mHealth Messaging to Motivate Quitline use and Quitting among Persons Living With HIV in Vietnam (M2Q2-HIV)

7.项目摘要/摘要 我们建议M2Q2-HIV[mHealth Message]在患有艾滋病的患者中激励Quitline的使用和戒烟 HIV(PLWH)在越南(M2Q2-HIV)]，适应我们目前的计算机定制戒烟 对越南的干预。我们寻求促进未充分利用的政府资源用于公共卫生(Quiline)和 以可持续的方式在PLWH中进行尼古丁替代疗法(NRT)。吸烟和吸烟的交集 艾滋病毒/艾滋病对越南的公共卫生构成严重威胁。越南正在应对这两个挑战 并行计划，而不是综合计划。越南目前有431家艾滋病毒检测门诊，有188家诊所 提供公共保险覆盖的抗逆转录病毒(ARV)治疗。越南开通了电话“Quiline” 咨询训练有素的烟草治疗专家，他们也提供NRT。这些临床(艾滋病毒)和公众 卫生资源(免费电话)没有连接，从而减少了这两个项目的影响。为了连接这些资源，我们 将使我们目前针对越南计算机定制的、基于文本的戒烟干预措施具体化 例如，通过制定激励和量身定制的方法来解决艾滋病毒污名问题，从而减少吸烟行为 PLWH吸烟者写的信息。为了进一步提高PLWH吸烟者的信息相关性，我们将增加一个 计算机定制创新：一种机器学习的集体智能系统。像亚马逊这样的公司使用 可持续学习和适应用户反馈(例如，喜欢的页面或产品)的集体智能系统 购买)，从而提高了消息的相关性。我们开发了第一个集体智能系统，用于 吸烟者。我们的试点数据表明，持续学习的能力可能对吸烟者更有好处 那些不太愿意辞职的人，比如PLWH。我们将通过进行随机对照试验来检测M2Q2-HIV 在越南北部的两个省，有600名PLWH吸烟者(26家诊所；9877名艾滋病毒患者)。在目标1中，我们将 为长寿吸烟者准备M2Q2-HIV系统的形成工作。在目标2中，我们将随机和 对吸烟者进行六个月的跟踪调查。我们的有效性假设将评估经证实的一氧化碳(CO)，6- 一个月、七天的时点患病率停止。过程假设将评估自我效能感、Quiline和NRT 使用并测试我们的假设模型，即特定的测量过程将部分中介观察到的过程 干预效果。通过对关键利益相关者和PLWH吸烟者的定性采访，Aim 3将 支持全国M2Q2-HIV传播评估可接受性和背景因素 实用、稳健的实施和可持续发展模式(PRISM)。这个项目建立在一个长期的、 越南各机构之间的成功合作(卫生部、Bach Mai Quitline、研究所 人口健康与发展(河内医科大学)和UMMS。我们的团队在吸烟方面很有经验 戒烟、艾滋病毒干预，包括与使用伴随物质有关的耻辱，以及实施 复杂的干预措施。越南卫生部致力于将M2Q2-HIV纳入永久 国家基础设施的一部分，如果被证明有效的话。

7. PROJECT SUMMARY/ABSTRACT We propose M2Q2-HIV [mHealth Messaging to Motivate Quitline use and Quitting among Persons Living with HIV (PLWH) in Vietnam (M2Q2-HIV)], an adaptation of our current computer-tailored smoking cessation intervention in Vietnam. We seek to promote underused government resources for public health (quitline) and nicotine replacement therapy (NRT) among PLWH in a sustainable manner. The intersection of smoking and HIV/AIDS poses a serious public health threat in Vietnam. Vietnam is dealing with these two challenges with parallel rather than integrated plans. Vietnam currently has 431 outpatient clinics for HIV testing, with 188 clinics providing antiretroviral (ARV) treatment, covered by public insurance. Vietnam has setup telephone “quitline” counseling with trained tobacco treatment specialists who also provide NRT. These clinical (HIV) and public health resources (quitlines) are not connected, reducing both programs’ impact. To connect these resources, we will adapt our current intervention for computer-tailored, text-based smoking cessation in Vietnam to be specific to PLWH smoking behavior, for example, by addressing HIV stigma via developing motivational and tailored messages written by PLWH smokers. To further increase message relevance for PLWH smokers, we will add a computer-tailoring innovation: a machine-learning, collective intelligence system. Companies like Amazon use collective intelligence systems to continuously learn and adapt to user feedback (e.g., pages liked, or products purchased), thus, increasing message relevance. We developed the first collective intelligence system for smokers. Our pilot data indicates that the ability to continuously learn may be even more beneficial for smokers who are less ready to quit, such as like PLWH. We will test M2Q2-HIV by conducting a randomized control trial with 600 PLWH smokers in two provinces in Northern Vietnam (26 clinics; 9,877 HIV patients). In Aim 1, we will conduct formative work to prepare the M2Q2-HIV system for PLWH smokers. In Aim 2, we will randomize and follow smokers for six months. Our effectiveness hypothesis will evaluate carbon monoxide (CO) verified, six- month, seven-day point prevalence cessation. Process hypotheses will evaluate self-efficacy, quitline and NRT use, and test our hypothesized model that specific measured processes will partially mediate observed intervention effectiveness. Using qualitative interviews with key stakeholders and PLWH smokers, Aim 3 will support nationwide M2Q2-HIV dissemination assessing acceptability and contextual factors guided by the Practical, Robust Implementation and Sustainability Model (PRISM). This project builds upon a long-standing, successful collaboration between institutions in Vietnam (Ministry of Health, Bach Mai Quitline, Institute of Population Health and Development, Hanoi Medical University) and UMMS. Our team has expertise in smoking cessation, HIV intervention including stigma related to concomitant substance use, and implementation of complex interventions. The Vietnam Ministry of Health is committed to incorporating M2Q2-HIV as a permanent part of the national infrastructure if proven effective.