A Pilot Test of an Online HIV Medication Adherence Intervention

在线艾滋病毒药物依从性干预的试点测试

• 批准号: 7992361
• 负责人: J Michael Oakes
• 金额: $ 22.42万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-02-12 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7992361
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adherence; African American; Applications Grants; Behavioral; Caring; Chronic Disease; Clinic; Clinical; Clinical Sciences; Communities; Community Health; Control Groups; Data Security; Development; Dose; Electronics; Enrollment; Ensure; Environment; Epidemic; Epidemiology; Expenditure; Feedback; Future; Goals; HIV; HIV Seropositivity; Health Care Costs; Health Psychology; Highly Active Antiretroviral Therapy; Individual; Internet; Intervention; Intervention Studies; Laboratories; Leadership; Length; Life; Link; Mails; Measures; Medical; Mental Health; Minnesota; Modeling; Monitor; Motivation; Needs Assessment; Outcome; Participant; Patient Self-Report; Persons; Pharmaceutical Preparations; Pharmacy facility; Pilot Projects; Population; Population Study; Procedures; Process; Process Measure; Production; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Recruitment Activity; Reporting; Research; Research Personnel; Research Proposals; Resources; Risk; Risk Factors; Sampling; Scientific Advances and Accomplishments; Self Medication; Source; Staging; Surveys; Target Populations; Technology; Testing; Text; Time; TimeLine; United States; United States National Institutes of Health; Universities; Validation; Viral Load result; Woman; base; computer science; cost; design; experience; follow-up; high risk; human subject; improved; innovation; interest; medication compliance; member; men who have sex with men; multidisciplinary; peer; post intervention; programs; prototype; public health relevance; response; satisfaction; skills; social networking website; theories; therapy adherence; therapy development; treatment adherence; usability; virtual; web site

DESCRIPTION (provided by applicant): The HIV epidemic continues to be a significant public health threat in the United States (US), particularly as HIV-positive (HIV+) individuals live longer as a result of improved treatments. However, poor adherence to highly active antiretroviral therapy (HAART) is common, and has a high societal cost in terms of medical expenditures associated with suboptimal adherence. The long-term objective of this proposal by a new investigator is to increase medication adherence among HIV+ individuals in the US. To achieve this, the specific aims are to: 1) conduct formative research on medication adherence and its risk factors among Internet-using HIV+ persons, 2) design a peer support Internet-based HIV medication adherence intervention grounded in the Information-Motivation-Behavioral Skills theory; and 3) pilot the online intervention to assess intervention feasibility and procedures, as well as to obtain population parameters to calculate more precise power and design estimates for a future randomized controlled trial. We propose to develop core intervention components that include user-driven personal profiles that enable participants to communicate with one another and receive peer support, medication self-monitoring and e-mail and text message reminders, and tailored IMB-related feedback that address common problems of adherence. All intervention features will be highly mobile to allow for utilization in contexts in which adherence problems arise. Innovation in this project includes the use of a theoretically-grounded and empirically-derived Internet- based intervention to address HAART adherence, with incorporation of peer interaction and self-monitoring features that have not been widely used in HIV-related online interventions. The PI is experienced in Internet-based HIV-related intervention research, and has assembled a strong multidisciplinary team - representing Epidemiology and Community Health, Psychology, Computer Science, and Pharmacy - to develop the first of its kind intervention. The HIPS Program environment has a national reputation in online HIV prevention studies, and has developed extensive protocols for human subjects' considerations, including data security and cross-validation protocols, which are identified barriers to effective Internet- based research. The significance to HIV treatment adherence research of this proposal includes the development of a comprehensive approach to theoretically-grounded online intervention development and implementation, empirically-based in formative research to understand the risks and needs of Internet-using HIV+ individuals and the use of technology standards for future adherence efforts. The significance of this project to public health involves the development and pilot testing of the first online HAART medication adherence intervention for Internet-using HIV+ individuals that, if successful, can be easily adapted for a more definitive subsequent randomized controlled trial. PUBLIC HEALTH RELEVANCE: The proposed project is to a) conduct formative research on medication adherence and its risk factors among Internet-using HIV-positive individuals and b) design and pilot a theoretically grounded, peer support online HIV medication adherence intervention. The impact of the proposed intervention at the individual level is the reduction of HIV viral load, thereby curtailing progression to AIDS, and at the societal level, by reducing health care costs that result from poor adherence. Using the Internet to deliver the intervention will allow it to be distributed widely and adapted for use with a variety of populations.

