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。尽管存在不成比例的风险，但有色人种年轻人接受检测的情况并不常见。虽然建议对所有13岁及以上的年轻人进行艾滋病毒检测，但许多人不寻求现有服务，在获得医疗保健方面面临障碍。在美国，来自纽约市最贫穷社区的有色人种年轻人感染艾滋病毒/艾滋病和性传播感染（STI）的比例最高。艾滋病毒阳性年轻人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。“青年援助服务项目”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合作项目，它提供了一种创新的外展解决方案，将得不到服务的年轻人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提供预防教育。然而，目前没有机制与参与者持续接触，以促进筛选和加强讲习班材料。与参与者保持联系以传播持续预防信息的有效方法可以通过克服获得服务的后勤和动机障碍来改善与护理的联系。移动和互联网技术是保持联系的理想选择。我们建议开展形成性工作，以开发和评估整合移动、互联网和短信（SMS）技术的创新干预措施的可行性和接受度，以改善与护理的联系，并促进18至24岁的项目参与者的艾滋病毒风险降低行为。我们将与目标终端用户和诊所利益相关者进行启发性研究，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。然后将对90名参与者进行干预试验，分为两组设计，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。这项形成性研究的结果将为更大的R01评估提供干预和研究设计规划的改进信息。成功的短信干预措施改善了服务不足的少数民族青年与艾滋病毒保健服务之间的联系，将对公共卫生产生重大影响，并将成为将社区预防外联与更广泛的直接护理结合起来的典范。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）的使命非常一致。

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.