A Multisite Randomized Trial of BattleViro: A Mobile Gaming App to Improve ART Adherence for Youth

BattleViro 的多站点随机试验：一款提高青少年 ART 依从性的移动游戏应用程序

• 批准号: 10175048
• 负责人: James Benjamin Brock
• 金额: $ 69.5万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-24 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10175048
• 关键词: AIDS/HIV problem; Accounting; Achievement; Adherence; Administrator; Adolescent and Young Adult; Analysis of Covariance; Behavioral; Biological; Boston; Caring; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Chronic; Clinic; Collection; Control Groups; Data; Development; Devices; Disease; Elements; HIV; HIV Infections; Health Benefit; Immersion; Individual; Information Systems; Intervention; Interview; Knowledge; Life; Measures; Mediator of activation protein; Medical; Mississippi; Modeling; Motivation; Nature; New England; Participant; Patients; Pharmaceutical Preparations; Play; RNA; Research; Risk; Sample Size; Self Efficacy; Social support; Subgroup; Technology; Testing; Text; Text Messaging; Time; Translating; United States; Viral Load result; Youth; adherence rate; age group; body system; clinical research site; comparative efficacy; comparison intervention; efficacy testing; electronic data; experience; fighting; follow-up; hedonic; improved; mobile application; novel; organizational structure; portability; randomized controlled study; randomized trial; skills; smartphone Application; social engagement; treatment adherence; virtual reality game

Despite need for consistent adherence to medical care, youth living with HIV (YLWH) have low rates of adherence and retention in care, and are at great risk for being lost to follow-up.(5,16-18) There is a great need for adherence interventions that are novel and appealing for YLWH.(7,8,14) We developed, and preliminarily examined, a multi-level technology that integrates a 7-day smart medication device (Wisepill) WITH an immersive and appealing smartphone app/game that is attractive and engaging for YLWH.(82,83) During gameplay, YLWH fight HIV in colorful and immersive organ systems, and receive adherence related text messages with game graphics. Wisepill openings guide game-related text messages and can result in bonus points in the app/game. We tested the Multilevel Gaming Intervention in a developmental trial. The impact of the intervention was greatest among those who had newly begun ART. In participants who had newly begun ART, the intervention decreased viral load and improved ART adherence. Those newly starting ART in the intervention, compared to those newly starting ART in the control, experienced a 0.96 log viral load greater decrease and evidenced a large effect size for improved adherence as measured by Wisepill (d=1.18, 71% vs. 48% adherence at post-test). These interactions between intervention and newly starting ART were significant in ANCOVAs, accounting for baseline values (viral load: F=4.33, p=0.04, adherence: F=3.20, p=0.05). For this next proposed stage of research, we will further test the Multilevel Gaming Intervention with YLWH who are newly starting ART at clinical sites in New England and in Mississippi. A multisite randomized controlled study (48 weeks) among 120 YLWH newly starting ART will test the efficacy of the intervention compared to a control condition (who receive a non-HIV game and the Wisepill) on behavioral and biological measures. Information, Motivation, Behavioral Skills Adherence to ART Immersive iPhone Electronic, portable, 7-day medication game with text organizer/dispenser: measures adherence messaging integrates into iPhone gameHIV RNA Viral Load

尽管需要始终如一地坚持医疗护理，但青年艾滋病毒携带者(YLWH)的 坚持和保留在护理中，有很大的风险失去随访。(5，16-18) 需要对青瓦台具有新颖性和吸引力的依从性干预措施。(7，8，14)我们开发，和 初步检验，一项集成了7天智能服药设备(Wisepill)的多层次技术 通过身临其境、吸引人的智能手机应用程序/游戏，这款应用程序/游戏对YLWH具有吸引力和吸引力。 在游戏中，YLWH在五颜六色的沉浸式器官系统中对抗艾滋病毒，并获得与 带有游戏图形的文本消息。Wisepill的空缺会引导与游戏相关的短信，并可能导致 应用程序/游戏中的加分。我们在一项发展试验中测试了多级游戏干预。这个 干预的影响在那些新开始ART的人中最大。在新加入的参与者中 开始抗逆转录病毒治疗后，干预降低了病毒载量，提高了抗逆转录病毒治疗的依从性。那些在中国新起步的艺术 与对照组中新开始的ART相比，干预组经历了0.96log的病毒载量 根据Wisepill的测量，减少并证明了改善依从性的大效应尺寸(d=1.18，71%比 在测试后48%的依从性)。干预和新开始的抗逆转录病毒治疗之间的相互作用是重要的。 在ANCOVA中，考虑基准值(病毒载量：F=4.33，p=0.04，依从性：F=3.20，p=0.05)。为了这个 下一个拟议的研究阶段，我们将进一步测试YLWH的多层次游戏干预，他们是 在新英格兰和密西西比州的临床站点新开始的ART。一项多点随机对照研究 (48周)在120名新开始的青少年儿童中，ART将与对照组相比测试干预的效果 (接受非HIV游戏和Wisepill的人)行为和生物指标。 信息、动机、 行为技能 对艺术的坚持 身临其境的iPhone 电子便携，7天服药 带文本的游戏 组织者/分发者：衡量遵守情况 消息传递 整合到iPhone游戏中HIV RNA病毒载量