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Behavioral Aspects of Low-cost Medical Devices to Improve HIV Care

低成本医疗设备的行为方面改善艾滋病毒护理

基本信息

批准号：
9297371
负责人：
MARK J SIEDNER
金额：
$ 18.34万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-07-12 至 2018-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9297371
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Africa South of the Sahara Anti-Retroviral Agents Anxiety Attention Behavioral Behavioral Sciences Biosensor Caring Cellular Phone Clinic Clinical Research Clinical Trials Collaborations Communication Data Detection Devices Disease Outcome Elements Emerging Technologies Engineering Enrollment Evaluation Factor Analysis Failure Feedback Foundations Funding Future General Hospitals Goals HIV Health Health Technology Healthcare Human Intervention Interview Investments Massachusetts Measures Medical Device Medical Technology Mentors Methods Modeling Monitor Outcome Participant Patient Monitoring Patients Pilot Projects Positioning Attribute Public Health Qualitative Methods Qualitative Research Questionnaires Research Research Design Research Methodology Resources Risk Structure Surveys Target Populations Technology Testing Time Training Uganda United States United States National Institutes of Health Wireless Technology Work advanced disease base career cost design efficacy testing experience health care delivery health care disparity high risk improved innovation mHealth mortality new technology novel patient oriented primary outcome public health relevance skills social social stigma success theories

项目摘要

DESCRIPTION (provided by applicant): HIV-related mortality in sub-Saharan Africa remains high, partly due to challenges with monitoring and intervening on patients presenting with advanced disease. Mobile health technologies, including biosensors and cellular phone platforms, among others, hold great promise to improve monitoring, communication and targeting of interventions to at-risk people living with HIV/AIDS (PLWHA). Yet, the majority of these technologies are not implemented due to inadequate attention to behavioral aspects of the human- technology interface. The Consortium for Affordable Medical Technologies (CAMTech), based at the Massachusetts General Hospital, is developing a robust portfolio of technologies for improving healthcare in resource limited settings (RLS). I will derive and validate a behavioral science framework of technology acceptance for novel, patient-centered technologies in RLS by evaluating 1 device in the CAMTech portfolio, a wireless biosensor for remote detection of abnormal vital signs. My overarching goal is to become a leader in the study of acceptance and implementation of low-cost medical technologies to improve healthcare delivery in RLS, using a foundation in behavioral theory to evaluate and address barriers to technology acceptance. To achieve independence, I require further training in: 1) qualitative research methods to derive a technology acceptance theoretical framework for patient-centered interventions in RLS; 2) behavioral theory and analysis methods focused on developing and testing technology acceptance frameworks in RLS; and 3) aspects of technology evaluation, including clinical research methods and technical elements of devices, to evaluate technology acceptance and communicate results with engineers. My mentoring team includes Dr. David Bangsberg, an expert in behavioral aspects of HIV treatment who leads CAMTech, and experts in qualitative methods (Ware), behavioral theory and technology acceptance (Safren, Venkatesh), technology design and implementation (Fletcher, Remien), and clinical study design and analysis in RLS (Lockman, Mulogo, Petersen). With their guidance, I will test my central hypothesis that behavioral theory can optimize the evaluation of novel technologies in RLS, through the following specific aims: 1) develop a technology acceptance model relevant to PLWHA in RLS using qualitative research methods; 2) derive and test scales to measure constructs in the emergent model from Aim 1; and 3) using the framework derived in Aims 1 and 2, perform a pilot study of acceptability and feasibility of the biosensor to identify abnormal vitl signs in at-risk PLWHA. The research plan is innovative because it will derive and test a framework applicable to the multitude of promising low-cost technologies to improve healthcare delivery in RLS. Further, it will position me to apply for an NIH R01 to test the efficacy of this and other devices. I am well positioned to accomplish these aims based upon my success conducting research in Uganda, strong mentoring team, and institutional support both in the United States and Uganda.

描述（由申请人提供）：撒哈拉以南非洲的艾滋病毒相关死亡率仍然很高，部分原因是监测和干预晚期疾病患者的挑战。移动的保健技术，包括生物传感器和移动电话平台等，在改善对艾滋病毒/艾滋病高危感染者的监测、沟通和干预措施的针对性方面具有很大的前景。然而，由于对人-技术界面的行为方面的关注不足，这些技术中的大多数没有实现。位于马萨诸塞州总医院的负担得起的医疗技术联盟（CAMTech）正在开发一套强大的技术组合，以改善资源有限环境（RLS）中的医疗保健。我将通过评估CAMTech产品组合中的1个设备（用于远程检测异常生命体征的无线生物传感器），推导并验证RLS中以患者为中心的新型技术接受的行为科学框架。我的首要目标是成为接受和实施低成本医疗技术的研究的领导者，以改善RLS的医疗保健服务，使用行为理论的基础来评估和解决技术接受的障碍。为了实现独立性，我需要进一步培训：1）定性研究方法，以获得以患者为中心的RLS干预技术接受理论框架; 2）行为理论和分析方法，专注于开发和测试RLS技术接受框架; 3）技术评价方面，包括临床研究方法和器械技术要素，评估技术验收并与工程师沟通结果。我的指导团队包括大卫邦斯伯格博士，他是艾滋病治疗行为方面的专家，领导CAMTech，以及定性方法（Ware），行为理论和技术接受（Safren，Venkatesh），技术设计和实施（弗莱彻，Remien）以及RLS临床研究设计和分析（Lockman，Mulogo，Petersen）的专家。在他们的指导下，我将通过以下具体目标来验证我的中心假设，即行为理论可以优化RLS中新技术的评估：1）使用定性研究方法开发与RLS中PLWHA相关的技术接受模型; 2）从目标1中推导并测试测量涌现模型中结构的量表;以及3）使用在目标1和2中导出的框架，进行生物传感器识别处于风险中的PLWHA中的异常vitl体征的可接受性和可行性的初步研究。该研究计划是创新的，因为它将推导和测试适用于众多有前途的低成本技术的框架，以改善RLS的医疗保健服务。此外，它将使我能够申请NIH R 01来测试这种和其他设备的功效。基于我在乌干达的成功研究，强大的指导团队以及美国和乌干达的机构支持，我完全有能力实现这些目标。