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Development and Evaluation of an Interactive Mobile Health Intervention to Support Patients with Active Tuberculosis

支持活动性结核病患者的交互式移动健康干预措施的开发和评估

基本信息

批准号：
9534197
负责人：
Sarah Jo Hannah Iribarren
金额：
$ 14.57万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-01 至 2020-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9534197
关键词：
Address Adherence Adverse effects Argentina Automation Behavior Therapy Behavioral Car Phone Caring Cause of Death Cellular Phone Cessation of life Communication Communication Tools Communities Conduct Clinical Trials Critiques Development Development Plans Directly Observed Therapy Discipline of Nursing Disease Drug resistance in tuberculosis Drug usage Economics Epidemic Evaluation Face Feedback Focus Groups Future Goals Health Health Personnel Health Promotion Health Technology Imagery Income Individual Informatics Information Technology Interdisciplinary Study Interruption Intervention Intervention Studies Knowledge Lead Medical Care Team Mentors Methodology Monitor Morbidity - disease rate Participant Patient-Focused Outcomes Patients Personal Satisfaction Pharmaceutical Preparations Phase Positioning Attribute Postdoctoral Fellow Provider Public Health Informatics Recommendation Reporting Research Research Personnel Science Scientist Self Administration Self Management Supervision Sustainable Development Symptoms Technology Testing Text Text Messaging Training Transportation Treatment outcome Tuberculosis United States National Institutes of Health Work World Health Organization Writing adverse outcome base career career development collaborative care comparative effectiveness design efficacy testing experience global health health care availability health management improved innovation iterative design mHealth member novel patient engagement patient oriented patient oriented research pre-doctoral prevent primary outcome public health priorities response secondary outcome skills social stigma success tool treatment adherence treatment as usual tuberculosis treatment usability

项目摘要

PROJECT SUMMARY Tuberculosis (TB) remains an urgent global health problem and a leading cause of death worldwide with most of the 1.5 million annual deaths being preventable. Much of the adverse outcomes are related to poor treatment adherence resulting in prolonged infectivity, morbidity and economic hardship, and the growing drug resistant TB. To improve adherence, directly observed therapy (DOT) has been a long standing recommended strategy. However, because DOT is labor intensive, transportation dependent, and often inconvenient to patients it continues to be challenging to implement universally and new supportive treatment supervision strategies are needed. Mobile health technologies, including apps, with increased sophistication capable of accommodating multiple tools (e.g., automated reminders, symptom tracking), among others, hold great promise to provide supportive treatment supervision, heighten patient involvement in their own care and improve monitoring, communication, and individual tailoring. To date, few TB related apps have directly targeted patients and none included functions to support patient engagement in self-management of their care . The proposed research will use rapid iterative methodology to convert and expand TextTB to include innovative adherence monitoring into a mobile optimized app, refine and enhance with end-users and stakeholders and assess feasibility, usability and initial efficacy in a setting with historically low treatment success rates where treatment delivery is commonly by self-administration. The training and research builds upon pre- and post-doctoral work where the candidate led a team of patients in active TB treatment and TB experts to develop TextTB, a text messaging-based intervention. This intervention aimed to support patients receiving TB treatment by self-administration and healthcare teams to more quickly respond to patients with non- or problematic adherence. Although successful as a pilot, needed improvements were identified, such as increasing automation of alerts, expanding educational messages, incorporating visualization of treatment course, and improving patient tailoring. Responsive design apps could address these issues. The candidate's long-term career goal is to become an independent researcher and lead in the development of cutting-edge interventions, suitable for the emerging economies of the world, that facilitate self-management of health and prevent disease. The career development plan integrates didactic coursework with practical mentored research experience to achieve the following training goals: 1) obtain advanced training in health informatics, 2) develop expertise in iterative development of patient-centered technologies, 3) achieve capacity to effectively conduct clinical trials to design and evaluate information technology to improve patient outcomes, and 4) obtain proficiency with scientific writing and grantsmanship. The candidate has developed a clear research trajectory for patient-oriented intervention research, which meets NINR's programmatic priorities to promote self-management, to promote health and prevent disease, and to advance nursing science to improve the health and well-being of the world's citizens.

项目总结