Mobile Augmented Screening Tool to Increase Adolescent HIV Testing and Linkage to Care

移动增强筛查工具可增加青少年艾滋病毒检测和与护理的联系

• 批准号: 9678036
• 负责人: Ian David Aronson
• 金额: $ 47.73万
• 依托单位: DIGITAL HEALTH EMPOWERMENT, INC.
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-19 至 2020-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9678036
• 关键词: AIDS prevention; Accident and Emergency department; Address; Adolescent; Adolescent and Young Adult; African American; Age; Appointment; Area; Behavioral; Caring; Centers for Disease Control and Prevention (U.S.); Child; Client; Clinic; Clinical; Clinical Trials; Counseling; Data; Data Collection; Development; Doctor of Philosophy; Education; Emergency Department patient; Emergency department visit; Evaluation; Face; Feedback; Fright; Funding; Gender; Goals; Grant; HIV; HIV Infections; HIV Seropositivity; HIV risk; Health; Health Personnel; Health care facility; High Prevalence; Hospitals; Human immunodeficiency virus test; Infection; Insurance; Insurance Carriers; Intervention; Interview; Knowledge; Laws; Lead; Measures; Minority; Modeling; Motivation; New York City; Outcome; Paper; Participant; Patients; Phase; Population; Preparation; Prevention; Prevention education; Primary Health Care; Privacy; Privatization; Prophylactic treatment; Provider; Public Health; Race; Randomized; Randomized Controlled Trials; Research; Research Assistant; Risk; Screening procedure; Sex Orientation; Small Business Technology Transfer Research; Stigmatization; Tablet Computer; Tablets; Technology; Testing; Text; Text Messaging; Time; TimeLine; United States National Institutes of Health; Universities; Woman; Work; Youth; aged; base; care providers; cost; design; digital; effectiveness trial; emerging adult; experience; follow-up; health empowerment; improved; intervention participants; maltreatment; men; programs; randomized trial; recruit; response; school health; screening; secondary outcome; sexual minority; sexually active adolescent; skills; social cognitive theory; social stigma; software development; statistics; success; therapy development; tool; treatment as usual; treatment group

ABSTRACT Adolescents face increased HIV risk, infrequent testing, inconsistent linkage to care, and a lack of prevention related knowledge. We propose to address this by completing and evaluating the Mobile Augmented Screening (MAS) tool to increase youth HIV testing via a tablet-based intervention in clinical settings, and then use text messages to facilitate linkage to care for those who test positive, and deliver ongoing prevention education via text message to those who test negative. Many adolescents and young adults at greatest risk for HIV are unlikely to have access to primary care, and therefore have limited access to HIV testing and prevention education. When young people are offered testing, many decline because they believe (perhaps incorrectly) they are not at risk or because they fear being stigmatized. Our proposed MAS will enable care providers to privately and discretely offer routine HIV testing and counseling, including prevention education, to high need, diverse adolescent and young adult populations at a low cost. Further, because federal law requires public and private insurers to cover routine HIV testing, healthcare providers who use our proposed MAS to test an increased number of youth can potentially generate significant additional revenue through increased insurance reimbursements. The MAS will consist of 3 components. A tablet-based intervention including a brief video (approximately 5 minutes) designed to increase adolescent HIV testing, automated text-messages to facilitate linkage to care for those who test positive, and text-based education for those who test negative or decline testing. Our team has created multiple NIH-funded interventions to increase HIV testing among patients in high volume, urban emergency departments (EDs). Patients, including youth who initially declined testing, cited the privacy and clarity of our technology-based approach as reasons they ultimately agreed to test for HIV. During the Phase I grant period we conducted formative research with young ED patients, and then created the video portion of the MAS. Preliminary evaluations indicate the video was highly acceptable, led to significant knowledge increases, and encouraged testing. We now plan an effectiveness trial during the Phase II period. Digital Health Empowerment is a minority and woman owned SBC. Principals So-Young Oh and Ian David Aronson, Ph.D. have more than 10 years experience developing technology products together, including video- based health interventions and other digital content, for commercial, non-profit, and university clients. We seek to build upon this expertise, along with the initial success of our Phase I work, to: complete full intervention development; and evaluate the product through a randomized controlled trial with ED patients aged 13 – 24 (N=350), as well as qualitative interviews with a subset of young patients (n=40) and ED staff (n=10).

抽象的 青少年面临的艾滋病毒风险增加，不频繁的测试，与护理的联系不一致以及缺乏预防 相关知识。我们建议通过完成和评估移动增强筛选来解决这一问题 （MAS）通过在临床环境中基于平板电脑的干预来增加青年艾滋病毒测试的工具，然后使用文本 消息以促进链接以照顾那些测试阳性的人，并通过 短信给那些测试负面的人。 许多艾滋病毒风险最大的青少年和年轻人不太可能获得初级保健，并且 因此，获得艾滋病毒测试和预防教育的机会有限。当提供年轻人测试时 许多人跌倒是因为他们相信（也许是错误地）他们没有危险，或者因为他们担心 受污名化。我们提出的MAS将使护理提供者能够私下并离散地提供常规的HIV测试 以及包括预防教育在内的咨询，高需求，潜水员青少年和年轻人人群 以低成本。此外，由于联邦法律要求公共和私人确保涵盖常规的艾滋病毒测试，所以 使用我们建议的MAS测试越来越多的年轻人的医疗保健提供者可能会产生 通过增加保险报销，大量额外收入。 MAS将由3个组件组成。基于平板电脑的干预措施，包括简短的视频（大约5个 分钟）旨在增加青少年艾滋病毒测试，自动文本消息，以促进链接以照顾 那些测试阳性和基于文本的教育的人，为那些测试阴性或下降测试的人。 我们的团队已经创建了多种NIH资助的干预措施，以增加高位患者的HIV测试 卷，城市紧急部门（eds）。患者，包括最初拒绝测试的年轻人，引用了 我们基于技术的方法的隐私和清晰度是他们最终同意测试艾滋病毒的原因。期间 第一阶段授予期我们与年轻的ED患者进行了形成性研究，然后创建了视频 Mas的一部分。初步评估表明该视频是高度可接受的，导致了重要的知识 增加并鼓励测试。现在，我们计划在第二阶段期间进行有效试验。 数字健康授权是少数族裔，妇女拥有的SBC。校长So Young OH和Ian David 阿隆森博士拥有十多年的经验一起开发技术产品，包括视频 - 基于商业，非营利和大学客户的基于健康干预措施和其他数字内容。我们寻找 以这一专业知识以及我们的第一阶段工作的最初成功为基础：完整的干预 发展;并通过与13-24岁的ED患者进行随机对照试验评估产品 （n = 350），以及对年轻患者（n = 40）和ED员工（n = 10）的定性访谈。