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

项目总结/摘要 拟议的指导研究科学家发展奖（K 01）将为Mulawa博士提供 培训和指导，成为一个独立的行为科学家，专注于发展和 评价在资源-环境领域减少艾滋病相关发病率和死亡率的创新性多层次干预措施， 有限的设置。这项研究的目的是确定社会网络层面的相关因素， 开普敦围产期感染艾滋病毒的青少年坚持抗逆转录病毒治疗， 南非，并利用这些信息开发和试点测试一种移动的健康干预措施， 通过参与这一人群的社交网络，促进抗逆转录病毒疗法的坚持。此K 01将提供 为Mulawa博士提供必要的支持，以实现以下科学培训目标：（1）获得研究者- 在临床试验的设计，执行和评估水平的技能，（2）建立在mHealth干预的专业知识 开发、部署和评估，（3）丰富分析自我中心和自我中心的统计能力 纵向社会网络数据，以及（4）熟练掌握行为改变的特定理论 与南非文化背景相关的概念。其他专业培训目标 包括扩大在低资源环境下跨文化研究道德行为的培训， 培养一般专业发展技能。为了支持这些目标，Mulawa博士有一个指导小组， Kathleen Sikkema博士是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开发艾滋病毒相关移动医疗的专业知识 干预青少年（丽莎海托韦德曼博士），使用社会网络分析，以了解 青少年行为（詹姆斯·穆迪博士），南非青少年精神卫生（杰奎琳·霍尔博士）， 以及定量（Joseph Egger博士）和定性方法（Melissa Watt博士）。培训目标将 通过一个全面的培训计划，包括一对一的会议，教学/培训，导师， 指导阅读、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 通过执行补充研究计划付诸行动。拟议的研究将 对Aim 1数据中年龄为12-14岁的围产期HIV感染青少年队列进行研究， 开普敦青少年抗逆转录病毒队列（CTAAC）的子研究。目的1是分析自我中心的社会 CTAAC参与者（n = 100）的网络数据，以确定社交网络水平 因素（结构和功能特征）和ART依从性。目标2是迭代地定制 利用社交网络促进该人群坚持抗逆转录病毒治疗的移动健康干预措施。目标3是 对50名CTAAC青少年进行移动健康干预的试点测试，以a）评估其可行性和可接受性， B）探索对ART依从性和社会支持的初步影响。拟议的研究将提供数据， 博士Mulawa的第一个R 01提案，将在该提案的最后一年提交。

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.