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，男男性行为黑人 (MSM) 一旦确诊，不太可能最佳地参与艾滋病毒护理和治疗。这破坏了最近预防方法减少艾滋病毒/艾滋病对黑人社区过度影响的承诺，强调了加强研究重点和制定干预措施的紧迫性。在二元背景下理解艾滋病毒护理参与可能是解决艾滋病毒护理参与结果的多层次影响的综合努力的一部分，这些影响是艾滋病毒+黑人男男性行为者所特有的，以实现治疗即预防的最大公共卫生效益。然而，二元层面研究的缺乏限制了我们对艾滋病毒护理参与中涉及的夫妻动态的理解，从而无法为针对夫妇的干预措施的制定提供信息，这强调了基于夫妇的关系动态研究的必要性，这对艾滋病毒+伴侣的艾滋病毒护理参与很重要。基于移动技术的策略 (mHealth) 作为可接受、可行和有效的干预平台提供了巨大的潜力，可通过促进最适合艾滋病毒护理参与的夫妻动态来增强艾滋病毒+黑人男男性接触者之间的艾滋病毒护理参与度。此外，移动医疗在解决之前针对夫妻的干预研究中的局限性方面提供了潜力，其中之一是由于缺乏加强治疗而导致干预效果随着时间的推移而消散。因此，本研究的目的是： 阐明夫妻动态对合作伙伴之间艾滋病毒护理参与度的影响 综合目标 1 的定量和定性（混合方法）结果，以确定干预措施针对的问题，并迭代确定干预措施的核心组成部分 针对 HIV+ 黑人 MSM 的基于夫妇的干预（目标 2）；开发一种新颖的、基于技术的干预原型，以提高艾滋病毒+黑人男男性接触者夫妇中艾滋病毒护理的参与度（目标 3）。 HIV+ 黑人 MSM（目标 1）；该应用程序的总体目标是更好地了解同性关系中艾滋病毒+黑人男性参与艾滋病毒护理所涉及的夫妻动态。最终目标是开发一种移动医疗工具，该工具针对对提高艾滋病毒护理参与度至关重要的夫妻动态。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、由美国国立卫生研究院资助的调查员奠定基础，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，该努力结合了技术和行为医学的进步，以减少艾滋病毒的种族/民族差异。