Text Messaging Adherence Assessment & Intervention Tool for Rural HIV+ Drug Users

短信依从性评估

• 批准号: 8241014
• 负责人: KAREN S INGERSOLL
• 金额: $ 34.65万
• 依托单位: UNIVERSITY OF VIRGINIA
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8241014
• 关键词: AIDS/HIV problem; Address; Adherence; Adoption; African American; Area; Behavior Therapy; Car Phone; Caring; Chronic Disease; Clinic; Clinical Trials; Communities; Consent; Development; Devices; Dropout; Drug usage; Drug user; Ethnic group; Evaluation; Event; Focus Groups; Fostering; HIV; HIV Infections; HIV Seropositivity; Health; Intervention; Interview; Learning; Life; Methods; Modeling; Morbidity - disease rate; NIH Program Announcements; Outcome; Participant; Patients; Pattern; Penetration; Persons; Pharmaceutical Preparations; Pharmacy facility; Population; Poverty; Public Health; Randomized; Reporting; Research; Research Personnel; Rural; Staging; Stigmata; Structure; System; Technology; Telephone; Testing; Text; Time; Transportation; Treatment Failure; Viral Load result; Visit; Woman; base; cost effectiveness; drug craving; ethnic minority population; follow-up; health disparity; high risk; improved; medication compliance; metropolitan; novel; pill; pilot trial; programs; public health relevance; randomized trial; residence; response; scale up; social stigma; therapy development; tool; treatment adherence; treatment as usual; treatment center; trend; usability

DESCRIPTION (provided by applicant): This is a new application under PAS-10-098, Technology-based Adherence Interventions for Substance Abusing Populations with HIV (R34). New methods to promote HIV treatment adherence are needed for drug users, ethnic minorities, and women, who reside outside major metropolitan areas who have worse health outcomes. Familiar technological devices such as mobile phones could overcome some of the health disparities seen among rural HIV+ patients. In this project, investigators will develop and test the feasibility and promise of a text messaging system that uses Ecological Momentary Assessment (EMA) methods to detect nonadherence and drug use episodes, then immediately intervenes to improve HIV treatment adherence (both medication adherence and treatment engagement) in drug users living with HIV/AIDS. Using formative research with the targeted patients and partnership with a technology developer, we will develop the application and administrative system, Treatment Extension by Text (Text). Text will assess routine adherence, allow users to report critical events, and respond to randomly timed queries about adherence, drug use, and drug craving. When the Text EMA application detects threats to adherence, it will deliver a personalized, tailored intervention text message chosen by the participant. These customized messages will remind the user to take medications on time and reduce drug use. Investigators will pilot test the new adherence tool against treatment as usual over a three month period in a small pilot randomized trial to determine the feasibility, acceptability, and promise of Text. This R34 is a Stage 1b/2a project in the Stage Model of Behavioral Therapy Development in that it will develop novel interventions and methods, and generate preliminary estimates of effect sizes that will determine whether a larger, more expensive clinical trial with a longer follow-up period and evaluation of cost-effectiveness is warranted. By using technology to assess and detect episodes of nonadherence, drug use, and drug craving in real time, the project will deliver an intervention "on the fly" in time to help the person resume medication adherence before health damages occur. If successful, Text has the possibility of rapid scale-up for further trials across the rural U.S. to follow. PUBLIC HEALTH RELEVANCE: This project will develop and pilot test a text messaging system for mobile phones to assess HIV treatment adherence, quickly detect problems as they occur, and send personalized intervention messages to help rural and non-urban drug using patients achieve HIV medication adherence and interrupt drug use. This intervention could be scaled up quickly as a novel, sustainable approach to maintaining treatment adherence. Lessons learned could hasten the development of interventions for other chronic diseases in the U.S.

描述（由申请人提供）：这是 PAS-10-098 下的新申请，针对 HIV 药物滥用人群的基于技术的依从性干预措施 (R34)。对于居住在主要大都市地区以外、健康状况较差的吸毒者、少数民族和妇女来说，需要采取新的方法来促进艾滋病毒治疗的依从性。移动电话等熟悉的技术设备可以克服农村艾滋病病毒感染者之间的一些健康差异。在该项目中，研究人员将开发并测试短信系统的可行性和前景，该系统使用生态瞬时评估（EMA）方法来检测不依从性和吸毒事件，然后立即进行干预，以提高感染艾滋病毒/艾滋病的吸毒者的艾滋病毒治疗依从性（药物依从性和治疗参与度）。通过对目标患者的形成性研究以及与技术开发商的合作，我们将开发应用程序和管理系统“文本治疗扩展”（Text）。文本将评估日常依从性，允许用户报告关键事件，并回答有关依从性、药物使用和药物渴望的随机定时查询。当文本 EMA 应用程序检测到对遵守的威胁时，它将提供参与者选择的个性化、量身定制的干预文本消息。这些定制的信息将提醒用户按时服药，减少药物使用。研究人员将在为期三个月的小型试点随机试验中对新的依从性工具与往常治疗进行试点测试，以确定 Text 的可行性、可接受性和承诺。该 R34 是行为治疗发展阶段模型中的 1b/2a 阶段项目，它将开发新的干预措施和方法，并生成效应大小的初步估计，从而确定是否需要进行更大规模、更昂贵、更长随访期的临床试验以及成本效益评估。通过使用技术实时评估和检测不依从性、药物使用和药物渴望的发作，该项目将及时“即时”提供干预措施，以帮助患者在健康损害发生之前恢复药物依从性。如果成功，Text 有可能迅速扩大规模，在美国农村地区进行进一步的试验。 公共健康相关性：该项目将开发并试点测试手机短信系统，以评估艾滋病毒治疗依从性，快速发现出现的问题，并发送个性化干预信息，帮助农村和非城市吸毒患者实现艾滋病毒药物依从性并中断药物使用。这种干预措施可以作为一种保持治疗依从性的新颖、可持续的方法迅速扩大规模。吸取的经验教训可能会加速美国其他慢性病干预措施的发展。

项目成果

Pilot RCT of bidirectional text messaging for ART adherence among nonurban substance users with HIV.

• DOI: 10.1037/hea0000295
• 发表时间: 2015-12
• 期刊: Health psychology : official journal of the Division of Health Psychology, American Psychological Association
• 作者: Ingersoll KS;Dillingham RA;Hettema JE;Conaway M;Freeman J;Reynolds G;Hosseinbor S
• 通讯作者: Hosseinbor S