A social media mHealth intervention to improve retention in care for adolescents and young adults with HIV in Uganda

社交媒体移动医疗干预措施旨在改善乌干达感染艾滋病毒的青少年和年轻人的护理保留率

• 批准号: 10752740
• 负责人: Julian Adong
• 金额: $ 10.04万
• 依托单位: MBARARA UNIVERSITY/SCIENCE/ TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10752740
• 关键词: Acquired Immunodeficiency Syndrome; Address; Adolescence; Adolescent; Adolescent Behavior; Adolescent and Young Adult; Adult; Age; Area; Award; Behavior; Behavioral; Behavioral Sciences; Caring; Cellular Phone; Childhood; Clinic; Clinical; Clinical Trials; Cognitive; Communities; Continuity of Patient Care; Data Analyses; Data Collection; Dedications; Development; Effectiveness of Interventions; Emotional; Epidemic; Epidemiology; Fatigue; Future; Goals; HIV; HIV/AIDS; Health Priorities; Health behavior; Health behavior change; Healthcare; Infection; Intention; Intervention; Interview; Knowledge; Life; Mental Health; Mentors; Morbidity - disease rate; Neurobiology; Outcome; Perinatal; Persons; Planning Theory; Population; Positioning Attribute; Process; Professional counselor; Randomized; Randomized, Controlled Trials; Research; Research Methodology; Research Training; Resource-limited setting; Rewards; Risk Taking; Role; Route; Science; Scientist; Self Efficacy; Social Change; Statistical Methods; System; Technology; Testing; Training; Transportation; Treatment Efficacy; Treatment outcome; Uganda; Universities; Viral; Visit; Visual; Waiting Lists; Work; acceptability and feasibility; aged; care delivery; cost; design; disability; efficacy testing; experience; feasibility testing; flexibility; follow-up; improved; innovation; iterative design; mHealth; mortality; multidisciplinary; neurodevelopment; pilot test; poor health outcome; primary outcome; response; skill acquisition; skills; social; social cognitive theory; social media; theories; therapy development; transmission process; usability

PROJECT SUMMARY/ABSTRACT Background: Only about 50% of adolescents and young adults with HIV (AYWH) who initiate HIV care remain in care at 12 months. Moreover, in 2020, AYWH recorded a 50% increase in AIDS-related mortality. These poor clinical outcomes are multi-factorial and heavily influenced by their neurodevelopmental stage and by route of infection (perinatal vs non-perinatal). Current interventions to retain AYWH in care are limited and do not address these key aspects of HIV care for AYWH. Social media-based mobile health (mHealth) interventions offer flexible and attractive features to AYWH to help overcome barriers to retention in care. Candidate: The goal of the proposed K43 Emerging Global Leader Award is to support Dr. Julian Adong’s research training to attain independence as a clinician-scientist focused on improving treatment and care for AYWH in low resourced settings. Dr. Adong is currently a research fellow at Mbarara University of Science and Technology, Uganda. The proposed study will enable training in three areas: 1) Qualitative and mixed methods research, including design, data collection, analysis and interpretation; 2) Behavioural science skills to better understand influences of adolescent behaviour and implications for mHealth-based intervention development and deployment; and 3) Statistical methods for clinical trials, including longitudinal data analysis. This application builds on Dr, Adong’s current clinical experience and background in epidemiology, as well as ongoing formative work in mHealth intervention development. Research: The research goals of this proposal are to develop and test the feasibility and acceptability of an adolescent-tailored social media-based mHealth intervention to improve retention in HIV care for AYWH. The intervention will be informed by Social Cognitive Theory and the Theory of Planned Behaviour, and the development process will be guided by the IDEAS Framework. First, Dr. Adong will define the cognitive, environmental, and behavioural challenges among AYWH who are new or newly re-engaging in HIV care, characterizing these factors by neurodevelopmental stage and route of infection and their impact on behavioural intention (Aim 1). She will then iteratively develop the intervention with input from AYWH and clinic counsellors (Aim 2). Finally, she will test the acceptability, feasibility, and preliminary effectiveness of the intervention on one-year retention in care through a pilot wait-list controlled trial among AYWH who are new or newly re-engaging in HIV care (Aim 3). Innovation: This study will be the first to address the important role of neurodevelopmental stage and route of infection for retention in care and will leverage the strong potential of mHealth interventions in this mHealth-receptive population. Future directions: Dr. Adong’s research and training aims are well aligned and supported by a multidisciplinary team of dedicated mentors. At the end of the award, she will be an excellent candidate for an R01 application to definitively assess mHealth interventions to improve HIV treatment outcomes among AYWH in low resourced settings.

项目总结/摘要 背景：只有大约50%的青少年和年轻的艾滋病毒感染者（AYWH）谁开始艾滋病毒护理仍然存在 在12个月的护理。此外，于二零二零年，青少年健康中心录得艾滋病相关死亡率上升50%。这些可怜 临床结果是多因素的，并受到其神经发育阶段和治疗途径的严重影响。 感染（围产期vs非围产期）。目前的干预措施，以保持AYWH的照顾是有限的，并没有解决 艾滋病毒护理的这些关键方面。基于社交媒体的移动的健康干预措施提供了灵活的 和有吸引力的功能，以帮助AYWH克服障碍，以保持在照顾。候选人：目标 拟议的K43新兴全球领袖奖是为了支持朱利安·阿东博士的研究培训，以实现 作为一名临床医生-科学家的独立性，专注于改善低资源地区AYWH的治疗和护理。 设置. Adong博士目前是乌干达姆巴拉拉科技大学的研究员。 拟议的研究将在三个领域开展培训：1）定性和混合方法研究，包括 设计、数据收集、分析和解释; 2）行为科学技能，以更好地理解影响 青少年行为及其对基于移动健康的干预措施开发和部署的影响;以及3） 临床试验的统计方法，包括纵向数据分析。此应用程序建立在阿东博士的 目前的临床经验和流行病学背景，以及正在进行的形成性工作，在mHealth 干预发展。研究：本提案的研究目标是开发和测试可行性 和可接受性，以提高艾滋病毒的保留率 关注AYWH干预将以社会认知理论和计划理论为指导， 行为和开发过程将以IDEAS框架为指导。首先，阿东博士将定义 AYWH中的认知，环境和行为挑战，他们是新的或新重新参与 艾滋病毒护理，以神经发育阶段和感染途径为特征的这些因素及其对 行为意向（目标1）。然后，她将根据AYWH和诊所的输入反复开发干预措施 辅导员（目标2）。最后，她将测试的可接受性，可行性和初步的有效性， 通过在新来青少年家庭佣工中进行的一项试验性等待名单对照试验， 最近重新参与艾滋病毒护理（目标3）。创新：这项研究将是第一个解决的重要作用， 神经发育阶段和感染途径的保留护理，并将利用强大的潜力， 在这一接受移动健康的人群中采取移动健康干预措施。未来的方向：阿东博士的研究和 培训目标是一致的，并得到一个由专职导师组成的多学科小组的支持。结束时 她将是R 01申请的优秀候选人，以明确评估移动健康干预措施， 在资源匮乏的环境中，改善青年妇女健康协会的艾滋病毒治疗结果。