描述（由申请人提供）：艾滋病毒流行病仍然是美国（US）的一个重大公共卫生威胁，特别是艾滋病毒阳性（HIV+）个体由于治疗方法的改进而寿命更长。然而，对高效抗逆转录病毒疗法（HAART）的依从性差是常见的，并且在与次优依从性相关的医疗支出方面具有较高的社会成本。一位新研究人员提出的这项提案的长期目标是提高美国艾滋病毒+患者的药物依从性。具体目标是：（1）对互联网使用者的服药依从性及其影响因素进行形成性研究;（2）以信息-动机-行为技能理论为基础，设计基于互联网的同伴支持的HIV服药依从性干预;（3）开展网上干预试点，评估干预可行性和程序，以及获得群体参数，以计算更精确的功效，并为未来的随机对照试验设计估计值。我们建议开发核心干预组件，其中包括用户驱动的个人资料，使参与者能够相互沟通，并接受同行的支持，药物自我监测和电子邮件和短信提醒，并定制IMB相关的反馈，解决常见的问题的坚持。所有干预功能都将是高度移动的，以便在出现依从性问题的情况下使用。该项目的创新之处包括使用一种基于理论和实践的互联网干预措施来解决HAART依从性问题，并纳入了尚未广泛用于艾滋病毒相关在线干预措施的同伴互动和自我监测功能。PI在基于互联网的艾滋病毒相关干预研究方面经验丰富，并组建了一个强大的多学科团队-代表流行病学和社区卫生，心理学，计算机科学和药学-开发第一个此类干预。HIPS方案环境在在线艾滋病毒预防研究方面享有全国声誉，并为人类受试者的考虑制定了广泛的协议，包括数据安全和交叉验证协议，这些协议已被确定为有效的基于互联网的研究的障碍。该提案对艾滋病毒治疗依从性研究的重要性包括制定一种全面的方法，以理论为基础的在线干预措施的制定和实施，以实验为基础的形成性研究，以了解使用互联网的艾滋病毒+个人的风险和需求，以及使用技术标准进行未来的依从性工作。该项目对公共卫生的重要性涉及开发和试点测试第一个在线HAART药物依从性干预使用互联网的艾滋病毒+个人，如果成功，可以很容易地适应更明确的后续随机对照试验。 公共卫生关系：拟议的项目是：a）在使用互联网的艾滋病毒阳性者中开展关于药物依从性及其风险因素的形成性研究，以及B）设计和试点一个有理论基础的、同伴支持的在线艾滋病毒药物依从性干预措施。拟议的干预措施在个人一级的影响是减少艾滋病毒载量，从而遏制向艾滋病的进展，在社会一级的影响是减少因坚持不良而产生的保健费用。利用互联网提供干预措施将使其能够广泛传播，并适应各种人群的使用。

项目成果

An empirical test of the information-motivation-behavioral skills model of ART adherence in a sample of HIV-positive persons primarily in out-of-HIV-care settings.

• DOI: 10.1080/09540121.2013.802283
• 发表时间: 2014-02
• 期刊: AIDS care
• 影响因子: 1.7
• 作者: Horvath KJ;Smolenski D;Amico KR
• 通讯作者: Amico KR

Feasibility, acceptability and preliminary efficacy of an online peer-to-peer social support ART adherence intervention.

• DOI: 10.1007/s10461-013-0469-1
• 发表时间: 2013-07
• 期刊: AIDS AND BEHAVIOR
• 影响因子: 4.4
• 作者: Horvath, Keith J.;Oakes, J. Michael;Rosser, B. R. Simon;Danilenko, Gene;Vezina, Heather;Amico, K. Rivet;Williams, Mark L.;Simoni, Jane
• 通讯作者: Simoni, Jane

Engagement in HIV Medical Care and Technology Use among Stimulant-Using and Nonstimulant-Using Men who have Sex with Men.

• DOI: 10.1155/2013/121352
• 发表时间: 2013
• 期刊: AIDS research and treatment
• 影响因子: 1.7
• 作者: Horvath KJ;Carrico AW;Simoni J;Boyer EW;Amico KR;Petroll AE
• 通讯作者: Petroll AE

A cost analysis of an Internet-based medication adherence intervention for people living with HIV.

• DOI: 10.1097/qai.0b013e318250f011
• 发表时间: 2012-05-01
• 期刊: Journal of acquired immune deficiency syndromes (1999)
• 作者: Page TF;Horvath KJ;Danilenko GP;Williams M
• 通讯作者: Williams M

Leadership Qualities Emerging in an Online Social Support Group Intervention.

• DOI: 10.1080/14681994.2014.941346
• 发表时间: 2014-11-01
• 期刊: Sexual and relationship therapy : journal of the British Association for Sexual and Relationship Therapy
• 作者: Kodatt SA;Shenk JE;Williams ML;Horvath KJ
• 通讯作者: Horvath KJ