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.

项目摘要/摘要 背景：只有大约50％的青少年和艾滋病毒（AYWH）启动艾滋病毒护理的年轻人仍然存在 12个月的护理。此外，在2020年，Aywh的死亡率增加了50％。这些贫穷 临床结果是多因素的，受其神经发育阶段的影响很大，并通过 感染（围产期与非周）。当前保留AYWH护理的干预措施有限，并且不会解决 艾滋病毒护理的这些关键方面对Aywh。基于社交媒体的移动健康（MHealth）干预措施可灵活 以及AYWH的吸引人功能，以帮助克服保留护理的障碍。候选人：目标 拟议的K43新兴全球领导者奖是为了支持朱利安·阿登（Julian Adong）博士的研究培训 独立作为临床科学家，重点是改善低资源的治疗和护理Aywh 设置。 Adong博士目前是乌干达Mbarara科学技术大学的研究员。 拟议的研究将在三个领域进行培训：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 青少年行为以及对基于MHealth的干预开发和部署的影响； 3） 用于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Dr，Adong的 当前的流行病学临床经验和背景以及MHealth的持续形成性工作 干预开发。研究：该提案的研究目标是开发和测试可行性 以及基于社交媒体的青少年批准的MHealth干预措施的可接受性，以改善艾滋病毒的保留率 关心Aywh。干预将由社会认知理论和计划的理论告知 行为，发展过程将由思想框架指导。首先，Adong博士将定义 AYWH之间的认知，环境和行为挑战，他们是新的或新的重新参与的 艾滋病毒护理，通过神经发育阶段和感染途径及其对 行为意图（目标1）。然后，她将通过AYWH和诊所的输入进行迭代开发干预措施 辅导员（目标2）。最后，她将测试可接受性，可行性和初步有效性 通过试点等待名单的对照试验，在新的或 新的重新参与艾滋病毒护理（AIM 3）。创新：这项研究将是第一个解决重要作用的研究 神经发育阶段和感染途径保留在护理中，并将利用强大的潜力 MHealth干预此MHealth受感染人群。未来的方向：Adong博士的研究和 培训目标是由敬业导师组成的多学科团队很好地对准和支持。在 奖项，她将成为R01申请的出色候选人，以确定评估MHealth干预措施 在低资源环境中，改善AYWH的艾滋病毒治疗结果。