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.

项目概要/摘要 背景：只有约 50% 的艾滋病毒青少年和年轻人 (AYWH) 开始艾滋病毒护理后仍继续接受治疗 12个月时接受护理。此外，2020 年，AYWH 记录的艾滋病相关死亡率增加了 50%。这些穷人 临床结果是多因素的，并且很大程度上受到其神经发育阶段和途径的影响 感染（围产期与非围产期）。目前维持 AYWH 护理的干预措施有限，并且不能解决 AYWH 艾滋病毒护理的这些关键方面。基于社交媒体的移动健康 (mHealth) 干预措施提供灵活的 以及对 AYWH 有吸引力的功能，以帮助克服保留护理的障碍。候选人：目标 拟议的 K43 全球新兴领袖奖旨在支持 Julian Adong 博士的研究培训，以实现 作为临床医生科学家的独立性，专注于改善资源匮乏的 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。 拟议的研究将实现三个领域的培训：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医疗的干预措施开发和部署的影响；和 3) 临床试验的统计方法，包括纵向数据分析。该应用程序基于 Adong 博士的 目前的临床经验和流行病学背景，以及移动医疗领域正在进行的形成性工作 干预发展。研究：该提案的研究目标是开发和测试可行性 为青少年量身定制的基于社交媒体的移动医疗干预措施的可接受性，以提高艾滋病毒保留率 照顾 AYWH。干预措施将基于社会认知理论和计划理论 行为和开发过程将由 IDEAS 框架指导。首先，阿东博士将定义 新加入或刚刚重新参与的 AYWH 的认知、环境和行为挑战 HIV 护理，通过神经发育阶段和感染途径及其对这些因素的影响来描述这些因素 行为意图（目标 1）。然后，她将根据 AYWH 和诊所的意见迭代开发干预措施 辅导员（目标 2）。最后，她将测试该方案的可接受性、可行性和初步有效性。 通过在新 AYWH 或新 AYWH 中进行试点等候名单对照试验，对保留一年的护理进行干预 新近重新参与艾滋病毒护理（目标 3）。创新：这项研究将首次探讨 神经发育阶段和感染途径，以保留护理，并将利用强大的潜力 对这一接受移动医疗的人群进行移动医疗干预。未来方向：阿东博士的研究和 培训目标得到了由专业导师组成的多学科团队的充分协调和支持。结束时 奖，她将成为 R01 申请的优秀候选人，以明确评估移动医疗干预措施 改善资源匮乏地区 AYWH 的艾滋病毒治疗结果。