A Text-Based Adherence Game for Young People Living with HIV in Ghana

项目总结 坚持艾滋病毒治疗是一项挑战，不坚持治疗会增加风险 因为艾滋病毒的二次传播和糟糕的健康结果。在撒哈拉以南非洲，估计有三分之一的人 患者没有按照处方接受抗逆转录病毒治疗(ART)，四分之一的患者停止治疗 在创办艺术的一年内。对护理结果的坚持在年龄较大的青少年中甚至更差 艾滋病毒携带者(YPLH)的年轻人，他们经历了最高比率的抗逆转录病毒药物不坚持， 与其他年龄段相比，治疗磨耗和病毒学失败。与艾滋病分部一致 高度优先的研究领域，目前的项目目标是YPLH使用一种新的mHealth游戏干预 以促进他们坚持艾滋病毒护理。应聘者：应聘者是一位临床科学家，拥有 具有临床和社区心理学背景。他之前的研究重点是开发 预防服务不足的青少年感染艾滋病毒的干预措施，主要是在美国(美国)。他是 申请为期五年的K23职业发展奖，以扩大自己的专业知识并支持他的 在撒哈拉以南非洲国家一个新的干预领域内的培训、指导和研究 (加纳)。指导：六位知名研究人员担任这项提议的顾问。每个人都带来了 与研究目的和培训目标一致的免费专业知识。拉里·布朗博士是 主要导师，在为YPLH在美国创建移动游戏干预方面有经验。 导师是专注于艾滋病毒的研究人员，在全球卫生研究方面具有专业知识(马修·米米亚加博士)，研究 在加纳(Awewura Kwara博士和Margaret Lartey博士)，并应用了定性方法(凯特·格思里博士)。Dr。 贝丝·博克是移动健康干预方面的专家，包括使用短信解决物质使用问题。 研究：拟议项目的目标是(1)收集有关障碍和促进者的信息，以 在加纳一家艾滋病毒诊所就诊的青少年儿童对护理的坚持程度，并评估青少年儿童对mHealth的偏好 通过与杨百合医院、他们的治疗伙伴和诊所工作人员的深入访谈进行干预；(2)制定文本- 基于遵守游戏，通过咨询mHealth开发人员并进行以下操作来促进遵守护理 YPLH干预的迭代开放试验(n=24)；和(3)评估干预的可行性 以及通过一项小型随机试验检验生物行为依从性结果的初步效果 在接受基于文本的遵守游戏的YPLH样本与获得标准的YPLH样本中的年份 护理组(n=60)。培训：由指导团队通过正式课程进行监督的具体培训， 工作坊、研讨会、会议、定向阅读、临床工作和指导经验将会收到。 由候选人主持。重点领域包括撒哈拉以南非洲和加纳以艾滋病毒为重点的研究， 具体地说；方法和技术上的mHealth技能；以及游戏化知识。候选人是 由罗德岛医院和布朗大学阿尔伯特医学院提供机构支持。

PROJECT SUMMARY Maintaining adherence to HIV treatment is a challenge and nonadherence is associated with heightened risks for secondary HIV transmission and poor health outcomes. In sub-Saharan Africa, an estimated one in three patients do not take antiretroviral therapy (ART) as prescribed and one in four disengage from treatment within a year of initiating ART. Adherence to care outcomes are even worse among older adolescents and young adults (young people) living with HIV (YPLH) who experience the highest rates of ART nonadherence, treatment attrition, and virologic failure compared to other age groups. Consistent with the Division of AIDS Research’s areas of High Priority, the current project targets YPLH using a novel mHealth gaming intervention in order to promote their adherence to HIV care. Candidate: The candidate is a clinical scientist with a background in clinical and community psychology. His prior research focuses on the development of interventions to prevent HIV infection among underserved youth, primarily in the United States (U.S.). He is applying for a five-year K23 Career Development Award in order to expand his expertise and support his training, mentorship, and research within a novel area of intervention in a sub-Sahara African country (Ghana). Mentoring: Six well-established researchers serve as mentors on this proposal. Each brings complimentary expertise consistent with the study’s aims and training objectives. Dr. Larry Brown is the Primary Mentor and has experience in creating mobile gaming interventions for YPLH in the U.S. Four other mentors are HIV-focused investigators with expertise in global health research (Dr. Matthew Mimiaga), studies in Ghana (Drs. Awewura Kwara and Margaret Lartey), and applied qualitative methods (Dr. Kate Guthrie). Dr. Beth Bock is an expert in mHealth interventions including the use of text messages to address substance use. Research: The aims of the proposed project are to (1) gather information on the barriers and facilitators to adherence to care among YPLH attending an HIV clinic in Ghana and gauge YPLH preferences for an mHealth intervention via in-depth interviews with YPLH , their treatment buddies, and clinic staff; (2) develop a Text- Based Adherence Game to promote adherence to care by consulting with an mHealth developer and conducting an iterative open trial of the intervention with YPLH (n = 24); and (3) evaluate the intervention for feasibility and preliminary efficacy with a small randomized pilot examining biobehavioral adherence outcomes over one year in a sample of YPLH who receive the Text-Based Adherence Game versus YPLH who receive the standard of care (n = 60). Training: Specific training overseen by the mentorship team through formal coursework, workshops, seminars, conferences, directed readings, clinical work, and mentored experiences will be received by the candidate. Areas of focus include HIV-focused research in sub-Saharan Africa, broadly, and in Ghana, specifically; methodological and technical mHealth skills; and knowledge of gamification. The candidate is institutionally supported by Rhode Island Hospital and the Alpert Medical School of Brown University.