The Role of an Artificially Intelligent Chatbot in Social Support, Antiretroviral Adherence, and Depressive Symptoms among Young Adults Living with HIV in South Africa

人工智能聊天机器人在南非艾滋病毒感染者的社会支持、抗逆转录病毒药物依从性和抑郁症状中的作用

基本信息

批准号：
10251005
负责人：
Brooke Jarrett
金额：
$ 4.6万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-09-01 至 2022-08-31
项目状态：
已结题

项目摘要

PROJECT SUMMARY Specific Aims: Developing effective interventions to reduce disparities in treatment outcomes among populations disproportionately affected by HIV is a priority for NIH-funded HIV research in 2019. This study will explore the effects and uptake of an artificially intelligent, socially supportive chatbot – a computer that texts with users via mobile phone – among young women and men who have sex with men (YMSM) living with HIV in South Africa. Specifically, the study will (1) develop an online scale to measure social support from a chatbot among young adults; (2) evaluate associations of social support from a chatbot with changes in depressive symptoms and adherence to antiretroviral therapy (ART) among young women and YMSM in South Africa; and (3) describe barriers and facilitators to uptake of a chatbot among young women and YMSM in South Africa. Significance: Young South Africans between the ages of 15 to 24 are at high risk of contracting and dying from HIV. Though ART extends life and prevents transmission, many young adults have poor adherence. Research in high-income countries suggest that automated two-way messaging with chatbots improves adherence to health behaviors. Chatbots may also address depressive symptoms and lack of social support, which are consistently identified barriers to adherence. Chatbots are rarely used to improve HIV care in low- and middle-income countries. If this study’s aims are achieved, then (1) future researchers will be able to more accurately measure social support from chatbots; (2) chatbots could potentially be used to promote adherence to medications and increase access to mental health support; and (3) future design and implementation of chatbots to improve HIV care will be optimized. This study’s long-term objective is to generate evidence for an effective, scalable intervention that engages hard-to-reach populations living with HIV. Approach: Aim 1 will develop a scale to measure social support from a chatbot using principal components and exploratory factor analyses applied to data gathered from 1,200 young adults worldwide who use Replika, a freely available mobile application (app). Aims 2 and 3 will invite 160 young women and YMSM living with HIV in Cape Town, South Africa to use the Replika app for four weeks in a pre-post study design. Aim 2 will employ an analysis of covariance using generalized multivariable linear regression models to assess the relationship between feelings of social support from the Replika app and changes in depressive symptoms and ART adherence. Aim 3 will leverage surveys (quantitative) and interviews (qualitative) in a mixed methods study to characterize differences between users with high- and low-frequency engagement with the app. Fellowship Information: This study is the dissertation for Ms. Brooke Jarrett, a PhD student in the Department of Epidemiology at Johns Hopkins University. Her training will consist of research methods and science communication toward her career goal of becoming a researcher of state-of-the-art mobile technologies to improve the physical and mental health of young people affected by health disparities.

项目摘要具体目的：制定有效的干预措施，以减少治疗结果的分布受HIV影响不成比例的人群是NIH资助的HIV研究的优先事项。这项研究将探索人工智能，社会支持的聊天机器人的效果和吸收，这是一台发短信的计算机与用户通过手机 - 在与男性发生性关系（YMSM）的年轻男性中在南非。特别是，该研究将（1）开发在线量表，以衡量聊天机器人的社会支持在年轻人中；（2）评估聊天机器人的社会支持协会以及抑郁症的变化南非的年轻妇女和YMSM的症状和遵守抗逆转录病毒疗法（ART）；和（3）将障碍和促进者描述为在南非的年轻妇女和YMSM中吸收聊天机器人。意义：15至24岁的南非年轻人处于收缩和垂死的高风险来自艾滋病毒。尽管艺术延长了生命并阻止传播，但许多年轻人的依从性较差。高收入国家的研究表明，与聊天机器人的自动化双向消息会有所改善遵守健康行为。聊天机器人也可能解决抑郁症状和缺乏社会支持，始终确定遵守的障碍。聊天机器人很少用于改善低 - 和中等收入国家。如果实现了这项研究的目标，那么（1）未来的研究人员将能够提高更多准确地衡量聊天机器人的社会支持；（2）聊天机器人有可能用于促进依从性进行药物并增加获得心理健康支持的机会；（3）未来的设计和实施聊天机器人改善艾滋病毒护理将得到优化。这项研究的长期目标是为有效，可扩展的干预措施与艾滋病毒的难以触及的人群参与。方法：AIM 1将使用主要组件制定量表来衡量聊天机器人的社会支持以及适用于全球1,200名年轻人收集的数据的探索性因素分析，他们使用Replika，免费的可用移动应用程序（应用程序）。目标2和3将邀请160名年轻女性和YMSM与在南非开普敦的艾滋病毒在验证前研究设计中使用Replika应用程序四个星期。 AIM 2意志员工使用通用多变量线性回归模型的协方差分析以评估 Replika应用程序的社会支持感觉与抑郁符号的变化之间的关系和艺术依从性。 AIM 3将通过混合方法利用调查（定量）和访谈（定性）研究以表征与应用程序高频和低频参与的用户之间的差异。奖学金信息：这项研究是布鲁克·贾瑞特女士的论文，约翰·霍普金斯大学流行病学系。她的培训将包括研究方法和科学沟通以成为她成为最先进手机的研究人员的职业目标改善受健康差异影响的年轻人的身心健康的技术。