SMS/GIS Integration for HIV Surveillance and Health Care Delivery

用于艾滋病毒监测和医疗保健服务的 SMS/GIS 集成

• 批准号: 8603562
• 负责人: DEBORAH THOMAS
• 金额: $ 19.32万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8603562
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adherence; Africa; Africa South of the Sahara; African; Anti-Retroviral Agents; Area; CD4 Lymphocyte Count; Car Phone; Caring; Cells; Cellular Phone; Child Care; Client; Clinic; Collaborations; Continuity of Patient Care; Counseling; Data; Data Collection; Developing Countries; Diagnosis; Diffusion of Innovation; District Hospitals; Elements; Ensure; Evaluation; Female; Female of child bearing age; Geographic Information Systems; Goals; HIV; HIV Infections; HIV Seropositivity; HIV diagnosis; Health; Health care facility; Human Resources; Human immunodeficiency virus test; Infant; Infection; Information Systems; Maps; Modeling; Mothers; Outcome; Patient Monitoring; Patients; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Pregnant Women; Prevalence; Prevention; Process; Quality of Care; Randomized Controlled Trials; Reaction Time; Relative (related person); Reporting; Research; Research Design; Resources; Rural; Services; South Africa; System; Tanzania; Technology; Testing; Text; Time; Update; Vertical Disease Transmission; Woman; Work; base; care delivery; efficacy testing; efficacy trial; experience; follow-up; health information technology; improved; programs; public health relevance; response; rural area; scale up; surveillance data; theories; tool

DESCRIPTION (provided by applicant): The goal of the proposed pilot project is to better understand how geographic information systems (GIS) integrated with SMS cell-phone technology can facilitate improvements in linkage to Prevention of Mother to Child Transmission of HIV (PMTCT) and reduce time between diagnosis and consistent treatment with antiretrovirals (ARV) in a rural setting in Tanzania. While promising improvements in PMTCT have occurred, there remains varied access to HIV counseling and testing and subsequent access to antiretroviral treatment for mothers testing positive for HIV. Research is emerging that underscores the potential for mobile phones to improve HIV diagnosis, prevention, and adherence to treatment throughout Sub-Saharan Africa and additional evidence illustrates the utility of using geographic information systems (GIS) in HIV care. Through combining these technologies, the interactive and dynamic system can be used to: facilitate real-time responses to delivery of care, to establish HIV VCT in areas with emergent infections, to increase referrals to the District Hospital, and to inform the distribution of additional medication and treatment for mothers and infants for facilitation of PMTCT. Guided by the Diffusion of Innovation (DI) Theory, the proposed pilot project will achieve a baseline for a subsequent randomized controlled trial that will test the efficacy of a culturally sensitive, technologically relevant PMTCT program for Misungwi, Tanzania. The pilot will develop and test a mobile phone-based record keeping system that will interface with existing GIS resource maps to facilitate and document delivery of PMTCT and VCT in Misungwi. The system will be implemented in the district over a 3-month period in order to establish how well the system works. The implementation phase will be followed by evaluation of the system with respect to the HIV treatment cascade, including whether an increased number of new HIV infections are identified, if the time is reduced between HIV diagnosis and start of treatment for women of childbearing age, and whether increased adherence to medication among female clients of HW using the mobile phone based tools occurs. We anticipate that this interactive and dynamic system will contribute to best practices in PMTCT by facilitating improved responses to delivery of care in these rural settings, assisting in locating additional HIV PMTCT programs in areas with emergent infections, and informing the distribution of additional medication and treatment for mothers. The explicit design of the study provides a model that could be scaled up in Tanzania and other East African settings. Additionally, if successful, the proposed approach holds great potential for replication to other priority populations for HIV and other health outcomes.

说明(申请人提供)：拟议试点项目的目标是更好地了解地理信息系统(地理信息系统)与短信手机技术相结合如何促进改善与预防艾滋病毒母婴传播(PMTCT)的联系，并缩短坦桑尼亚农村地区诊断和持续抗逆转录病毒药物治疗之间的时间。虽然预防母婴传播取得了可喜的改善，但艾滋病毒咨询和检测的机会仍然很多，艾滋病毒检测呈阳性的母亲随后获得抗逆转录病毒治疗的机会仍然很多。正在出现的研究强调了移动电话在整个撒哈拉以南非洲地区改善艾滋病毒诊断、预防和坚持治疗的潜力，更多的证据表明在艾滋病毒护理中使用地理信息系统(GIS)的效用。通过结合这些技术，互动和动态系统可用于：促进对提供护理的实时响应，在紧急感染地区建立艾滋病毒VCT，增加到地区医院的转诊，以及通知分配额外的药物和治疗 母亲和婴儿促进母婴传播。在创新扩散(DI)理论的指导下，拟议的试点项目将实现随后的随机对照试验的基线，该试验将测试坦桑尼亚米松威市具有文化敏感性和技术相关性的防止母婴传播计划的有效性。试点项目将开发和测试一个基于移动电话的记录保存系统，该系统将与现有的地理信息系统资源地图对接，以便利和记录在米松威的防止母婴传播和虚拟传播技术的交付。该系统将在该地区实施，为期3个月，以确定该系统的运作情况。在实施阶段之后，将针对艾滋病毒治疗级联对该系统进行评价，包括是否发现了更多新的艾滋病毒感染病例，是否缩短了从艾滋病毒诊断到育龄妇女开始治疗之间的时间，以及卫生保健服务的女性客户是否更多地坚持使用基于移动电话的工具进行药物治疗。我们预计，这个互动和动态的系统将通过促进改善对这些农村地区提供的护理的反应，帮助在紧急感染地区寻找更多艾滋病毒预防母婴传播方案，并为母亲分发额外的药物和治疗，从而促进预防母婴传播的最佳做法。这项研究的明确设计提供了一个可以在坦桑尼亚和其他东非环境中推广的模型。此外，如果成功，拟议的方法具有很大的潜力，可以复制到其他优先人群，以实现艾滋病毒和其他健康结果。