CareConekta: Mobile health for a mobile population

摘要 南非是世界上最大的抗逆转录病毒疗法(ART)项目的发源地，但仍保持着较高的存留率 事实证明，在该国和整个更广泛的区域，艾滋病毒护理连续不断具有挑战性。 人口流动在南非很常见，但描述这种流动的重要研究空白和 它对参与艾滋病毒护理的影响。在南非，产后妇女和她们的婴儿是已知的 在分娩后退出艾滋病毒护理的风险很高，而且经常流动。我们最近开发了一个测试版 智能手机应用程序(App)的版本-CareConekta-检测用户的智能手机位置以允许 以便对机动性进行前瞻性的描述。通过这个为期三年的奖项，我们建议适应和测试 CareConekta将对移动性进行基本的形成性工作并评估干预措施-CareConekta 应用程序外加文本通知和可选的员工电话和/或WhatsApp消息-以促进参与 在流动时期的艾滋病毒护理方面。在三年的项目期内，我们提出了以下目标：1)适应 CareConekta为当地人口使用适当的智能手机技术；2)描述移动性 围产期南非妇女及其对参与艾滋病毒护理的影响；3) 评估使用CareConekta作为改善干预措施的可接受性、可行性和初步效果 参与艾滋病毒护理。我们将与一家南非科技公司合作，该公司与 南非卫生部将对这款应用进行改编。我们将在观测站内观察到机动性 然后将评估在研究期间旅行的参与者中干预的影响 句号。这项工作对于使现有应用程序广泛使用至关重要，它提供了以下关键信息 围产期的流动性及其对艾滋病毒护理参与度的影响，并试行干预措施 以提高参与度。这项研究将为更大范围的疗效试验奠定必要的基础。 不同地理环境下的干预。

ABSTRACT South Africa is home to the world's largest antiretroviral therapy (ART) program, but sustaining high retention along the HIV care continuum has proven challenging in the country and throughout the wider region. Population mobility is common in South Africa, but important research gaps exist describing this mobility and its impact on engagement in HIV care. Postpartum women and their infants in South Africa are known to be at high risk of dropping out of HIV care after delivery and are frequently mobile. We recently developed a beta version of a smartphone application (app) – CareConekta – that detects a user's smartphone location to allow for prospective characterization of mobility. Through this three-year award, we propose to adapt and test CareConekta to conduct essential formative work on mobility and evaluate an intervention – the CareConekta app plus text notifications and optional staff phone calls and/or WhatsApp messages – to facilitate engagement in HIV care during times of mobility. During the three-year project period, we propose these aims: 1) adapt CareConekta to use appropriate smartphone technology for the local population; 2) characterize mobility among South African women during the peripartum period and its impact on engagement in HIV care; and 3) evaluate the acceptability, feasibility, and initial efficacy of using CareConekta as an intervention to improve engagement in HIV care. We will work with a South African technology company with a strong connection to the South African Department of Health to adapt the app. We will observe mobility within an observational cohort and will then assess the impact of the intervention among participants who travel during the study period. This work is critical to adapting an existing app for widespread use, providing critical information about mobility during the peripartum period and the impact on engagement in HIV care, and piloting an intervention to improve engagement. This study will lay the necessary groundwork for a larger efficacy trial of the intervention within different geographic settings.