VITAL Start (Video-intervention to Inspire Treatment Adherence for Life): Brief facility based video intervention to improve retention and adherence to ART among pregnant and breastfeeding women

VITAL Start(视频干预,以激发终生治疗依从性):基于设施的简短视频干预,以提高孕妇和哺乳期妇女对 ART 的保留和依从性

基本信息

  • 批准号:
    10335141
  • 负责人:
  • 金额:
    $ 36.43万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2018
  • 资助国家:
    美国
  • 起止时间:
    2018-04-01 至 2024-01-31
  • 项目状态:
    已结题

项目摘要

Abstract We propose to evaluate the impact, implementation and cost effectiveness of VITAL Start, a brief facility- based video intervention for HIV-positive (HIV+) pregnant women, in a multisite randomized controlled trial (RCT) in Malawi with the primary composite outcome of retention and adherence (viral suppression) 12 months after starting antiretroviral therapy (ART). Universal HIV testing and treatment can accelerate population-level ART initiation and is critical to realize the UNAIDS 90-90-90 goals. Malawi pioneered Option B+ (B+), a novel application of test-and-treat that provided life-long ART for HIV+ pregnant and breastfeeding women. While maternal ART uptake improved 7-fold, retention and adherence remained suboptimal: only 59% were retained after two years, and of these, only two-thirds achieved adequate ART adherence. Other B+ countries are observing steep drops in retention. Reasons are multi-factorial; women who feel healthy are unprepared to commit to lifelong ART; inadequate counseling due to increased demands on healthcare workers; and limited partner disclosure affecting retention and adherence. There is an urgent need for evidence-based interventions to improve retention and adherence that can be easily incorporated into overextended health systems. Using formative participatory research, applied theoretical frameworks, and evidence-based message framing techniques, we created an innovative 37-minute video-based intervention for pregnant women newly initiating ART. The video promotes retention and adherence by providing a VITAL Start (Video intervention to Inspire Treatment Adherence for Life) at the critical teachable moment before committing to lifelong ART. Preliminary findings suggest high levels of patient and HCW satisfaction, and improved ART knowledge, rates of partner disclosure, and retention. With these promising results, the proposed study aims to rigorously evaluate the impact, implementation, and cost-effectiveness of VITAL Start. A sample of 796 HIV+ pregnant women will be randomized on a 1:1 basis to receive VITAL Start or standard of care counseling prior to ART initiation. The primary endpoint will be a composite of retention and adherence (virologic suppression), at 12 months post ART initiation. Secondary outcomes include self-reported adherence, pharmacy data, and tenofovir diphosphate testing. We will also examine the delivery of VITAL Start via surveys and interviews with patients, partners, and HCW and conduct cost-effectiveness analyses. If successful, VITAL Start will provide an intervention that (1) standardizes and improves counseling at a critical teaching moment through an engaging and culturally sensitive experience, (2) is inexpensive and rapidly scalable without decelerating ART expansion, and (3) allows more efficient use of precious HCW time. Building on a longstanding collaboration with the Malawi Ministry of Health, we are poised to support rapid dissemination of VITAL Start if the results are promising.
摘要

项目成果

期刊论文数量(5)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Intervention Fidelity to VITAL Start (Video Intervention to Inspire Treatment Adherence for Life) in a Randomized Controlled Trial Among Women Living With HIV in Malawi.
在马拉维感染艾滋病毒的妇女中进行的随机对照试验中对 VITAL Start 的干预忠诚度(视频干预,以激发终生坚持治疗)。
  • DOI:
    10.1177/15248399231177303
  • 发表时间:
    2023
  • 期刊:
  • 影响因子:
    1.9
  • 作者:
    Tembo,TapiwaA;Markham,ChristineM;Masiano,StevenP;Sabelli,Rachael;Wetzel,Elizabeth;Ahmed,Saeed;Mphande,Mtisunge;Mkandawire,AngellaM;Chitani,MikeJ;Khama,Innocent;Nyirenda,Rose;Mazenga,Alick;Abrams,ElaineJ;Kim,MariaH
  • 通讯作者:
    Kim,MariaH
The relationship between adverse childhood experiences and common mental disorders among pregnant women living with HIV in Malawi.
  • DOI:
    10.1016/j.jad.2022.06.028
  • 发表时间:
    2022-09-01
  • 期刊:
  • 影响因子:
    6.6
  • 作者:
    Masiano, Steven P.;Yu, Xiaoying;Tembo, Tapiwa;Wetzel, Elizabeth;Mphande, Mtisunge;Khama, Innocent;Mkandawire, Angella;Chitani, Mike;Liwimbi, Olive;Udedi, Michael;Mazenga, Alick;Nyasulu, Phoebe;Abrams, Elaine;Ahmed, Saeed;Kim, Maria H.
  • 通讯作者:
    Kim, Maria H.
Video-Based Intervention for Improving Maternal Retention and Adherence to HIV Treatment: Patient Perspectives and Experiences.
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Saeed Ahmed其他文献

Saeed Ahmed的其他文献

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{{ truncateString('Saeed Ahmed', 18)}}的其他基金

VS4A: VITAL Start (Video-Intervention to Inspire Treatment Adherence for Life) for Adolescents, a video intervention to improve retention and adherence to ART among adolescents living with HIV
VS4A:针对青少年的 VITAL Start(激发终生治疗依从性的视频干预),一种视频干预措施,旨在提高艾滋病毒感染青少年对 ART 的保留和依从性
  • 批准号:
    10749263
  • 财政年份:
    2023
  • 资助金额:
    $ 36.43万
  • 项目类别:

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