Development of a Couple-Based Mobile Health Intervention for Enhancing HIV Care Engagement Outcomes

开发基于夫妇的移动健康干预措施以增强艾滋病毒护理参与成果

• 批准号: 9204429
• 负责人: Judy You Rong Tan
• 金额: $ 19.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-04-01 至 2019-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9204429
• 关键词: AIDS prevention; AIDS/HIV problem; Abate; Access to Information; Acquired Immunodeficiency Syndrome; Address; Adherence; Behavioral Medicine; CD4 Lymphocyte Count; Caring; Communication; Communities; Continuity of Patient Care; Couples; Data; Development; Diagnosis; Effectiveness; Epidemic; Ethnic group; Foundations; Funding; Goals; HIV; HIV Seropositivity; Health; Health Benefit; Health Personnel; Improve Access; Individual; Intervention; Intervention Studies; Interview; Mentors; Methods; Minority Groups; Outcome; Play; Prevention; Prevention approach; Prevention strategy; Preventive Intervention; Public Health; Research; Research Activity; Research Personnel; Role; Self Efficacy; Structure; Technology; Testing; Time; Training; United States National Institutes of Health; Unsafe Sex; Ursidae Family; Viral; Work; base; black men who have sex with men; career; career development; design; effective intervention; improved; innovation; innovative technologies; intervention effect; intimate behavior; mHealth; meetings; member; men; men who have sex with men; mobile computing; new technology; prototype; public health relevance; racial and ethnic; racial and ethnic disparities; research and development; risk minimization; same-sex partnership; skills; technological innovation; theories; therapy development; tool; transmission process

 DESCRIPTION (provided by applicant): Compared to other racial/ethnic groups in the US, Black men who have sex with men (MSM), once diagnosed, are less likely to be optimally engaged in HIV care and treatment. This undermines the promise of recent prevention approaches for reducing the disproportionate effects of HIV/AIDS on Black communities, emphasizing the urgency for increased research focus and intervention development. Understanding HIV care engagement in the context of the dyad may be part of a comprehensive effort to addressing multilevel influences on HIV care engagement outcomes that are unique to HIV+ Black MSM towards achieving the maximum public health benefit of treatment-as-prevention. However, the scarcity of dyad-level research limits our understanding of couple dynamics involved in HIV care engagement to inform intervention development targeting the couple, underscoring the need for couple-based studies of relational dynamics important to the HIV care engagement of the HIV+ partner(s). Mobile technology-based strategies (mHealth) offer tremendous potential as an acceptable, feasible, and effective intervention platform for enhancing HIV care engagement among HIV+ Black MSM in couples by facilitating couple dynamics optimal to HIV care engagement. Further, mHealth offers potential in addressing limitations in previous intervention research with couples, one of which is the dissipation of intervention effects over time due to absence of booster sessions. Therefore, the aims of the study are to: elucidate the effects of couple dynamics on HIV care engagement among partnered synthesize the quantitative and qualitative (mixed methods) outcomes from Aim 1 to identify the issues the intervention will target, and to iteratively determine core components of a couple-based intervention for HIV+ Black MSM (Aim 2); and develop a novel, technology-based intervention prototype for enhancing HIV care engagement among HIV+ Black MSM in couples (Aim 3). HIV+ Black MSM (Aim 1); The overall objective of this application is to achieve a better understanding of the couple dynamics involved in HIV care engagement among HIV+ Black men in same-sex relationships. The end goal is the development of an mHealth tool that targets couple dynamics important to enhancing HIV care engagement. Through these aims, I will acquire additional training necessary for my career development in (a) theory and mixed methods for conducting couple-based research, (b) formative research in intervention development, and (c) prototype design. These research and career development activities will build the foundation to my becoming an independent, NIH-funded investigator with skills to conduct couple-based intervention research that is part of a comprehensive effort in HIV prevention integrating advances in technology and behavioral medicine to reduce racial/ethnic disparities in HIV.

 描述（由申请人提供）：与美国其他种族/族裔群体相比，与男性发生性关系的黑人男性（MSM），一旦确诊，不太可能最佳地参与艾滋病毒护理和治疗。这破坏了最近的预防方法减少艾滋病毒/艾滋病对黑人社区的不成比例的影响的承诺，强调迫切需要增加研究重点和干预措施的发展。了解艾滋病毒护理参与的上下文中的二元体可能是一个全面的努力，以解决艾滋病毒护理参与的结果，是独特的艾滋病毒+黑人男男性行为者实现最大的公共卫生效益的治疗作为预防的多层次影响的一部分。然而，缺乏二元层次的研究限制了我们对参与艾滋病毒护理参与的夫妇动态的理解，以告知针对夫妇的干预措施的制定，强调需要以夫妇为基础的关系动态研究对艾滋病毒+合作伙伴的艾滋病毒护理参与很重要。移动的技术为基础的战略（mHealth）提供了巨大的潜力，作为一个可接受的，可行的，有效的干预平台，以提高艾滋病毒感染的黑人男男性行为者在夫妇之间的艾滋病毒护理参与，促进夫妇动态最佳的艾滋病毒护理参与。此外，mHealth提供了解决以前对夫妇进行干预研究的局限性的潜力，其中之一是由于缺乏助推器会议，随着时间的推移干预效果的消散。因此，本研究的目的是：阐明夫妇动态对艾滋病毒护理参与的影响，综合目标1的定量和定性（混合方法）结果，以确定干预措施将针对的问题，并反复确定一个 为艾滋病毒阳性的黑人男男性行为者提供基于夫妇的干预措施（目标2）;并开发一种新的、基于技术的干预原型，以加强艾滋病毒阳性的黑人男男性行为者在夫妇中的艾滋病毒护理参与（目标3）。HIV+黑人男男性行为者（目标1）;本申请的总体目标是更好地了解同性关系中HIV+黑人男性参与艾滋病毒护理的夫妇动态。最终目标是开发一个移动健康工具，针对对加强艾滋病毒护理参与至关重要的夫妇动态。通过这些目标，我将获得职业发展所需的额外培训，包括（a）进行基于夫妇的研究的理论和混合方法，（B）干预开发的形成性研究，以及（c）原型设计。这些研究和职业发展活动将为我成为一名独立的NIH资助的研究人员奠定基础，该研究人员具有进行基于夫妇的干预研究的技能，这是艾滋病毒预防综合努力的一部分，结合技术和行为医学的进步，以减少艾滋病毒的种族/民族差异。