mLab App for Improving Uptake of rapid HIV self-testing and Linking Youth to Care

mLab 应用程序可提高艾滋病毒快速自我检测的采用率并将青少年与护理联系起来

• 批准号: 9927670
• 负责人: Robert Garofalo
• 金额: $ 81.64万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-03 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9927670
• 关键词: AIDS prevention; AIDS/HIV diagnosis; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Africa; Age; Algorithms; Awareness; Back; Biological Assay; Car Phone; Caring; Cellular Phone; Cessation of life; Continuity of Patient Care; Data; Data Collection; Death Rate; Detection; Development; Devices; Diagnosis; Diagnostic; Discrimination; Engineering; Enrollment; Epidemic; Evaluation; Feedback; Future; Gender; Goals; HIV; HIV Seropositivity; Health; Health Technology; Healthcare Systems; Home environment; Homophobia; Human immunodeficiency virus test; Image; Individual; Infection; Intervention; Lateral; Latino; Link; Malaria; Methods; Modeling; Monitor; New York City; Notification; Outcome; Perception; Persons; Preventive Intervention; Preventive care; Process; Public Health; Randomized; Reporting; Research; Risk; Scientist; Secure; Sensitivity and Specificity; Sex Orientation; Signal Transduction; Site; Socioeconomic Factors; Stigmatization; Technology; Test Result; Testing; Time; Treatment outcome; United States; Ursidae Family; Visual; Work; Youth; age group; arm; base; care outcomes; computer human interaction; cost; design; digital; disenfranchised population; ethnic minority population; follow-up; group intervention; health information technology; high risk; image processing; improved; improved outcome; innovation; iterative design; mHealth; member; mobile computing; multi-site trial; multidisciplinary; next generation; novel diagnostics; prevention service; racial minority; racism; response; sexual minority; smartphone Application; social; social factors; social stigma; standard of care; study population; testing services; tool; transgender women; transmission process; uptake; usability; user centered design; wireless fidelity; young man; young men who have sex with men

The number of youth living with HIV continues to rise, and they are disproportionately represented at each stage of the care continuum. Most relevant to this application, it is estimated that less than half of HIV-infected youth in the United States (US) have been diagnosed with HIV, and AIDS-related deaths among youth have increased over the past decade despite decreased death rates among all other age groups, pointing to the urgent need for increased testing among youth. Black and Latino youth are at increased risk of poor HIV-related outcomes and have disparate testing rates as compared to White youth. Mobile Health (mHealth) technology is a powerful and relevant tool which represents a promising approach for improving outcomes among youth living with HIV. Youth are avid adopters and heavy users of smartphones and digital technologies, and these technologies offer opportunities to tailor interventions to developmental stages and personal needs. Importantly, these technologies are capable of delivering interventions in real-time and in ecologic settings. This creates an opportunity to remotely reach youth through mobile and connected health approaches to strengthen their HIV care continuum engagement and treatment outcomes. In response, our study team has developed the mLab App, an innovative mobile and connected technology that combines HIV prevention information with push notifications/reminders to complete HIV testing and an automated image processing feature to provide accessible, objective, secure, and real-time feedback on home-based OraQuick (lateral flow assay) HIV test results. The mLab App also contains an innovative automated data collection and a results reporting feature. Findings from our preliminary work in New York City indicate that youth perceive the mLab App as useful, easy to use, and effective at improving health outcomes and intend to use the technology. Findings from our preliminary work in Africa support the sensitivity and specificity of the imaging algorithm for interpreting lateral flow assay results. Theoretically-guided by the Health Information Technology Usability Evaluation Model (Health-ITUEM), the proposed project will refine and test a next- generation diagnostic intervention delivered on a mobile platform to improve HIV testing and linkage-to-care outcomes among youth living with and at-risk for HIV. Well in line with the objectives of RFA-MH-18-606, we will conduct a careful, iterative process of technology refinement based on input from end users, experts, and our youth advisory board. We will then enroll 500 high-risk youth (age 17-29 years) in a 12-month RCT to assess differences in HIV testing rates and linkage to care between the intervention (mLab App) and control arm. Finally, we will analyze paradata, defined as auxiliary data that capture details about the process of interaction with the technology, to understand the effect of user engagement of the mLab App on improving HIV testing rates and linkage to care. Interventions delivered through mHealth technology represent a promising approach for improving outcomes among youth. Given the pervasiveness, low cost, and convenience of mobile technology, the mLab App holds promise to help achieve the goals of the National HIV/AIDS Strategy in the US by increasing the number of persons living with HIV who know their serostatus, decreasing HIV-related disparities, and ultimately reducing the risk of HIV transmission and acquisition.

感染艾滋病毒的青年人数继续上升，他们在人生的每个阶段所占比例都不成比例