mHealth intervention for ART adherence and sexual risk reduction among HIV+ YMSM

描述（由申请人提供）：候选人是费城儿童医院的青少年医学专家和青少年艾滋病毒服务主任，研究重点是使用移动技术改善有感染艾滋病毒/艾滋病风险的青少年的依从性和其他健康结果。候选人提出了一个职业发展计划，该计划将为她提供技能和经验，使她成为青少年艾滋病研究领域的独立调查员。除了定量和定性研究方法和健康行为理论的教学课程外，候选人的职业发展将由一个由国家认可的顾问组成的多学科团队指导，致力于她的成功。[她将成立一个技术顾问委员会，在移动医疗（mHealth）技术的各个方面提供指导和指导，包括基于技术的健康干预措施的孵化和开发，大数据/机器学习的研究设计和分析技术，游戏化理论，用户界面/响应式设计技术，可用性测试，以及健康行为理论在移动医疗干预措施开发中的应用。]

DESCRIPTION (provided by applicant): The candidate is an adolescent medicine specialist and Director of Adolescent HIV Services at The Children's Hospital of Philadelphia with a research focus on using mobile technology to improve adherence and other health outcomes for adolescents at risk for and living with HIV/AIDS. The candidate proposes a career development program that will provide her with the skills and experience to become an independent investigator in the field of adolescent HIV research. In addition to didactic coursework in quantitative and qualitative research methodology and health behavior theory, the candidate's career development will be guided by a multidisciplinary team of nationally recognized advisors committed to her success. [She will form a Technology Advisory Board for mentorship and preceptorships in all aspects of mobile health (mHealth) technology, including incubation and development of technology-based health interventions, study design and analysis techniques for big data/machine learning, gamification theory, user interface/responsive design techniques, usability testing, and the application of health behavior theory to develop mHealth interventions.] Career development activities will be complemented by practical experience gained through the conduct of original research. This proposal examines key health behaviors of medication adherence and sexual risk among young men who have sex with men (YMSM) living with HIV/AIDS, and proposes to develop a mobile phone based intervention targeted at improving these health behaviors in the real times and places youth need support. AIM 1 will describe the incidence of STI co-infections and virologic failure and report the standardized risk of these outcomes across strata of HIV+ YMSM through retrospective chart review augmented by in-depth structured interviews for further understanding of key psychosocial and behavioral factors. Using focus groups of youth at high- and low-risk, selected based on findings from AIM 1, AIM 2 will explore how HIV+ YMSM use mobile technology, and their attitudes towards various mobile phone-based tools to improve adherence and reduce sexual risk. Delphi methodology will first be used in AIM 3 to convene a panel of mHealth and adolescent health experts to establish consensus guidelines for adolescent sexual health technology-based intervention development. These results, combined with youth input from AIM 2, will serve as a guiding framework for development of a new mHealth secondary prevention intervention for HIV+ YMSM. The new mHealth intervention composed of theory-driven elements, for example, including time and location-based reminders, and individual and group-based gaming incentives will then undergo usability testing consisting of (a) a focus group for specific feedback on design and user experience and then (b) a 12-month feasibility trial where 20 youth will have the application installed and usage, satisfaction, and clinical outcome data will be collected. In line with NIMH's research priorities, this proposal sets out to develop an innovative secondary prevention strategy targeting improved medication adherence and sexual risk reduction among HIV+ YMSM.