Developing a Two-way SMS Platform to Prevent and Treat Wasting Among HIV-infected and HIV-exposed Uninfected Children

开发双向短信平台来预防和治疗艾滋病毒感染者和暴露于艾滋病毒的未感染儿童的消瘦

• 批准号: 10537094
• 负责人: Arianna Rubin Means
• 金额: $ 19.58万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-08-17 至 2024-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10537094
• 关键词: 2 year old; Address; Age; Age-Months; Behavioral; Breast Feeding; Caregivers; Caring; Cessation of life; Child; Child Care; Child Health; Childhood; Clinic; Complementary Feeding; Complex; Consumption; Cost Analysis; Developmental Delay Disorders; Diagnosis; Diet; Early identification; Education; Educational Intervention; Effectiveness; Enrollment; Exclusive Breastfeeding; Exposure to; Failure; Family; Feeds; Food; Frequencies; Grant; Guidelines; HIV; HIV Infections; HIV diagnosis; HIV-exposed uninfected infant; Health Personnel; Health system; Healthcare; Healthcare Systems; Height; Home; Hospitalization; Incidence; Individual; Infant; Infection; Intention; Intervention; Iron; Kenya; Knowledge; Life; Malnutrition; Measures; Medical; Methods; Monitor; Morbidity - disease rate; Mothers; Nutritional; Nutritional Support; Opportunistic Infections; Outcome; Pathway interactions; Phase; Population; Predisposition; Prevalence; Prevention; Process; Qualifying; Randomized; Randomized Clinical Trials; Recovery; Reporting; Risk; Services; Surveys; System; Techniques; Testing; Text Messaging; Time; Trust; Underweight; Upper arm; Weight; adverse outcome; arm; behavioral outcome; care seeking; care systems; caregiver education; clinical care; cost effective; cost effective intervention; cost effectiveness; design; dietary; effectiveness testing; empowered; feeding; follow-up; health care availability; health care service; high risk; implementation outcomes; improved; improved outcome; incremental cost-effectiveness; intervention delivery; mHealth; maternal outcome; medical complication; mortality; novel; phase III trial; prevent; programs; randomized trial; response; social stigma; standard of care; vaccine response; wasting

PROJECT SUMMARY/ABSTRACT Twenty-five percent of children with HIV-infection have childhood wasting (low weight-for-height or low mid-upper arm circumference, and HIV-exposed uninfected (HEU) children are twice as likely to be underweight as comparable HIV-unexposed children. Wasting is known to promote morbidity, HIV-progression, and mortality among these children. Improving wasting prevention and treatment for children and in early infant diagnosis and HIV-care programs could not only improve the child health outcomes of these children, but also substantially lower the global burden of childhood wasting. This proposal will develop a novel two-way short message service (SMS) platform that targets key barriers to improving nutritional care for HEU and HIV-infected children. This intervention will combine a maternally administered malnutrition monitoring system (MAMMS) with infant and young child education (IYCF) delivered by SMS. After developing the intervention using participatory design methods, we will complete a proof-of- concept quasi-experimental trial of MAMMS-IYCF in the R21. If the R21 milestones are meet, we will use the R33 to conduct a randomized trial testing the effectiveness of MAMMS-IYCF at reduced the incidence wasting, and the duration of wasting treatment. During this trial we will also assess the cost and cost-effectiveness of MAMMS-IYCF, and to better understand which barriers are being successfully addressed by intervention we will measure its effect on key attitudinal and behavioral outcomes including trust in the healthcare system, intention to seek if a child becomes wasted, and IYCF knowledge. This trial will generate the evidence necessary to integrate MAMMS-IYCF interventions into existing HIV-mHealth programs across the globe, and improve the outcomes of children in early infant diagnosis and HIV-care services while also substantially lowering the global burden of childhood wasting.

项目总结/摘要 25%的艾滋病毒感染儿童有儿童期消瘦（身高比体重低或中上部体重低 臂围，艾滋病毒暴露未感染（高浓缩铀）的儿童体重不足的可能性是 未感染艾滋病毒的儿童。众所周知，消瘦会促进发病率、艾滋病毒进展和死亡率 在这些孩子中。改善对儿童和婴儿早期诊断的消瘦预防和治疗， 艾滋病护理计划不仅可以改善这些儿童的儿童健康状况， 降低全球儿童消瘦的负担。 该提案将开发一个新的双向短信服务（SMS）平台， 改善高浓缩铀和感染艾滋病毒儿童的营养护理。这种干预将联合收割机 管理的营养不良监测系统，并提供婴幼儿教育 通过SMS。在使用参与式设计方法开发干预措施后，我们将完成一个证明- 在R21中进行的MAMMS-IYCF概念准实验性试验。如果满足R21里程碑，我们将使用 R33进行一项随机试验，测试MAMMS-IYCF在降低消瘦发生率方面的有效性， 以及消瘦治疗的持续时间。在此试验期间，我们还将评估成本和成本效益， 为了更好地了解哪些障碍正在通过干预措施得到成功解决，我们将 衡量其对关键态度和行为结果的影响，包括对医疗保健系统的信任， 如果一个孩子被浪费了，和IYCF知识。这次审判将提供必要的证据 将MAMMS-IYCF干预措施纳入地球仪现有的艾滋病毒移动健康计划， 儿童在早期婴儿诊断和艾滋病毒护理服务中的结果，同时也大大降低了全球 童年浪费的负担。