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Research towards implementing technology-based prevention with positives

研究以积极的方式实施基于技术的预防

基本信息

批准号：
9193655
负责人：
Stephanie Lynn Marhefka
金额：
$ 18.95万
依托单位：
UNIVERSITY OF SOUTH FLORIDA
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-12-10 至 2018-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9193655
关键词：
AIDS prevention AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Adopted Adoption Anti-Retroviral Agents Area Behavior Therapy Behavioral Car Phone Caring Case Manager Characteristics Client Communities Computers County Data Devices Diagnosis Effectiveness Ensure Florida Follow-Up Studies Funding Future Geographic Locations HIV HIV Seropositivity Health Personnel Internet Intervention Interview Knowledge Link Medical Methods Modeling Participant Patients Perception Persons Pharmaceutical Preparations Phase Prevention Privacy Probability Provider Public Health Readiness Recruitment Activity Research Services Sexually Transmitted Diseases Shapes Structure Surveys System Technology Testing Text Thinking Time Translational Research United States National Institutes of Health Videoconferencing antiretroviral therapy base cost cost effective cost effectiveness demographics eHealth evidence base implementation research implementation science improved innovation programs public health relevance research study rural underserved scale up sex risk skills willingness

项目摘要

DESCRIPTION (provided by applicant): Despite increased access to antiretroviral (ARV) drugs and behavioral interventions, HIV remains a public health problem worldwide. Access to interventions is oftentimes limited, especially for people living with HIV (PLH) living in the rura and underserved areas. Providing Internet or mobile text-message based interventions can increase reach and there is increasing evidence of cost-effectiveness. However, data are scarce on PLH's access to technology and the acceptability of such interventions. It is also important to get the perspective of the health care providers who provide services to PLH to ensure that technology-based, or ehealth, prevention with [HIV] positives interventions (henceforth, ePWPIs) can fit with existing systems for reaching PLH clients. Aim 1 is to determine the extent to which PLH in Florida have the technical capacity (i.e., device access) to participate in technology-based, or eHealth, prevention with (HIV) positives interventions (henceforth, ePWPIs) via their own devices. This will be done with a statewide survey (approximate N=17656) of English and Spanish-speaking PLH in Florida via Ryan White case managers, as well as a more in-depth assessment with a subset of the statewide survey participants. Aim 2 is to describe PLH's willingness to adopt ePWPIs via their own devices and how adoption may vary based on participant (e.g., demographics, technology readiness), technology (e.g., text, app, video-chat), and intervention characteristics (i.e., perceptions of usefulness, cost, relative advantage). We will do this through an exploratory sequential mixed methods follow-up study with a sub-set of participants from the statewide assessment. Findings from 30 qualitative, in-person PLH interviews (Phase 2a) about willingness to adopt ePWPIs will inform an in-depth primarily quantitative assessment (N=400 PLH) regarding access, use, and willingness to adopt ePWPIs, guided in part by an adapted Technology Readiness and Acceptance Model (TRAM35). Aim 3 is to examine key stakeholder (i.e., medical care providers and ASO staff) perceptions of fit between ePWPIs and their existing systems for reaching clients and delivering programs, and identify potential ePWPI implementation strategies to maximize fit. This will be done via semi-structured interviews. The study is innovative as it is guided by the consolidated framework for implementation research (CFIR) and the TRAM. Findings will be critical in shaping the scientific agenda regarding ePWPIs and will lead to subsequent R01 applications, including a R01 trial that tests effectiveness of an approach that matches ePWPIs to geographical areas and subpopulations, employing implementation strategies that emerged from this R21.

描述（由申请人提供）：尽管抗逆转录病毒 (ARV) 药物和行为干预措施的获取有所增加，但艾滋病毒仍然是世界范围内的公共卫生问题。获得干预措施的机会往往有限，特别是对于生活在乡村和服务欠缺地区的艾滋病毒感染者 (PLH) 而言。提供基于互联网或移动短信的干预措施可以扩大影响范围，并且越来越多的证据表明其具有成本效益。然而，关于 PLH 获得技术的情况以及此类干预措施的可接受性的数据很少。同样重要的是，了解向 PLH 提供服务的医疗保健提供者的观点，以确保基于技术或电子健康的 [HIV] 阳性干预措施（以下称为 ePWPI）预防能够适应现有系统，以覆盖 PLH 客户。目标 1 是确定佛罗里达州的 PLH 在多大程度上拥有通过自己的设备参与基于技术或电子健康的 (HIV) 阳性干预措施（以下简称 ePWPI）的预防。这将通过 Ryan White 案例经理对佛罗里达州英语和西班牙语 PLH 进行全州范围内的调查（大约 N=17656），以及对全州范围内调查参与者的子集进行更深入的评估来完成。目标 2 是描述 PLH 通过自己的设备采用 ePWPI 的意愿，以及采用情况如何根据参与者（例如人口统计、技术准备情况）、技术（例如文本、应用程序、视频聊天）和干预特征（即有用性、成本、相对性的看法）而变化。优势）。我们将通过对全州评估中的一部分参与者进行探索性顺序混合方法后续研究来做到这一点。 30 次关于采用 ePWPI 意愿的定性面对面 PLH 访谈（第 2a 阶段）的结果将为有关获取、使用和采用 ePWPI 意愿的深入的主要定量评估（N=400 PLH）提供信息，部分由适应的技术准备和接受模型 (TRAM35) 指导。目标 3 是检查主要利益相关者（即医疗保健提供者和 ASO 工作人员）对 ePWPI 与其用于接触客户和交付项目的现有系统之间的契合度的看法，并确定潜在的 ePWPI 实施策略以最大化契合度。这将通过半结构化访谈来完成。该研究具有创新性，因为它以实施研究综合框架 (CFIR) 和 TRAM 为指导。研究结果对于制定有关 ePWPI 的科学议程至关重要，并将导致后续的 R01 应用，包括 R01 试验，该试验采用 R21 中提出的实施策略，测试将 ePWPI 与地理区域和亚人群相匹配的方法的有效性。