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）项目的所在地，但保持着高保留率。 事实证明，在该国和整个更广泛的区域，艾滋病毒护理的连续性沿着具有挑战性。 人口流动在南非很常见，但在描述这种流动性方面存在重要的研究空白， 它对参与艾滋病毒护理的影响。据了解，南非的产后妇女及其婴儿在 她们在分娩后退出艾滋病毒护理风险很高，而且经常是移动的。我们最近开发了一个测试版 智能手机应用程序（应用程序）的版本- CareConekta -检测用户的智能手机位置，以允许 用于流动性的前瞻性表征。通过这三年的奖励，我们提出要适应和检验 CareConekta对移动性进行必要的形成性工作，并评估干预措施-CareConekta 应用程序加上文本通知和可选的员工电话和/或WhatsApp消息-以促进参与 在流动期间的艾滋病护理。在三年的项目期间，我们提出了这些目标：1）适应 CareConekta为当地居民使用适当的智能手机技术; 2）描述移动性 在南非妇女中的围产期及其对参与艾滋病毒护理的影响;和3） 评价使用CareConekta作为干预措施的可接受性、可行性和初步疗效， 参与艾滋病护理。我们将与一家南非技术公司合作， 南非卫生部调整应用程序。我们将在观察范围内观察流动性 然后将评估干预措施对研究期间旅行的参与者的影响 期这项工作对于调整现有应用程序以使其广泛使用至关重要， 围产期的流动性及其对参与艾滋病毒护理的影响，以及试点干预措施 以提高参与度。这项研究将为更大规模的疗效试验奠定必要的基础。 在不同的地理环境中进行干预。

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.