Mobile Technology and Incentives (MOTIVES) for Racial and Ethnic Minorities in Los Angeles, CA

项目摘要 艾滋病毒对性和性别少数群体的影响不成比例，例如男男性行为者(MSM)和 变性人妇女(TGW)。这些人并不总是快速收到最新的信息 在暴露前预防等新预防技术时代不断演变的指导方针，导致 面对最近艾滋病毒预防的发展，人们感到困惑。缺乏对传统健康的参与 护理系统也导致对艾滋病毒的不频繁检测。迫切需要新的方式来供应MSM和TGW 以最新和准确的艾滋病毒预防信息促进艾滋病毒健康素养，并突出 间接评估潜在传染性而不是按照 疾控中心。文本消息等移动技术提供了一种动态的新方式来改善对关键信息的访问 为MSM和TGW提供预防信息和关怀，但更好地使其适应 MSM和TGW是必要的，保持他们参与的创造性方法至关重要。鉴于不断增长的 认识到，即使人们拥有所有必要的信息并有动力，他们通常也无法表现出 健康的行为，这项建议使用了行为经济学的新见解来提供频繁的反馈 以及激励措施，以保持参与者的参与并支持他们保持艾滋病毒阴性的意图。这 该提议需要一个以移动技术为基础并得到支持的三阶段艾滋病毒预防干预措施--称为 移动技术和奖励(动机)--增加对艾滋病毒预防信息和 提高检测频率。形成阶段1包括与MSM和TGW进行30次半结构化访谈，以 根据初步研究的见解最终确定计划的干预措施。第二阶段将招收200名艾滋病毒感染者- 在为期18个月的双臂随机对照试验(RCT)中，MSM和TGW均为阴性。那些参与干预的人 群组每周将收到包含艾滋病毒预防信息的短信，并可赢得奖励积分 正确回答每周的测验，以保持他们的参与度，并提高他们对艾滋病毒预防的记忆力 信息。那些每三个月至少进行一次艾滋病毒检测呈阴性的人可以进入奖品 抽签赢得奖品，那些正确回答每周测验的人有更大的机会。对照组 将获得相同的艾滋病毒预防信息，但没有激励措施。主要成果包括 艾滋病病毒检测频率和艾滋病预防知识。第三阶段包括7个退出焦点小组(5-8个 每组参与者)，以评估研究改进的领域，并为未来扩大规模估计参数。 具体目标是1)开发动机并最终确定每周短信信息内容和 激励的类型；2)实施和评估动机的影响；3)评估以下领域 通过焦点小组改进动机，并使用POINT评估关键任务设计参数 以及对后续完全支持的R01应用程序的可信区间估计。

PROJECT ABSTRACT HIV disproportionately affects sexual and gender minorities such as men who have sex with men (MSM) and transgender women (TGW). These individuals do not always receive the most up-to-date information on rapidly evolving guidelines in a time of new prevention technologies such as pre-exposure prophylaxis, leading to confusion in the face of recent HIV prevention developments. A lack of engagement in the traditional health care system also leads to infrequent testing for HIV. Novel ways are urgently needed to supply MSM and TGW with the most recent and accurate HIV prevention information to promote HIV health literacy and highlight the pitfalls of indirect assessments of potential infectivity rather than trimestral testing as recommended by the CDC. Mobile technologies such as text messaging present a dynamic new way to improve access to critical prevention information and care for MSM and TGW, but better ways of adapting them to the unique needs of MSM and TGW are needed, and creative ways of keeping them engaged are critical. Given the growing recognition that even if people have all necessary information and are motivated, they commonly fail to show healthy behavior, this proposal employs novel insights from behavioral economics to provide frequent feedback and incentives to keep participants engaged and support them in their intention to remain HIV negative. This proposal entails a 3-phase mobile technology based and BE supported HIV prevention intervention – called Mobile Technology and Incentives (MOTIVES) - to increase engagement with HIV prevention information and improve testing frequency. Formative Phase 1 includes 30 semi-structured interviews with MSM and TGW to finalize the planned intervention based on the insights from a preliminary study. Phase 2 will enroll 200 HIV- negative MSM and TGW in an 18-month, two-arm randomized controlled trial (RCT). Those in the intervention group will receive weekly text messages with HIV prevention information, and can win reward points for correctly answering weekly quizzes to keep them engaged and improve their retention of the HIV prevention information. Those who continue to test negative for HIV at least once every three months can enter a prize drawing to win prizes, with larger chances for those correctly answering the weekly quizzes. The control group will receive the same HIV prevention information but without the incentives. The primary outcomes include frequency of HIV testing and HIV prevention knowledge. Phase 3 includes 7 exit focus groups (with 5-8 participants per group) to evaluate areas for study improvement and estimate parameters for future scale up. The Specific Aims are to 1) develop MOTIVES and finalize the weekly text message information content and the types of incentives; 2) implement and evaluate the impact of MOTIVES; and 3) evaluate areas of improvement for MOTIVES through focus groups and estimate mission-critical design parameters with point and confidence interval estimates for a subsequent, fully-powered R01 application.