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Mobile WACh Empower: Mobile solutions to empower reproductive life planning for women living with HIV

Mobile WACh Empower：为感染艾滋病毒的女性提供生殖生活规划的移动解决方案

基本信息

批准号：
10636940
负责人：
Alison L Drake
金额：
$ 67.2万
依托单位：
UNIVERSITY OF WASHINGTON
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：
2021-06-01 至 2026-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10636940
关键词：
Address Africa South of the Sahara Behavior Behavioral Caring Climate Clinic Communication Complex Conceptions Consolidated Framework for Implementation Research Contraceptive Agents Contraceptive Usage Contraceptive methods Counseling Data Decision Making Drug Interactions Effectiveness of Interventions Enrollment Ensure Environment Evaluation Face Family Planning Fertility Focus Groups Goals HIV Health Health Personnel Health Technology Health system Healthcare Systems Intervention Justice Kenya Life Maternal and Child Health Maternal-Child Health Services Measures Methods Modeling Mother-to-child HIV transmission Motion Motivation Outcome Pharmaceutical Preparations Planned Pregnancy Population Pregnancy Prevention Provider Randomized, Controlled Trials Readiness Reproductive Health Reproductive Health Services Resource-limited setting Resources Rights Risk STI prevention Self Efficacy Services Site Surveys Testing Time Training Treatment Protocols Viral Woman acceptability and feasibility antiretroviral therapy arm care providers cost cost effective cost effectiveness cost estimate design economic evaluation economic impact empowerment experience future implementation health care service health economics health goals healthy pregnancy implementation barriers implementation science improved internalized stigma intervention cost mHealth mathematical model meeting abstracts meetings microcosting novel patient level intervention postpartum contraception pregnancy prevention prevent programs reproductive secondary outcome service delivery side effect skills standard of care texting support theories tool treatment arm two way texting unintended pregnancy

项目摘要

PROJECT SUMMARY/ ABSTRACT Meeting reproductive health needs of women living with HIV (WLWH) is essential to help women prevent unintended pregnancies, safely conceive, and eliminate mother-to-child HIV transmission (MTCT). Reproductive life planning is complex for WLWH, who are faced with making decisions about antiretroviral treatment selections and potential for drug interactions with contraceptive methods, planning for safe conception, and STI prevention. While family planning (FP) use is high among WLWH, discontinuation of FP is common among women who desire pregnancy prevention, and is an important driver of unmet need for FP and subsequent risk of unintended pregnancy and adverse maternal and child health outcomes. Many programs in sub-Saharan Africa integrate FP service delivery into routine HIV care, but HIV care providers face challenges with implementing these models of care. HIV care providers may be ill equipped to ensure WLWH receive high-quality, rights’ based reproductive health counseling and services due to lack time, training, resources, and skills. Prior studies on integrating FP services into HIV care consistently cite implementation challenges. Mobile health technology may provide a low cost solution to augment counseling services, strengthen health care systems, and alleviate demands on HIV providers. We hypothesize that providing comprehensive counseling and two-way SMS communication, will 1) improve delivery of integrated HIV and reproductive health care services, 2) reduce contraceptive discontinuation rates, 3) be acceptable and feasible to implement, and 4) be cost-effective and contribute to prevention MTCT efforts. We will adapt a unique two-way SMS platform (Mobile WACh) that combines automated bulk SMS messaging and dialogue with a health care provider for a new population, new environment, and new outcomes for long-term impact. The Mobile WACh platform will be customized to provide continuous reproductive life planning counseling for WLWH. We will test the combined intervention in a cluster randomized controlled trial among women receiving HIV care at 10 facilities in Kenya (330 per facility). We propose to evaluate the effect of the counseling and SMS communication intervention, Mobile WACh Empower, on reproductive health outcomes. In Aim 1, we will determine the effect of the Mobile WACh Empower intervention on FP discontinuation, dual method use, and unmet need for FP over 2 years. In Aim 2, we will evaluate acceptability, feasibility, and scalability of implementing Mobile WACh Empower under real- world settings, from both WLWH and provider perspectives in focus group discussions. In Aim 3, we will construct a mathematical model to measure health and economic impacts of Mobile WACh Empower, including cost- effectiveness of the intervention per pregnancy and MTCT averted. This trial will evaluate a novel intervention to address a crucial gap in provision of integrated reproductive health and HIV care, and has the potential to make a significant contribution to global goals of universal access to FP and elimination of MTCT.

项目摘要/摘要