Using mobile technology to prevent HIV and related Youth Health problems: Sexual health, Mental health, and Substance use in southwest Uganda (Youth Health SMS)

拟议的K01奖将为候选人克雷尼斯克博士提供实现其长期目标的技能 作为一名独立的艾滋病毒调查员和利用数字技术改善 青少年和青壮年(Aya)对艾滋病毒预防(包括PrEP和艾滋病毒检测)的了解以及与 行为健康护理。应聘者是一位发展心理学家，在定性和交叉方面有经验。 国内和国际的部门研究。拟议的培训和研究经验将扩大 候选人设计和评估针对艾滋病毒感染高危人群的干预措施的能力，并解决 国家卫生研究所(NIH)艾滋病研究办公室(OAR)减少 艾滋病毒的发病率。为了实现他的总体目标，Kreniske博士将接受以下方面的额外培训：(1)纵向 数据分析，目的是解释手机使用与防护和风险之间的联系 在资源不足的情况下艾滋病毒感染的因素；(2)调整以手机为基础的干预措施，以解决 与艾滋病毒预防和艾滋病毒护理级联有关的多种艾滋病毒风险因素；(3)评估移动电话- 使用随机对照试验(RCT)在资源不足的情况下对Aya进行干预；以及(4) 成功的独立研究生涯的专业技能，包括补助金和手稿写作。这个 候选人已经组建了一个由国家和国际领导人组成的指导团队，他们将支持他的成功 通过课程作业、定向阅读、一对一会议、动手研究过渡到独立 活动，并完成一个独立研究项目。克雷尼斯克博士的研究以东部和南部为基础 非洲(欧空局)，那里的艾滋病病毒感染率是世界上最高的。精神健康与物质使用 影响关于性健康和生殖健康的决策，从而成为预防的关键障碍 艾滋病毒感染的可能性。Aya，特别是在这种社会文化背景下，在接触辅导员方面面临着独特的挑战 世卫组织能够提供精神健康和物质使用评估和治疗。为了应对这些挑战， 应聘者将确定技术如何与已知的艾滋病毒风险因素(例如，性行为、精神健康)相关 症状、物质使用)，并调整和评估基于手机的干预措施。这将作为证据 R01提案的概念，评估可扩展的基于手机的干预措施以减少艾滋病毒感染 通过瞄准有风险的阿亚。研究和培训将在NYSPI/哥伦比亚大学以及国际 Sites，与NIH资助的两项研究合作，(1)SSTAR，一项关于Aya社会转型和决定因素的研究 (R01HD091003；Pi Santelli)，它将提供来自Rakai社区队列研究的辅助数据 (2)SuUBI4Her(R01MH113486；Pi Ssewamala)，这是一项针对乌干达阿亚女孩的艾滋病毒预防研究 这将提供有关心理健康的次要数据。在K01期间获得的研究成果和技能将 让Kreniske博士成为一名独立的调查员，为结束艾滋病毒的努力做出贡献 通过针对风险Aya量身定做的创新干预措施传播疫情。

The proposed K01 Award will provide the candidate, Dr. Kreniske, with the skills to achieve his long-term goal of being an independent HIV investigator and an international leader who leverages digital technology to improve adolescent and young adult (AYA) uptake of HIV prevention (including PrEP and HIV testing) and linkage to behavioral health care. The candidate is a developmental psychologist with experience in qualitative and cross- sectional research, domestically and internationally. The proposed training and research experience will expand the candidate’s ability to design and evaluate interventions for AYA at high risk for HIV infection and address the high priority topic of the National Institute of Health (NIH) Office of AIDS Research (OAR) of reducing the incidence of HIV. To achieve his overall goals, Dr. Kreniske will receive additional training in: (1) longitudinal data analysis for the purposes of interpreting associations between mobile phone use and protective and risk factors for HIV infection in under-resourced settings; (2) adapting mobile phone-based interventions to address multiple HIV risk factors as they relate to HIV prevention and the HIV care cascade; (3) evaluating mobile phone- based interventions for AYA in under-resourced settings using randomized controlled trials (RCT); and (4) professional skills for a successful independent research career, including grant and manuscript writing. The candidate has assembled a mentorship team of national and international leaders who will support his successful transition to independence through coursework, directed readings, one-on-one meetings, hands-on research activities, and completion of an independent research project. Dr. Kreniske’s work is based in East and Southern Africa (ESA) where AYA have the highest rates of HIV infection worldwide. Mental health and substance use affect decision making about sexual and reproductive health and thus function as critical barriers to prevention of HIV infection. AYA, particularly in this socio-cultural context, face unique challenges in accessing counselors who can provide mental health and substance use assessment and treatment. To address these challenges the candidate will identify how technology is related to known HIV risk factors (e.g. sexual behaviors, mental health symptoms, substance use) and adapt and evaluate a mobile phone-based intervention. This will serve as proof of concept for an R01 proposal to evaluate a scalable mobile phone-based intervention to reduce HIV infection by targeting at risk AYA. Research and training will occur at NYSPI/ Columbia University as well as international sites, in affiliation with two NIH-funded studies, (1) SSTAR, a study of AYA social transitions and determinants (R01HD091003; PI Santelli), which will provide secondary data from the Rakai Community Cohort Study (RCCS), and (2) SUUBI4Her (R01MH113486; PI Ssewamala), an HIV prevention study for AYA girls in Uganda that will provide secondary data on mental health. Research findings and skills obtained during the K01 will position Dr. Kreniske to become an independent investigator who can contribute to the efforts to end the HIV epidemic through innovative interventions tailored to at risk AYA.