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.

项目概要/摘要 全球 170 万感染艾滋病毒 (ALHIV) 的青少年迫切需要干预措施来帮助改善 保留、依从和最终的病毒载量抑制（VLS）。事件感染率很高 ALHIV 死亡率很高，每天大约有 100 人死亡。 成功的干预措施可提高低收入和中等收入国家 ALHIV 的保留率和 VLS （中低收入国家）仍然有限。为艾滋病毒感染者提供咨询的基于视频的干预措施 增加患者艾滋病毒知识、支持披露、促进行为改变和改善治疗 坚持。有针对性的信息可以融入具有引人入胜的故事情节和文化相关的电影中 在关键的教学时刻交付。电影可以在大批量的诊所放映，以提供标准化的服务 咨询内容，同时腾出医护人员的时间。虽然基于视频的干预措施有可能解决 保留和坚持 ALHIV ART 的障碍，在整个撒哈拉以南非洲地区并不普遍使用 （SSA）。我们的团队是最早试点和研究基于视频的干预措施对艾滋病毒服务影响的团队之一 送货;初步结果表明患者和医护人员满意度高，ART 得到改善 知识、坚持和保留。基于这些有希望的结果，我们建议进行调整、评估和 支持扩大针对 ALHIV 的量身定制的基于视频的咨询包：VITAL（视频干预以激励 终生坚持治疗）从青少年开始（VS4A）。我们的研究将考察 VS4A 对 多部位双臂保留和坚持（病毒载量<1000拷贝/毫升）的主要复合结果 在马拉维进行的整群随机对照试验 (CRCT)，采用 1:1 随机化。我们的总体假设是 VS4A 将 a) 实现广泛的覆盖范围，b) 可接受且实施可行，c) 改善青少年 VLS 和几个次要结果； d) 在规模上具有成本效益。如果有效，VS4A 可以成为 创新、可扩展的工具，可改善 ALHIV 的服务提供，同时还解放医护人员的时间并减少 马拉维卫生系统的负担。在与马拉维卫生部 (MOH) 15 年合作伙伴关系的基础上， 在 ALHIV 服务方面的卓越和创新记录，以及强有力的实施科学研究 投资组合，我们的团队准备成功实施 VS4A 研究和计划，并利用研究结果 支持快速、广泛的传播和扩大规模。