A Smartphone Game to Increase Engagement in Care among African Adolescents Living with HIV

一款提高非洲艾滋病毒青少年护理参与度的智能手机游戏

基本信息

批准号：
10311901
负责人：
S KATE WINSKELL
金额：
$ 19.48万
依托单位：
EMORY UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-02 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10311901
关键词：
Active Learning Address Adherence Adolescence Adolescent Adult Africa Africa South of the Sahara African Age Attitude Behavior Therapy Behavioral Caregivers Caring Cellular Phone Clinical Cognitive Communication Continuity of Patient Care Country Data Data Collection Development Disclosure Emotional Environment Epidemiology Evidence based practice Female Funding Future Goals HIV Health Human Resources Individual Infection Intervention Kenya Knowledge Learning Skill Life Life Expectancy Mediating Mediator of activation protein Medical Research Mental Health Modeling Morbidity - disease rate Motivation Outcome Perinatal Pharmaceutical Preparations Pilot Projects Population Randomized Controlled Trials Reproductive Health Research Research Institute Resources Risk Safety Sampling Self Care Self Efficacy Sexual Health Social Behavior Social support Structure Target Populations Technology Telephone Testing United States National Institutes of Health Universities Vertical Disease Transmission Viral Viral Load result Vulnerable Populations Youth adolescent health outcomes aged antiretroviral therapy base behavior influence care systems coping cost cost effective design digital efficacy trial experience feasibility testing global health handheld mobile device improved intervention effect mHealth male medication compliance mortality multidisciplinary mutual learning pedagogy prevent response safety testing scaffold sexual risk taking skills social social stigma theories transmission process treatment arm unintended pregnancy uptake usability virtual

项目摘要

Project Summary: The goal of the study is to contribute to efforts to improve health outcomes for adolescents living with HIV (ALHIV) in sub-Saharan Africa, a population of high demographic, clinical and epidemiological importance. We aim to advance this goal by creating and testing in Kisumu, Kenya, a smartphone game-based intervention for ALHIV aged 15-18 (MyLife). It will focus on increasing adherence to antiretroviral therapy (ART) and addressing sexual and reproductive health needs. It will be informed by socio-behavioral, communication and pedagogical theories, evidence-based practice, and unique research on young Africans’ narratives about HIV. It will be designed to increase ALHIV knowledge, motivation, skills, and resources to facilitate: (1) increased autonomy in treatment management and self-care; (2) mental health and strategies for addressing stigma; (3) social support including via dialogue with caregivers and disclosure to others; and (4) sexual risk avoidance and reduction. The increasing availability of smartphones in Africa provides unprecedented opportunities to deliver culturally relevant narrative-based behavioral interventions for ALHIV that incorporate digital resources to support adherence such as medication and refill trackers and reminders. Such interventions require little personnel to implement, have high entertainment and motivation appeal, and incorporate automated data collection to support theory-building. By allowing players to experience real agency in a virtual and safe environment, well-designed games offer a level of experiential learning unparalleled by most other interventions. The proposed project has the following aims: (1) (R21) To design, develop, and conduct usability, acceptability, and safety testing of a theory-based smartphone game for ALHIV ages 15-18 focused on increasing and sustaining engagement in HIV care and sexual risk avoidance and reduction, with iterative input from the target population; (2) (R33) Via a cluster-randomized controlled trial with a sample of 120 ALHIV ages 15-18 in Kisumu to conduct comprehensive feasibility testing and determine whether the game influences behavioral mediators of engagement in care and sexual risk avoidance and reduction (including knowledge, attitudes, behavioral intentions, and self-efficacy); and (3) (R21/R33) To strengthen the capacity of the established multidisciplinary team to conduct mHealth, specifically serious games for health, research in sSA. Our Secondary Aims are: (1) To provide preliminary data on the game’s impact on viral load, engagement in care, and sexual risk avoidance and reduction. (2) Through analysis of outcome data and game paradata, to identify the game components and theoretical constructs that mediated intervention effects. The proposed intervention holds promise to be highly scalable, cost-effective, and culturally adaptable to other settings. By advancing the evidence and theory base, addressing challenges to uptake through motivating pedagogy, assessing safety for a vulnerable population, attending to potential future dissemination, and building capacity for mHealth research in sub-Saharan Africa, the study shows promise to advance global mHealth.

项目摘要：研究的目的是为改善青少年的健康成果做出贡献在撒哈拉以南非洲的艾滋病毒（ALHIV）生活，人口高度，临床和流行病学重要性。我们的目标是通过在基于智能手机游戏的Kisumu创建和测试来促进这一目标 15-18岁的ALHIV干预（MyLife）。它将着重于增加对抗逆转录病毒疗法（ART）的依从性并满足性和生殖健康需求。它将通过社会行为的沟通来告知以及教学理论，基于证据的实践以及关于年轻非洲人关于艾滋病毒叙事的独特研究。它将旨在增加ALHIV知识，动力，技能和资源以促进：（1）增加治疗管理和自我保健的自主权；（2）解决污名的心理健康和策略；（3）社会支持，包括通过与看护人对话和向他人披露；（4）避免性风险和减少。非洲智能手机的可用性越来越多，提供了前所未有的机会基于文化相关的基于叙事的行为干预措施，将数字资源纳入支持依从性，例如药物，补充跟踪器和提醒。这样的干预措施几乎不需要实施人员，具有高娱乐和动机外观以及合并自动数据收集以支持理论建设。通过允许玩家在虚拟安全中体验真正的代理精心设计的游戏环境，提供了大多数其他干预措施无与伦比的专家学习水平。拟议的项目具有以下目的：（1）（R21）设计，开发和执行可用性，可接受性，以及针对15-18岁的ALHIV的基于理论的智能手机游戏的安全测试，重点是增加并维持参与艾滋病毒护理和避免性风险和减少性的参与，并从中迭代投入目标人群；（2）（r33）通过群集随机对照试验，样本为120个ALHIV年龄15-18 Kisumu进行全面的可行性测试并确定游戏是否影响行为参与护理和避免性风险和减少性风险的调解人（包括知识，参加者，行为意图和自我效能）；（3）（R21/R33）增强已建立的能力多学科团队在SSA中进行研究，特别是严重的健康游戏，特别是严重的健康游戏。我们的次要目的是：（1）提供有关游戏对病毒负荷，护理参与和性行为的影响的初步数据冒险避免和减少。（2）通过分析结果数据和游戏paradata，以识别游戏介导干预效果的组件和理论构造。拟议的干预措施具有高度可扩展性，具有成本效益和文化适应的承诺其他设置。通过推进证据和理论基础，通过激励来应对吸收挑战教学法，评估脆弱人群的安全，参与潜在的未来传播以及建设该研究在撒哈拉以南非洲的MHealth研究能力表明，有望促进全球MHealth。