Assessing the use of MY-RIDE, a just-in-time adaptive intervention, to Improve HIV prevention and Substance Use in Youth Experiencing Homelessness

评估 MY-RIDE（一种及时适应性干预措施）的使用情况，以改善无家可归青少年的艾滋病毒预防和药物使用

• 批准号: 10836097
• 负责人: Diane M. Santa Maria
• 金额: $ 72.9万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10836097
• 关键词: AIDS prevention; Accounting; Address; Attention; Behavioral; Caring; Communities; Counseling; County; Data; Detection; Discrimination; Drug usage; Ecological momentary assessment; Eligibility Determination; Epidemic; Face; Feedback; Geography; Goals; HIV; HIV disparities; HIV risk; Health; Health Care Costs; Health Insurance; Health Services Accessibility; Health Status; Health Technology; Healthcare; Heterosexuals; Homelessness; Housing; Hybrids; Infection; Intervention; Investments; Lead; Life Experience; Mental Health; Mental Health Services; Modeling; Motivation; Nurses; Personal Satisfaction; Pharmaceutical Preparations; Population; Prevalence; Prevention; Prevention strategy; Prophylactic treatment; Randomized; Reporting; Risk; Risk Factors; Services; Sexual Partners; Shelter facility; Stress; Technology; Testing; Time; Transcend; Transportation; Unsafe Sex; Wait Time; Youth; adaptive intervention; aged; attentional control; children of color; condoms; cost; design; digital health; digital intervention; emotion dysregulation; experience; health care service utilization; health equity; high risk; housing instability; implementation trial; improved; individualized prevention; innovation; mHealth; marginalization; meetings; men; mental disorder diagnosis; mobile computing; motivational enhancement therapy; pre-exposure prophylaxis; prevent; prevention service; preventive intervention; randomized trial; screening; service delivery; sex; shared decision making; skills; social determinants; social health determinants; social stigma; substance use; time use; transgender; uptake; willingness; young adult; young men who have sex with men; young woman

On any given night in the U.S., one in 10 youth aged 18-25 experience homelessness. The highest HIV risk groups disproportionately experience homelessness. Yet, YEH lack access to HIV prevention including highly effective pre- and post-exposure prophylaxis medications (i.e., PrEP, nPEP). Substance use and stress negatively impact HIV risk. Stress contributes to condomless sex, more sexual partners, and substance use with rates being twice that of housed youth. MY-RIDE, is a mobile health intervention that responds to Ecological Momentary Assessments to deliver personalized messaging and behavioral feedback. Pilot data found that MY-RIDE decreased drug use, sexual urges, and stress among YEH. This study will fully test MY- RIDE by conducting a randomized attention-controlled trial. MY-RIDE addresses HIV risk and its antecedents in real-time using messages developed using the Information-Motivation-Behavioral Skills model. Using Motivational Interviewing and Shared Decision Making approaches, nurse-led and on-demand sessions help YEH engage in HIV prevention despite their unstable housing circumstances. YEH receive personalized mobile messages that address their current HIV risk factors as well as substance use, mental health, and housing. Aim 1: Determine whether MY-RIDE decreases substance use compared to attention control youth (N=320; aged 18-25 years) at 3, 6, and 12 months. Aim 2: Determine whether MY-RIDE increases HIV prevention strategies (condom use, PrEP uptake, reduced STIs) when compared to attention control youth. Exploratory Aim 1: Evaluate MY-RIDE effects on willingness to take PrEP, stress, substance use urge, and use of mental health and substance use services when compared to attention control youth. This innovative study combines nurse-led counseling with JITAI technology to deliver personalized prevention supports at the time of heightened need. My-RIDE is a highly scalable intervention that increases reach to a disconnected population and facilitates delivery of an HIV prevention intervention that transcends barriers to access to care.

在美国的任何夜晚，十分之一的年轻人18-25岁的年轻人无家可归。最高的艾滋病毒风险 小组不成比例地经历无家可归者。但是，Yeh无法获得预防艾滋病毒的机会 有效的暴露前后预防药物（即PREP，NPEP）。物质使用和压力 负面影响艾滋病毒的风险。压力会导致无避孕套的性别，更多的性伴侣和使用物质 费率是住院青年的两倍。我的骑行是一种移动健康干预措施 生态瞬间评估，以提供个性化的消息传递和行为反馈。试点数据 发现我的骑车减少了毒品使用，性冲动和Yeh的压力。这项研究将完全测试我 通过进行随机注意力控制试验来骑行。我的骑车解决了艾滋病毒的风险及其前因 使用信息动机行为技能模型开发的消息实时实时。使用 动机访谈和共享决策方法，由护士主导和按需会议帮助 尽管住房状况不稳定，但Yeh进行了预防艾滋病毒。 Yeh获得个性化 解决其当前艾滋病毒危险因素以及药物使用，心理健康和 住房。目标1：确定与注意力控制青年相比，我的骑行是否减少了药物的使用 （n = 320；年龄18-25岁）在3、6和12个月。目标2：确定我的骑行是否增加了艾滋病毒 与注意力控制青年相比，预防策略（使用避孕套，预先吸收，减少性传播感染）。 探索目的1：评估我对愿意进行准备，压力，药物使用冲动和 与注意力控制青年相比，使用心理健康和药物使用服务。这种创新 研究结合了护士领导的咨询与Jitai技术，以提供个性化的预防支持 需要的时间。我的骑行是一种高度可扩展的干预措施，可以增加到连接 人口和促进艾滋病毒预防干预措施的交付，超越了获得护理的障碍。