A Pilot Gaming Adherence Program for Youth Living with HIV

描述（由申请人提供）：尽管需要持续坚持医疗护理，但感染艾滋病毒的青年（YLWH）在护理和坚持抗逆转录病毒药物（ARV）治疗方面的保留率不是最佳的。关于YLWH的依从性研究很少，结果好坏参半，因此非常需要开发新的干预措施。成人艾滋病毒依从性研究的结果表明，参与者对使用基于技术的方法感兴趣，并且最容易接受将技术设备与动机成分相结合的干预措施。服药监测装置已被发现是对抗逆转录病毒药物依从性的敏感测量，但单独使用时不能导致依从性或内在动机的持续改善。在此基础上，本研究将研究一种多层次技术，该技术将药物监测设备（Vitality Cap）与基于智能手机的交互式应用/游戏相结合，对YLWH具有吸引力和吸引力。这种多层次的方法将理论驱动的内容与新颖但直观的技术相结合，以提高艾滋病毒治疗的依从性。在这项研究中，每次打开药瓶都可以通过瓶盖（Vitality cap）无线传输到手机的数据访问智能手机上的应用程序/游戏。这个发展项目将调整和完善智能手机应用程序/游戏，使其包含符合信息-动机-行为技能（IMB）模型的内容。创作和改编将通过与YLWH就ART进行深入访谈（n=25）和干预措施的公开试验（n=20）进行。在玩游戏的同时，参与者将体验以行动为导向的冒险，这些冒险可以增加他们的健康信息（例如关于艾滋病毒治疗的知识），提高积极性（例如行动人物体验坚持治疗对健康的好处），并培养技能（例如利用临床医生作为合作伙伴）。在60名YLWH中进行的一项小型随机对照试验（24周）将检查IMB游戏依从性干预（将Vitality Cap与IMB知情应用/游戏相结合）的初步效果，并与接受Vitality Cap和智能手机但没有IMB游戏的对照组进行比较，在依从性和生物测量方面。

DESCRIPTION (provided by applicant): Despite need for consistent adherence to medical care, youth living with HIV (YLWH) have suboptimal rates of retention in care and adherence to antiretroviral medication (ARV) treatment. There are few adherence studies with YLWH and the results are mixed, so there is a great need for the development of novel interventions. Results of adult HIV adherence studies indicate that participants are interested in using technology-based methods and are most receptive toward interventions that couple technological devices with motivational components. Pill taking monitoring devices have been found to be a sensitive measure of adherence to ARV medications, but do not lead to sustained improvements in adherence or intrinsic motivation when used alone. Building on this knowledge, this study will examine a multi-level technology that integrates a medication monitoring device (Vitality Cap) WITH an interactive smartphone based app/game that is attractive and engaging to YLWH. This multi-level approach will integrate theory driven content with novel, but intuitive, technology to improve HIV treatment adherence. In this study, each opening of the pill bottle will allow access to the app/game on the smartphone via data transferred wirelessly from the bottle cap (Vitality Cap) to the phone. This developmental project will adapt and refine a smartphone app/game to include content consistent with the Information-Motivation-Behavioral Skills (IMB) Model. Creation and adaptation will occur from in-depth interviews with YLWH on ART (n=25) and an open trial of the Intervention (n=20). While gaming, participants will experience absorbing action-oriented adventures that increase information about their health (e.g. knowledge about HIV treatment), improve motivation (e.g. action-figures experience health benefits of adherence), and build skills (e.g. utilize clinicians as partners). A small randomized controlled pilot study (24 weeks) among 60 YLWH will examine the preliminary efficacy of the IMB Gaming Adherence Intervention (integration of the Vitality Cap with the IMB informed app/game) compared to a comparison group who receive the Vitality Cap and smartphone but no IMB game, on adherence and biological measures.