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A Telemedicine and mHealth Intervention for Reducing Alcohol Consumption among People Living with HIV/AIDS.

用于减少艾滋病毒/艾滋病患者饮酒量的远程医疗和移动健康干预措施。

基本信息

批准号：
10261369
负责人：
Carolyn Lauckner
金额：
$ 16.89万
依托单位：
UNIVERSITY OF KENTUCKY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-15 至 2023-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10261369
关键词：
AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adherence Age Alcohol consumption Alcohols Attitude Behavior Therapy Behavioral Bluetooth Caring Cellular Phone Client Clinic Clinical Clinical Data Cognitive Therapy Collection Communication Counseling Data Data Analyses Databases Disease Drug usage Educational workshop Effectiveness Ethnic Origin Evaluation Feedback Foundations Funding Gender General Population Goals HIV Health Health Insurance Portability and Accountability Act Highly Active Antiretroviral Therapy Improve Access Individual Interdisciplinary Study Intervention Intoxication Link Literature Measures Medical Mental Depression Mentors Methods Modernization Monitor National Institute on Alcohol Abuse and Alcoholism Outcome Outcomes Research Participant Patient Self-Report Patients Persons Pharmaceutical Preparations Prevention Process Professional counselor Public Health Questionnaires Race Randomized Randomized Controlled Trials Reading Recording of previous events Regimen Reporting Research Research Design Research Personnel Resources Secure Social support Survival Rate Technology Telemedicine Telephone Testing Time Training Transportation Travel Universities Validity of Self Report Videoconferencing Viral Visit Voice Waiting Lists Wireless Technology alcohol abuse therapy alcohol availability alcohol intervention alcohol monitoring alcohol related problem alcohol research alcohol testing base brief intervention cocaine use dosage drinking efficacy trial follow-up heroin use improved improved outcome innovation intervention effect intervention participants mHealth medication compliance meetings member motivational enhancement therapy new technology pilot trial problem drinker programs recruit reduced alcohol use response rural area skills telehealth therapy adherence therapy design tool treatment response urban area usability

项目摘要

Project Summary/Abstract With advances in treatment, people living with HIV/AIDS (PLWHA) have greatly improved survival rates and medical outcomes. However, despite the increased availability of highly-active antiretroviral therapy, many PLWHA fail to take their medication as directed. This reduces their chances of achieving viral suppression and is thus a crucial component of the HIV/AIDS treatment cascade. To improve the outcomes of PLWHA and address the low levels of viral suppression observed nationwide, it is essential to examine factors that are likely to decrease medication adherence. One such factor is alcohol consumption, which has been shown to have a significant and large effect on whether or not individuals follow their medication regimen. The primary objective of this research is to develop and test an alcohol reduction intervention for PLWHA. Based on collaborators’ previous research and prior literature, this eight-week intervention, titled Tracking and Reducing Alcohol Consumption (TRAC), will be delivered entirely using technology. Counselors will meet with patients using videoconferencing in partnership with the Georgia Department of Public Health’s Telehealth Network, as well as via phone-based conversations. This technology-based delivery will be highly accessible to patients in both rural and urban areas of Georgia, as it requires only two in-person visits to a local health department office for videoconferencing sessions. As a supplement to the intervention, participants will also engage in self-monitoring of alcohol consumption and medication adherence through mobile questionnaires and Bluetooth-enabled breathalyzers. The use of mobile breathalyzers represents an innovative application of modern technologies and has potential to improve the validity of self-reported alcohol consumption. Overall, the TRAC intervention will be developed and tested in two stages: an open trial (N=10) exploring acceptance and usability, and a small randomized pilot trial (N=60) assessing feasibility and evidence for efficacy in regard to reducing alcohol consumption, increasing medication adherence, and improving medical outcomes. I aim to receive comprehensive training to support this line of research related to reducing alcohol consumption among PLWHA. As part of my training plan, five mentors who specialize in HIV/AIDS, alcohol, intervention design, telemedicine, and advanced data analysis will provide guidance through directed readings, regular meetings, and feedback on research design. These mentors are located at the University of Georgia and Yale University. Both universities will provide me with access to extensive intellectual resources and partnering organizations who can aid in my research, including the Georgia Department of Public Health, Yale’s Center for Interdisciplinary Research on AIDS, and the NIAAA Consortia for HIV/AIDS and Alcohol-Related Research Trials. I will also participate in courses and workshops related to clinical data analysis, HIV/AIDS research, and behavioral intervention design. This training will provide me with the foundation needed to meet my long-term goal of conducting an externally-funded program of research in HIV/AIDS and alcohol and drug use.

项目总结/摘要随着治疗的进步，艾滋病毒/艾滋病感染者的存活率大大提高，医疗结果。然而，尽管高活性抗逆转录病毒疗法的可用性增加，艾滋病毒/艾滋病感染者没有按照指示服药。这降低了他们实现病毒抑制的机会，因此是艾滋病毒/艾滋病治疗级联的关键组成部分。改善艾滋病毒/艾滋病感染者和为了解决全国范围内观察到的病毒抑制水平低的问题，有必要检查可能来降低药物依从性其中一个因素是酒精消费，这已被证明有一个对个体是否遵循他们的药物治疗方案有显著且大的影响。这项研究的主要目的是开发和测试一种减少艾滋病毒感染者/艾滋病患者饮酒的干预措施。根据合作者以前的研究和以前的文献，这项为期八周的干预，题为跟踪和减少酒精消费（TRAC）将完全使用技术来实现。顾问们将会见与格鲁吉亚公共卫生部的远程医疗合作，网络，以及通过电话交谈。这种基于技术的交付将非常容易获得，患者在农村和城市地区的格鲁吉亚，因为它只需要两个人访问当地的健康新闻部办公室举行视频会议。作为干预的补充，参与者还将通过移动的调查问卷进行酒精消费和药物依从性的自我监测和蓝牙呼气测醉器移动的呼气测醉器的使用代表了现代技术，并有可能提高自我报告的酒精消费的有效性。总的来说， TRAC干预措施将分两个阶段进行开发和测试：一个开放试验（N=10），探索接受程度和可用性，以及一项小型随机化初步试验（N=60），评估在以下方面的可行性和疗效证据减少酒精消费，增加药物依从性，改善医疗结果。我的目标是接受全面的培训，以支持这一系列与减少饮酒有关的研究。在艾滋病毒/艾滋病感染者中。作为我培训计划的一部分，五位专门研究艾滋病，酒精，干预的导师设计、远程医疗和先进的数据分析将通过定向读数、定期会议和对研究设计的反馈。这些导师分别位于格鲁吉亚大学和耶鲁大学大学这两所大学将为我提供广泛的智力资源和合作伙伴关系，这些组织可以帮助我的研究，包括格鲁吉亚公共卫生部，耶鲁中心以及NIAAA艾滋病毒/艾滋病和酒精相关研究联盟审判我还将参加与临床数据分析，艾滋病毒/艾滋病研究，行为干预设计这项培训将为我提供所需的基础，以满足我的长期目标是进行一项由外部资助的艾滋病毒/艾滋病、酒精和毒品使用研究计划。