Mobile Health Intervention to Increase HIV Self Testing and Linkage to Services for High-Risk Men in China

移动健康干预措施旨在加强中国高危男性的艾滋病毒自我检测和服务联系

• 批准号: 10321664
• 负责人: DON OPERARIO
• 金额: $ 56.56万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-04-01 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10321664
• 关键词: AIDS prevention; Adherence; Age; Behavioral; Behavioral Mechanisms; Behavioral Model; Caring; Characteristics; China; Cities; Clinic; Communication; Consolidated Framework for Implementation Research; Continuity of Patient Care; Control Groups; Coping Skills; Country; Cultural Sensitivity; Data; Development; Disclosure; Early Diagnosis; Education; Excision; Goals; Grant; HIV; HIV Infections; HIV Seronegativity; HIV Seropositivity; HIV diagnosis; HIV risk; Health; Health Promotion; Health Services; High Prevalence; Human immunodeficiency virus test; Individual; Infection; Intervention; Link; Maps; Measures; Mediation; Motivation; National Institute of Mental Health; Outcome; Participant; Persons; Pilot Projects; Population; Prevention; Privatization; Process; Professional counselor; Qualitative Evaluations; Qualitative Research; Research; Resource-limited setting; Risk; Risk Reduction; Science; Secure; Self Efficacy; Services; Site; Strategic Planning; Test Result; Testing; Time; Translations; Treatment Efficacy; United States National Institutes of Health; Use Effectiveness; Visual; Work; arm; base; behavior change; behavior test; care outcomes; care systems; cost; effectiveness evaluation; effectiveness implementation study; effectiveness testing; efficacy evaluation; follow-up; high risk men; home test; hybrid type 1 design; implementation intervention; improved; informant; innovation; intervention effect; mHealth; men who have sex with men; minority stress; mobile application; pilot test; prevention service; primary outcome; recruit; same sex behavior; scale up; secondary outcome; self testing; sexual risk behavior; social stigma; testing services; testing uptake; theories; transmission process; treatment services; uptake; user centered design; willingness

PROJECT SUMMARY The overarching goal of this R01 application (PA-18-278: Innovations in HIV Testing, Adherence, and Retention to Optimize HIV Care Continuum Outcomes) is to advance the science of mobile health approaches to increase uptake of repeat HIV self-testing (HST) and linkage to HIV-related care with populations that underperform on these steps of the HIV care continuum. We propose an intervention entitled “WeTest- WeLink” that builds on years of formative work with MSM in China (R34MH106349), demonstrating promising effects from a pilot RCT and strong indication of intervention acceptability, feasibility, and cultural sensitivity. The intervention uses the “WeChat” mobile app platform, which offers multiple features built into the app that facilitate health information delivery and communication channels (e.g., capacity for private texts, group chats, video sharing, GPS, instant messaging, real-time audio and visual communication). Guided by the Information- Motivation-Behavioral (IMB) model and Minority Stress Theory, we will employ a user-centered design process to refine and expand app features to support repeat HST uptake, behavioral risk reduction, stigma coping strategies, and self-efficacy to link to HIV care. We will use an Effectiveness-Implementation Hybrid Type 1 design consisting of a three site, 2-arm RCT to test HST and linkage to HIV related care outcomes as well as qualitative research to examine implementation and scalability. We will recruit 1,800 HIV negative MSM in three cities with HIV high-prevalence among MSM – Chengdu (9%), Suzhou (13%), Wuhan (11%) – allocated to the intervention (access to the WeTest-WeLink app) or control group (education about HST and passive referral to HIV care for individuals who test HIV positive). We will assess participants at 6-, 12-, and 18 months to measure intervention effects on primary outcomes: repeated use of HST (including photographic confirmation) and linkage to care for individuals who test HIV-positive. Secondary outcomes include sexual risk behaviors and use of HIV prevention services, and we will conduct mediation analysis to examine theoretical mechanisms of behavior change. We will qualitatively assess intervention-related process characteristics that enable and/or impede implementation and scalability informed by the Consolidated Framework for Implementation Research (CFIR). This project will provide the first known evidence for a mobile health approach to optimize both HIV testing and linkage to care as part of a single intervention continuum with MSM. Such findings can be crucial for optimizing the care cascade in populations that underutilize HIV services, such as MSM in China and elsewhere in the world where HIV testing and linkage to care services are sub-optimal.

项目摘要 此R01应用程序的总体目标（PA-18-278：艾滋病毒测试，依从性和 保留以优化艾滋病毒护理连续性结果）是推进移动健康方法的科学 增加重复艾滋病毒自我测试（HST）的吸收，并与与艾滋病毒相关的护理联系在一起 在艾滋病毒护理连续体的这些步骤下表现不佳。我们提出了一种标题为“最湿的干预措施 - Welink”建立在与中国MSM的多年形成性工作（R34MH106349）的基础上，证明了有前途的 试点RCT的影响以及强烈的干预可接受性，可行性和文化敏感性的影响。 干预使用“微信”移动应用程序平台，该平台提供了该应用中内置的多个功能 促进健康信息交付和沟通渠道（例如，私人文本的能力，小组聊天， 视频共享，GPS，即时消息，实时音频和视觉通信）。在信息的指导下 - 动机行为（IMB）模型和少数派压力理论，我们将采用以用户为中心的设计过程 完善和扩展应用程序功能以支持重复吸收HST的吸收，降低行为风险，污名应对 策略和与艾滋病毒护理联系的自我效能。我们将使用有效性实施混合型1 设计由三个站点，2臂RCT组成，用于测试HST和与HIV相关的护理结果的联系以及 定性研究以进行考试实施和可伸缩性。我们将招募1,800 HIV负MSM MSM之间的三个具有HIV高尚的城市 - 成都（9％），苏州（13％），武汉（11％） - 分配 干预（访问最湿的应用程序）或对照组（有关HST和被动的教育 转介给艾滋病毒的艾滋病毒阳性的人）。我们将在6个，12个月和18个月的时间评估参与者。 测量干预对主要结果的影响：重复使用HST（包括摄影 确认）和与测试HIV阳性的个体保持联系的联系。次要结果包括性风险 行为和艾滋病毒预防服务的使用，我们将进行调解分析以检查理论 行为改变的机制。我们将定性评估与干预相关的过程特征 启用和/或阻碍由合并框架告知的实施和可伸缩性 实施研究（CFIR）。该项目将为移动健康提供第一个已知证据 作为单个干预连续体的一部分，优化HIV测试和关联的方法是与MSM的一部分。 此类发现对于优化不足的艾滋病毒服务的人群中的护理级联至关重要，例如 作为中国和世界其他地方的MSM，艾滋病毒测试和与护理服务的联系非常最佳。