Use of mHealth Technology for Supporting Symptom Management in Underserved Persons Living with HIV

使用移动医疗技术支持服务不足的艾滋病毒感染者的症状管理

• 批准号: 8902295
• 负责人: Rebecca Schnall
• 金额: $ 15万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-03 至 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8902295
• 关键词: Use; mHealth; Technology; Supporting; Symptom

 DESCRIPTION (provided by applicant): HIV has changed from an acute illness to a chronic disease. The success of HIV medications and treatments has significantly altered the course of the disease. While AIDS-related illnesses are no longer the primary threat, a new set of HIV-associated complications have emerged, resulting in a chronic disease that for many will span several decades of life. The ability to self-manage adverse symptoms of HIV illness has been shown to improve patient-centered outcomes. In response to this need a team at UCSF developed a paper-based symptom management manual with self-management strategies for 21 common HIV/AIDS adverse symptoms (PCOR evidence). The efficacy of the manual was demonstrated in a 775-person RCT over three months at 12 sites. However, subsequent use of these strategies has been very limited; mHealth offers an ideal platform for the implementation and dissemination of evidence-based strategies for HIV symptom management. Due to the high incidence of HIV among racial and ethnic minority populations, it is appropriate to develop mHealth tools tailored to the needs of these populations. mHealth technology has the potential to address many of the health care needs of persons living with HIV/AIDS (PLWH) including symptom management. In response to these current issues, our application seeks to inform the development and testing of a mHealth application that will incorporate findings from PCOR studies to improve the outcomes of PLWH. To improve outcomes for those most in need, our study activities are focused on communities with the greatest burden of HIV in the US, including racial and ethnic minorities and those of low socioeconomic status. The aims of this project are to: 1) Apply participatory design methods to incorporate PCOR evidence for HIV symptom management into a mobile health application (mVIP) for use in patient self-management; 2) Using a randomized design, examine the effect of mVIP as compared to an attention control group on primary outcomes of symptom frequency and intensity; 3) Guided by the PRECEDE-PROCEED model of health program planning and evaluation, examine PLWH's perceptions of the predisposing, enabling, and reinforcing factors for mVIP use. The tool developed using this research has the potential to extend the impact and reach of health care for PLWH. Findings from this study have the potential to make scientific evidence more accessible to patients through the use of mHealth technology. Ultimately the incorporation of HIV symptom management strategies into patients' lives through the use of mHealth technologies has the potential to advance the effective dissemination and implementation of PCOR findings.

 描述（由申请人提供）：艾滋病毒已从急性疾病转变为慢性疾病。艾滋病毒药物和治疗的成功极大地改变了疾病的进程。虽然与艾滋病有关的疾病不再是主要威胁，但出现了一系列与艾滋病毒有关的新并发症，导致许多人患上一种慢性病，寿命长达几十年。自我管理艾滋病毒疾病不良症状的能力已被证明可以改善以患者为中心的结果。为了满足这一需求，加州大学旧金山分校的一个团队开发了一个基于纸张的症状管理手册，其中包括21种常见艾滋病毒/艾滋病不良症状的自我管理策略（PCOR证据）。该手册的有效性在12个研究中心的775人RCT中得到了证实。然而，这些战略的后续使用非常有限;移动健康为实施和传播艾滋病毒症状管理的循证战略提供了一个理想的平台。由于艾滋病毒在种族和少数民族人口中的高发病率，开发适合这些人口需求的移动健康工具是适当的。移动医疗技术有可能解决艾滋病毒/艾滋病感染者（PLWH）的许多医疗保健需求，包括症状管理。为了应对这些当前的问题，我们的应用程序旨在告知移动健康应用程序的开发和测试，该应用程序将结合PCOR研究的结果，以改善PLWH的结果。为了改善那些最需要的人的结果，我们的研究活动集中在美国艾滋病毒负担最重的社区，包括种族和少数民族以及社会经济地位低的社区。该项目的目的是：1）应用参与式设计方法，将艾滋病毒症状管理的PCOR证据纳入移动的健康应用程序（mVIP），用于患者自我管理; 2）使用随机设计，检查mVIP与注意力控制组相比对症状频率和强度的主要结果的影响; 3）以PRECEDE-PROCEED卫生计划规划和评估模型为指导，检查PLWH对使用mVIP的诱发因素，使能因素和强化因素的看法。利用这项研究开发的工具有可能扩大艾滋病毒携带者健康护理的影响和范围。这项研究的结果有可能通过使用mHealth技术使患者更容易获得科学证据。最终，通过使用移动保健技术将艾滋病毒症状管理战略纳入患者的生活，有可能推动变革和组织振兴方案调查结果的有效传播和实施。