Text Messaging Adherence Assessment & Intervention Tool for Rural HIV+ Drug Users

短信依从性评估

• 批准号: 8140731
• 负责人: KAREN S INGERSOLL
• 金额: $ 34.65万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8140731
• 关键词: AIDS/HIV problem; Address; Adherence; Adoption; African American; Area; Behavior Therapy; Car Phone; Caring; Chronic Disease; Clinic; Clinical Trials; Communities; Consent; Development; Devices; Dropout; Drug usage; Drug user; Ethnic group; Evaluation; Event; Focus Groups; Fostering; HIV; HIV Infections; HIV Seropositivity; Health; Intervention; Interview; Learning; Life; Methods; Modeling; Morbidity - disease rate; NIH Program Announcements; Outcome; Participant; Patients; Pattern; Penetration; Persons; Pharmaceutical Preparations; Pharmacy facility; Population; Poverty; Randomized; Reporting; Research; Research Personnel; Rural; Staging; Stigmata; Structure; System; Technology; Telephone; Testing; Text; Time; Transportation; Treatment Failure; Viral Load result; Visit; Woman; base; cost effectiveness; drug craving; ethnic minority population; follow-up; health disparity; high risk; improved; medication compliance; metropolitan; novel; pill; pilot trial; programs; randomized trial; residence; response; scale up; social stigma; therapy development; tool; treatment adherence; treatment as usual; treatment center; trend; usability

DESCRIPTION (provided by applicant): This is a new application under PAS-10-098, Technology-based Adherence Interventions for Substance Abusing Populations with HIV (R34). New methods to promote HIV treatment adherence are needed for drug users, ethnic minorities, and women, who reside outside major metropolitan areas who have worse health outcomes. Familiar technological devices such as mobile phones could overcome some of the health disparities seen among rural HIV+ patients. In this project, investigators will develop and test the feasibility and promise of a text messaging system that uses Ecological Momentary Assessment (EMA) methods to detect nonadherence and drug use episodes, then immediately intervenes to improve HIV treatment adherence (both medication adherence and treatment engagement) in drug users living with HIV/AIDS. Using formative research with the targeted patients and partnership with a technology developer, we will develop the application and administrative system, Treatment Extension by Text (Text). Text will assess routine adherence, allow users to report critical events, and respond to randomly timed queries about adherence, drug use, and drug craving. When the Text EMA application detects threats to adherence, it will deliver a personalized, tailored intervention text message chosen by the participant. These customized messages will remind the user to take medications on time and reduce drug use. Investigators will pilot test the new adherence tool against treatment as usual over a three month period in a small pilot randomized trial to determine the feasibility, acceptability, and promise of Text. This R34 is a Stage 1b/2a project in the Stage Model of Behavioral Therapy Development in that it will develop novel interventions and methods, and generate preliminary estimates of effect sizes that will determine whether a larger, more expensive clinical trial with a longer follow-up period and evaluation of cost-effectiveness is warranted. By using technology to assess and detect episodes of nonadherence, drug use, and drug craving in real time, the project will deliver an intervention "on the fly" in time to help the person resume medication adherence before health damages occur. If successful, Text has the possibility of rapid scale-up for further trials across the rural U.S. to follow. PUBLIC HEALTH RELEVANCE: This project will develop and pilot test a text messaging system for mobile phones to assess HIV treatment adherence, quickly detect problems as they occur, and send personalized intervention messages to help rural and non-urban drug using patients achieve HIV medication adherence and interrupt drug use. This intervention could be scaled up quickly as a novel, sustainable approach to maintaining treatment adherence. Lessons learned could hasten the development of interventions for other chronic diseases in the U.S.

描述(由申请人提供)：这是根据PAS-10-098，针对艾滋病毒药物滥用人群的基于技术的遵守干预措施的新申请(R34)。对于吸毒者、少数民族和居住在大城市地区以外的健康状况较差的妇女来说，需要采取新的方法来促进艾滋病毒治疗的坚持。移动电话等熟悉的技术设备可以克服农村HIV+患者中出现的一些健康差距。在这个项目中，研究人员将开发和测试短信系统的可行性和前景，该系统使用生态瞬时评估(EMA)方法来检测不遵守和药物使用事件，然后立即进行干预，以提高艾滋病毒/艾滋病患者的艾滋病毒治疗依从性(包括服药依从性和治疗参与度)。利用针对目标患者的形成性研究并与技术开发商合作，我们将开发应用程序和管理系统，按文本(Text)延长治疗。Text将评估日常遵守情况，允许用户报告关键事件，并对有关遵守情况、吸毒和吸毒渴望的随机定时询问做出回应。当文本EMA应用程序检测到遵守威胁时，它将发送由参与者选择的个性化、量身定制的干预文本消息。这些定制的信息将提醒用户按时服药，减少药物使用。研究人员将在一项小型试点随机试验中，在三个月的时间里对新的依从性工具进行试点测试，并与通常的治疗进行对照，以确定文本的可行性、可接受性和前景。R34是行为疗法发展阶段模型中的1b/2a阶段项目，它将开发新的干预措施和方法，并产生效果大小的初步估计，以确定是否有必要进行更大、更昂贵的临床试验，并进行更长的随访期和成本效益评估。通过使用技术来实时评估和检测不遵守、药物使用和药物渴望的事件，该项目将及时提供干预措施，帮助患者在健康损害发生之前恢复服药。如果成功，TEXT有可能迅速扩大规模，随后在美国农村地区进行进一步的试验。 公共卫生相关性：该项目将开发并试点测试一个手机短信系统，以评估艾滋病毒治疗的依从性，在问题发生时快速发现问题，并发送个性化的干预信息，以帮助农村和非城市吸毒者实现艾滋病毒用药依从性和中断药物使用。这一干预措施可以迅速扩大，成为维持治疗依从性的一种新的、可持续的方法。吸取的经验教训可能会加速美国其他慢性病干预措施的发展。