会支持的初步影响。拟议的研究将为以下方面提供数据 穆拉瓦博士的第一份R01提案，将在本拟议奖项的最后一年提交。

PROJECT SUMMARY / ABSTRACT The proposed Mentored Research Scientist Development Award (K01) will provide Dr. Mulawa with the training and mentorship to become an independent behavioral scientist focused on the development and evaluation of innovative multi-level interventions that reduce AIDS-related morbidity and mortality in resource- limited settings. The objective of the proposed research is to identify social network-level factors associated with adherence to antiretroviral therapy (ART) among perinatally HIV-infected adolescents in Cape Town, South Africa, and to use this information to develop and pilot test a mobile health (mHealth) intervention to promote ART adherence by engaging the social networks of this population. This K01 will provide the necessary support for Dr. Mulawa to achieve the following scientific training objectives: (1) obtain investigator- level skills in the design, execution, and evaluation of clinical trials, (2) build expertise in mHealth intervention development, deployment, and evaluation, (3) enrich statistical capacities in the analysis of egocentric and longitudinal social network data, and (4) gain proficiency in adolescent-specific theories of behavior change and concepts with salience to the South African cultural context. Additional professional training objectives include expanding training in the ethical conduct of cross-cultural research in low-resource settings and building general professional development skills. To support these goals, Dr. Mulawa has a mentoring team led by Dr. Kathleen Sikkema, an expert in the development and evaluation of HIV behavioral trials in the South African context. Co-Mentors and Advisors will provide expertise in the development of HIV-related mHealth interventions for adolescents (Dr. Lisa Hightow-Weidman), the use of social network analysis to understand adolescent behaviors (Dr. James Moody), adolescent psychiatric health in South Africa (Dr. Jacqueline Hoare), as well as quantitative (Dr. Joseph Egger) and qualitative methods (Dr. Melissa Watt). Training objectives will be met through a comprehensive training plan involving one-on-one meetings, didactics/trainings, mentor- directed readings, seminars/lab meetings, and scientific meetings. Skills gained through the training plan will be put into action through the execution of a complementary research plan. The proposed study will be conducted with a cohort of perinatally HIV-infected adolescents, ages 12-14 years in Aim 1 data, enrolled in a sub-study of the Cape Town Adolescent Antiretroviral Cohort (CTAAC). Aim 1 is to analyze egocentric social network data from CTAAC participants (n = 100) to identify the relationship between social network-level factors (structural and functional characteristics) and ART adherence. Aim 2 is to iteratively customize an mHealth intervention that leverages social networks to promote ART adherence in this population. Aim 3 is to pilot test the mHealth intervention with 50 CTAAC adolescents to a) assess its feasibility and acceptability and b) explore preliminary effects on ART adherence and social support. The proposed study will provide data for Dr. Mulawa’s first R01 proposal, to be submitted in the final year of this proposed award.