VS4A: VITAL Start (Video-Intervention to Inspire Treatment Adherence for Life) for Adolescents, a video intervention to improve retention and adherence to ART among adolescents living with HIV

VS4A：针对青少年的 VITAL Start（激发终生治疗依从性的视频干预），一种视频干预措施，旨在提高艾滋病毒感染青少年对 ART 的保留和依从性

• 批准号: 10749263
• 负责人: Saeed Ahmed
• 金额: $ 117.67万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-24 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10749263
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adherence; Adolescent; Adoption; Africa South of the Sahara; Behavioral; Caring; Cessation of life; Childhood; Clinic; Complex; Counseling; Country; Dedications; Development; Dimensions; Disclosure; Drug resistance; Effectiveness; Enrollment; Film; Fostering; Friends; HIV; Health; Health Personnel; Health Resources; Health system; Human immunodeficiency virus test; Hybrids; Infection; International; Intervention; Kenya; Knowledge; Life; Malawi; Modeling; Outcome; Participant; Patients; Pharmaceutical Preparations; Procedures; Randomized; Randomized, Controlled Trials; Research; Services; Site; South Africa; Standardization; Stretching; Supervision; Teenagers; Time; Training; Uganda; Viral; Viral Load result; Youth; acceptability and feasibility; arm; behavior change; cost effective; cost effectiveness; cost-effectiveness ratio; disability-adjusted life years; experience; falls; human centered design; implementation science; improved; incremental cost-effectiveness; innovation; low and middle-income countries; mathematical model; mortality; multidisciplinary; primary outcome; programs; psychosocial; resistance mutation; satisfaction; scale up; secondary outcome; service delivery; standard of care; successful intervention; theories; tool; treatment adherence

PROJECT SUMMARY/ABSTRACT The 1.7 million adolescents living with HIV (ALHIV) globally urgently need interventions to help improve retention, adherence, and ultimately viral load suppression (VLS). With both high rates of incident infection and some of the lowest VLS rates, ALHIV experience high mortality with approximately 100 deaths per day. Successful interventions to improve retention and VLS among ALHIV in low- and middle-income countries (LMIC) remain limited. Video-based interventions that provide counseling to patients living with HIV have increased patient HIV knowledge, supported disclosure, fostered behavior change, and improved treatment adherence. Targeted messaging can be woven into culturally relevant films with engaging storylines and delivered at critical teachable moments. Films can be shown in high-volume clinics to deliver standardized counseling content while freeing up HCW time. While video-based interventions have the potential to address barriers to ALHIV ART retention and adherence, they are not commonly used throughout Sub-Saharan Africa (SSA). Our team was one of the first to pilot and study the impact of a video-based intervention on HIV service delivery; preliminary results have suggested high levels of patient and HCW satisfaction, improved ART knowledge, adherence, and retention. Based on these promising results, we propose to adapt, assess and support scale up of a tailored, video-based counseling package for ALHIV: VITAL (Video Intervention to Inspire Treatment Adherence for Life) Start for Adolescents (VS4A). Our study will examine the impact of VS4A on the primary composite outcome of retention and adherence (viral load <1000 copies/ml) in a multisite two-arm cluster randomized controlled trial (CRCT) with 1:1 randomization in Malawi. Our overall hypothesis is that VS4A will a) achieve broad reach, b) be acceptable and feasible to implement, c) improve adolescent VLS and several secondary outcomes; and d) be cost-effective at scale. If effective, VS4A can be an innovative, scalable tool to improve service delivery for ALHIV while also liberating HCW time and reducing health system burden in Malawi. Building on a 15-year partnership with the Malawi Ministry of Health (MOH), a track record of excellence and innovation in service to ALHIV, and a robust implementation science research portfolio, our team is poised to successfully implement the VS4A study and program and to use findings to support rapid, wide-scale dissemination and scale up.

项目摘要/摘要 全球急需艾滋病毒（ALHIV）的170万青少年需要干预措施以帮助改善 保留，依从性和最终抑制病毒负荷抑制（VLS）。两者都有高发射感染率 以及一些VLS最低的率，ALHIV经历了高死亡率，每天约有100人死亡。 在低收入国家 /地区的ALHIV中，成功改善了保留率和VLS的干预措施 （LMIC）仍然有限。基于视频的干预措施为艾滋病毒感染的患者提供咨询 增加患者艾滋病毒知识，支持披露，促进行为改变并改善治疗 坚持。有针对性的消息传递可以通过具有引人入胜的故事情节和与文化相关的电影编织成 在关键的可教时刻交付。电影可以在大批量诊所显示以提供标准化 咨询内容，同时释放HCW时间。虽然基于视频的干预措施有可能解决 ALHIV艺术保留和依从性的障碍，它们并不常用于撒哈拉以南非洲 （SSA）。我们的团队是第一个试行并研究基于视频干预对艾滋病毒服务的影响的团队之一 送货;初步结果表明，患者和HCW满意度很高，改善了ART 知识，依从性和保留。基于这些有希望的结果，我们建议适应，评估和 支持ALHIV的量身定制的，基于视频的咨询计划：Vital（Vital）（视频干预以激发灵感 青少年（VS4A）的寿命依从性。我们的研究将研究VS4A对 保留和依从性的主要综合结果（病毒载荷<1000份/ml）在多站点两臂中 在马拉维的簇随机对照试验（CRCT），随机化1：1。我们的总体假设是 VS4A将a）实现广泛的范围，b）可以接受且可行，c）改善青少年 VLS和几个次要结果； d）在大规模上具有成本效益。如果有效，VS4A可能是 创新，可扩展的工具，以改善ALHIV的服务交付，同时释放HCW时间并减少 马拉维的卫生系统负担。与马拉维卫生部（MOH）建立15年合作伙伴关系， 为ALHIV服务的卓越和创新记录，以及强大的实施科学研究 投资组合，我们的团队准备成功实施VS4A研究和计划，并使用调查结果进行 支持快速，广泛的传播并扩大规模。