A Pilot Gaming Adherence Program for Youth Living with HIV

描述（由申请人提供）：尽管需要一贯坚持医疗护理，但艾滋病毒感染青年（YLWH）在护理和坚持抗逆转录病毒药物（ARV）治疗方面的保留率并不理想。有几个与YLWH的依从性研究和结果是混合的，所以有一个新的干预措施的发展是一个巨大的需求。成人艾滋病毒依从性研究的结果表明，参与者有兴趣使用基于技术的方法，最容易接受的干预措施，夫妇的技术设备与动机的组成部分。服药监测装置已被发现是一个敏感的措施坚持抗逆转录病毒药物，但不导致持续改善坚持或内在动机时，单独使用。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）与基于交互式智能手机的应用程序/游戏集成在一起，该应用程序/游戏对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。 在本研究中，每次打开药瓶都将允许通过从瓶盖（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。这个开发项目将调整和完善智能手机应用程序/游戏，包括与信息动机行为技能（IMB）模型一致的内容。创作和改编将发生在与YLWH关于ART的深入访谈（n=25）和干预的开放试验（n=20）。在游戏过程中，参与者将体验到吸引人的以行动为导向的冒险，增加有关其健康的信息（例如有关艾滋病毒治疗的知识），提高动力（例如行动人物体验坚持的健康益处），并建立技能（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初步研究（24周）将检查IMB游戏依从性干预（Vitality Cap与IMB知情应用程序/游戏的整合）与接受Vitality Cap和智能手机但没有IMB游戏的对照组相比的依从性和生物学指标的初步疗效。

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.