Exploratory study of drug user health-related internet and mobile technology use

描述（由申请人提供）：本探索性研究的目的是探讨非法吸毒者使用互联网和移动技术的频率和类型，特别是使用互联网和短信获取医疗信息和从事医疗保健利用的相关因素。基于网络和基于移动技术的卫生干预措施已被证明在提供健康教育、改变健康行为和增加药物依从性/保留治疗方面是有效的。然而，这些干预措施对吸毒人群的潜在影响尚未得到充分探讨。针对吸毒者的基于互联网或移动技术的健康促进干预措施因以下方面的数据缺乏而受到阻碍：吸毒者在何处、多久以及出于何种目的使用互联网和移动技术，特别是出于与健康有关的原因；互联网和移动使用障碍；以及这些技术的使用如何因社会人口统计学、性和药物风险行为、卫生保健状况和卫生保健利用而异。在此，本研究的目的1是检验人口统计学、健康状况、行为、技术自我效能感和障碍之间的相关性：1)吸毒者在哪里、多久使用一次、出于什么目的使用互联网和移动技术；1b)愿意将互联网或移动技术用于与健康相关的目的；1c)为获取健康信息和/或与卫生保健系统/提供者接触而实际使用的互联网或手机应用程序/短信。目标2，在那些报告每月使用互联网100次的人（来自目标1）中，我们将引导他们访问研究开发的吸毒者交互式健康信息网站，我们将试点测试：2a)网站使用情况；2b)使用网站功能（例如，观看与健康有关的视频，使用可搜索的卫生保健服务地图）；(2)接收有关健康信息的自动更新短信。为了实现这些目标，我们将以纽约市的高毒品活动社区为目标，招募由药房工作人员招募的参与者（即通过纽约州扩大注射器获取计划购买注射器的注射吸毒者）或通过拨打张贴在药房的研究传单上的免费电话号码筛选合格的参与者。所有参与者（n=336）将接受ACASI，评估社会人口统计学、医疗保健获取和利用、性/药物使用行为、健康状况以及一般和与健康相关的互联网/移动技术使用的特征，包括促进或阻碍使用的因素。被确定为每月使用一次互联网的参与者（n=151）将返回进行为期两周的ACASI，以报告试点网站的使用情况（该网站将以印刷品/小册子/视频形式主要展示社区当前可用的信息）。数据将使用描述性统计和回归技术进行分析，以实现这两个目标，并使用多层次建模来解释聚类数据。我们的研究结果有可能为基于网络或基于移动的干预措施的未来发展提供信息，以改善非法吸毒者的健康状况。

DESCRIPTION (provided by applicant): The purpose of this exploratory study is to examine factors associated with frequency and type of internet and mobile technology use among illegal drug users, specifically use of internet and text-messaging to obtain health care information and engage in health care utilization. Web-based and mobile technology-based health interventions have been shown to be effective in providing health education, changing health behavior, and increasing medication adherence/retention in care. However, the potential impact of these interventions among drug-using populations has been grossly underexplored. Internet or mobile technology-based health promotion interventions for drug users has been hampered by the scarcity of data on: where, how often, and for what purpose drug users use internet and mobile technologies, especially for health-related reasons; barriers to internet and mobile use; and how use of these technologies vary by socio-demographics, sexual and drug risk behavior, health care status, and health care utilization. Herein, Aim 1 of the study is to examine demographic, health status, behavioral, technology self-efficacy and barrier correlates of: 1a) where, how often, and for what purpose drug users use internet and mobile technologies; 1b) willingness to use internet or mobile technology for health-related purposes; and 1c) actual internet or cell phone app/text message use for the purposes of acquiring health information and/or engaging the health care system/providers. Aim 2, among those who report internet use > 1x/month (from Aim 1) who will be directed to visit a study-developed interactive health information website for drug users, we will pilot test: 2a) website use; 2b) use of website functions (e.g. viewing health-related videos, use of searchable map of health care services); and 2c) uptake in receipt of automatic text message updates on relevant health information. To achieve these aims, we will target high drug activity neighborhoods in New York City and enroll participants recruited by pharmacy staff (i.e. injection drug users purchasing syringes through New York State Expanded Syringe Access Program) or screened eligible by calling a toll-free number on the study flyer posted in the pharmacy. All participants (n=336) will undergo an ACASI that will assess socio-demographics, health care access and utilization, sex/drug use behavior, health status, and characteristics of general and health-related internet/mobile technology use including factors that promote or hinder use. Participants identified as using the internet e 1/month (n=151) will return for a 2-week ACASI to report on use of the pilot website (which will largely display information currently available in the community in print/ pamphlet/ video form). Data will be analyzed using descriptive statistics and regression techniques for both aims, and multilevel modeling to account for clustered data. Our study results have the potential to inform the future development of web-based or mobile-based interventions to improve the health status of illegal drug users.