Mobile Text Message Intervention to Promote HIV/STI Service Use by At-Risk Youth

描述（由申请人提供）：在美国，有色人种的年轻人承担着不成比例的艾滋病毒/艾滋病负担。尽管风险不成比例，但在有色人种的年轻人中进行测试并不常见。虽然建议所有13岁及以上的年轻人进行艾滋病毒检测，但许多人没有寻求可用的服务，并面临获得医疗保健的障碍。来自大都市纽约市最贫困社区的有色人种年轻人是美国艾滋病毒/艾滋病和性传播感染（STI）发病率最高的人群之一。艾滋病毒阳性青年的性传播感染率甚至更高，增加了感染其他性传播感染和艾滋病毒传播的脆弱性。STAY项目（协助青年服务）是哈莱姆健康促进中心、哥伦比亚大学梅尔曼公共卫生学院和纽约长老会医院之间的一项合作，提供了一个创新的外联解决方案，将得不到充分服务的青年与性健康教育和艾滋病毒/性传播感染服务联系起来。STAY项目通过社区讲习班成功地向目标青年人提供了预防教育。然而，目前还没有与与会者保持联系的机制，以促进筛选和充实讲习班材料。与参与者保持联系以传播持续的预防信息的有效方法可以克服获得服务的后勤和动机障碍，从而改善与护理的联系。移动的和互联网技术是保持联系连续性的理想选择。我们建议开展形成性工作，以开发和评估一种创新干预措施的可行性和可接受性，该干预措施将移动的、互联网和短信（SMS）技术相结合，以改善与护理的联系，并促进18至24岁的STAY项目参与者减少艾滋病毒风险的行为。我们将与目标最终用户和诊所利益相关者进行启发式研究，以确保干预措施满足目标受众的需求，并与诊所基础设施兼容。然后，将在两组设计的90名参与者中进行干预试验，以检查评估和干预实施的可行性，结果和过程趋势以及最终用户对干预的接受程度。该形成性研究的结果将为更大规模R 01评价的干预和研究设计规划的细化提供信息。一项成功的短信干预措施改善了服务不足的少数群体青年与艾滋病毒保健服务的联系，将对公共卫生产生重大影响，并将成为更广泛地将社区预防外联与直接护理相结合的模式。该提案与国家艾滋病政策办公室当前的战略目标以及R34 PAR-09-173“试点干预和服务研究”的使命完全一致。 公共卫生相关性：一项成功的综合短信干预措施，增加了与艾滋病毒保健服务的联系，并为得不到充分服务的高危少数族裔青年提供了连续的护理，将对公共卫生产生很大的影响-仅纽约市的目标受众就有大约100万青年。对筛查、治疗和预防的重视符合国家艾滋病政策办公室的使命;该项目还将提供一个模式，将社区预防外联与直接护理相结合，以更广泛地促进年轻人对预防和保健的利用。最后，该项目将填补针对艾滋病毒/性传播感染服务利用和预防的短信短信干预研究文献中的一个重要空白。

DESCRIPTION (provided by applicant): Young people of color bear a disproportionate burden of HIV/AIDS in the US. Despite disproportionate risk, testing among young people of color is not common. Though HIV testing is recommended for all young people 13 and older, many do not seek available services and face barriers to accessing healthcare. Young people of color from the poorest communities in metropolitan New York City have among the highest rates of HIV/AIDS and sexually transmitted infections (STI) in the US. Rates of STI are even higher among HIV+ young people, increasing vulnerability to infection with other STI as well as transmission of HIV. Project STAY (Services to Assist Youth), a collaboration between the Harlem Health Promotion Center, Mailman School of Public Health at Columbia University and New York Presbyterian Hospital, offers an innovative outreach solution for connecting underserved young people with sexual health education and HIV/STI services. Project STAY has been successful at reaching target young people with prevention education through community-based workshops. Yet, there is currently no mechanism for ongoing contact with participants to promote screening and reinforce workshop material. An efficient way to maintain contact with participants to disseminate ongoing prevention information could improve linkages to care by overcoming the logistic and motivational barriers to service access. Mobile and Internet technologies are ideal for contact continuity. We propose to conduct formative work to develop and evaluate feasibility and acceptance of an innovative intervention that integrates mobile, Internet, and Short Text Messaging (SMS) technologies to improve linkages to care and promote HIV risk reduction behaviors for Project STAY participants aged 18 to 24. We will conduct elicitation research with target end-users and clinic stakeholders to ensure that the intervention addresses the needs of the target audience and is compatible with clinic infrastructure. The intervention will then be piloted with 90 participants in a two-group design to examine feasibility of assessment and intervention implementation, outcome and process trends, and end-user acceptance of the intervention. Results of this formative study will inform refinement of the intervention and research design planning for a larger R01 evaluation. A successful SMS text message intervention that improves links to HIV health services for underserved minority young people will have high public health impact and will serve as a model for integrating community prevention outreach with direct care more broadly. This proposal is well aligned with the current strategic goals of the Office of National AIDS Policy and with the mission of R34 PAR-09-173, Pilot Intervention and Services Research. PUBLIC HEALTH RELEVANCE: A successful integrated SMS text message intervention that increases linkages to HIV health services and continuity of care for underserved at risk minority young people will have high public health impact - there are approximately one million young people in the target audience in NYC alone. The focus on screening, treatment and prevention aligns with the mission of the Office of National AIDS Policy; the project will also provide a model for integrating community prevention outreach with direct care to promote prevention and health care utilization among young people more broadly. Finally, the project will fill an important gap in the research literature regarding SMS text message interventions targeted to HIV/STI service utilization and prevention.