An Accessible Digital Intervention to Promote HIV Testing/Counseling and Prevention Among Adolescents

促进青少年艾滋病毒检测/咨询和预防的便捷数字干预措施

• 批准号: 9537625
• 负责人: Lynn Elizabeth Fiellin
• 金额: $ 39.17万
• 依托单位: SCHELL GAMES, LLC
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2020-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9537625
• 关键词: 14 year old; 16 year old; AIDS prevention; AIDS/HIV problem; Accounting; Address; Adolescence; Adolescent; Age; Attitude; Behavior; Behavior Therapy; Behavioral Mechanisms; Centers for Disease Control and Prevention (U.S.); Cities; Clinical; Counseling; Data; Decision Making; Development; Devices; Diagnosis; Ensure; Female Adolescents; Focus Groups; Foundations; Funding; Future; Goals; Grant; HIV; HIV-1; Health; Health Promotion; High School Student; Home environment; Hour; Human immunodeficiency virus test; Intention; Internet; Intervention; Knowledge; Learning; Life; Male Adolescents; Manuals; Marketing; Mechanics; Methods; Minority; Modeling; Motivation; Nature; Online Systems; Outcome; Outcome Measure; Participant; Patient Self-Report; Perception; Performance; Phase; Pilot Projects; Planned Parenthood Federation of America; Play; Population; Prevention; Prevention program; Preventive; Preventive Intervention; Randomized Controlled Trials; Recommendation; Reporting; Research Personnel; Risk; Risk Reduction; Schools; Self Efficacy; Series; Standardization; Students; System; Technology; Testing; Theoretical model; Translating; Travel; United States; Vulnerable Populations; Work; Youth; after-school program; age group; aged; base; behavior change; boys; commercialization; cost; cost effectiveness; design; digital; disorder prevention; ethnic minority population; evidence base; experience; girls; handheld mobile device; high risk; high school; improved; innovation; junior high school; pediatrician; peer; phase 1 study; phase 2 study; programs; racial and ethnic; screening; sex; skills; social; teacher; tool; uptake; virtual; young adult

Abstract HIV disproportionately impacts minority adolescents, and most of them have neither undergone HIV testing and counseling (HTC) nor know their status. Adolescence is a "window of opportunity" to intervene with HIV behavior change interventions. Challenges to implementing and disseminating some effective HIV prevention programs in adolescents may limit their impact. To address these challenges, innovative digital technologies can be used as interventions to improve health-related behaviors. They meet adolescents "where they are at," are engaging, provide more consistent fidelity to the intervention, and are easier to disseminate, leading to potentially greater reach at a lower cost. Therefore, the goal of this proposal is to build on the work completed with a Phase I project to further adapt an existing iPad-based HIV prevention intervention with demonstrated efficacy, PlayForward: Elm City Stories (developed for adolescents aged 11-14 and focused on sexual risk reduction) to create a new intervention focused on promoting access to and uptake of HTC in adolescents, aged 14-16. In the original PlayForward, participants create a virtual character they use to travel through life, facing challenges and making decisions that bring different risks, benefits, and consequences. The participants can see how their actions influence their future. The intervention involves a series of realistic stories representing risky situations faced by adolescents in middle or high school, and participants successfully resolve each story to acquire "senses" and "powers." The subsequent Phase I study adapted the intervention for a greater focus on HTC with enhanced storylines and conducted a pilot study that demonstrated efficacy in increasing actual HTC, intentions, and knowledge. For the proposed Phase II study, we will conduct additional formative work with focus groups, and our team of product developers and researchers will expand on the content and scope of the intervention while translating the intervention to a web-based platform. We will move towards commercialization of the digital intervention by working with implementation and marketing partners. We will evaluate the adapted intervention in a randomized controlled trial with 296 racial/ethnic minority adolescents, determining its efficacy as a web-based intervention for impacting their intention to seek HTC, actual obtaining of HTC, and knowledge about HIV/AIDS and testing. They will interact with the intervention for 2 hours per week for 6 weeks, and standardized assessment data will be collected at baseline, 6 weeks, 3 and 6 months. Given the compelling evidence supporting the efficacy of technology in health promotion and disease prevention, and their increased access, fidelity, and potential cost-effectiveness, this proposal holds the promise of an effective, engaging, tailored, and highly accessible prevention intervention with the potential for greater sustainable dissemination and considerable impact on this vulnerable population of adolescents.

抽象的 艾滋病毒不成比例地影响少数族裔青少年，大多数人都没有接受过HIV测试 和咨询（HTC）也不知道他们的地位。青春期是干预艾滋病毒的“机会之窗” 行为改变干预措施。实施和传播一些有效的HIV预防的挑战 青少年的计划可能会限制其影响。为了应对这些挑战，创新的数字技术 可以用作改善与健康相关行为的干预措施。他们遇到了青少年“在哪里”， 引人入胜，为干预提供更一致的保真度，并且更容易传播，导致 可能更大的覆盖范围，成本较低。因此，该提议的目标是建立在完成的工作的基础上 通过I阶段项目，可以进一步调整现有的基于iPad的HIV预防干预措施 功效，Playforward：Elm City Stories（为11-14岁的青少年开发，专注于性风险 减少）创建一个新的干预措施，重点是促进青少年中HTC的访问和吸收， 14-16岁。在原始的Playforward中，参与者创建了他们用来度过生活的虚拟角色， 面临挑战并做出带来不同风险，收益和后果的决策。参与者 可以看到他们的行为如何影响他们的未来。干预涉及一系列现实的故事 代表中学或高中青少年面临的冒险情况，并成功地 解决每个故事以获取“感官”和“力量”。随后的I阶段研究改编了干预措施 为了通过增强的故事情节对HTC进行更大的关注，并进行了一项试验研究，证明了有效性 增加实际HTC，意图和知识。对于拟议的II期研究，我们将进行额外 与焦点小组的形成性工作，我们的产品开发人员和研究人员团队将扩展 将干预措施转化为基于Web的平台时，干预的内容和范围。我们将移动 通过与实施和营销合作伙伴合作来商业化数字干预。 我们将在296个种族/族裔的随机对照试验中评估改编的干预措施 青少年确定其作为基于Web的干预措施，以影响其寻求HTC的意图， 实际获得HTC，以及有关艾滋病毒/艾滋病和测试的知识。他们将与干预措施互动 每周2个小时，持续6周，标准化评估数据将在基线，6周，3周和 6个月。鉴于有令人信服的证据支持技术在健康促进和 疾病预防及其访问，忠诚度和潜在的成本效益的增加，该提议成立 有效，引人入胜，量身定制且高度可访问的预防干预的承诺，潜力 为了更大的可持续传播，并对这一脆弱的青少年人群产生了重大影响。