A Pilot Gaming Adherence Program for Youth Living with HIV

描述(由申请人提供)：尽管需要持续坚持医疗护理，但艾滋病毒携带者(YLWH)的护理保留率和抗逆转录病毒药物(ARV)治疗的依从性并不理想。YLWH的依从性研究很少，结果喜忧参半，因此非常需要开发新的干预措施。成人HIV依从性研究的结果表明，参与者对使用基于技术的方法感兴趣，并且最容易接受将技术设备与激励组件相结合的干预措施。已经发现，服药监测设备是衡量抗逆转录病毒药物依从性的敏感指标，但单独使用时并不会导致依从性或内在动机的持续改善。基于这些知识，这项研究将检验一项多层次技术，该技术将药物监测设备(Vitality Cap)与基于互动智能手机的应用程序/游戏集成在一起，这对YLWH具有吸引力和吸引力。这种多层次的方法将把理论驱动的内容与新颖但直观的技术结合起来，以提高艾滋病毒治疗的依从性。在这项研究中，每次打开药瓶将允许通过从瓶盖(Vitality Cap)到手机的无线传输数据访问智能手机上的应用程序/游戏。这个开发项目将改编和改进一款智能手机应用程序/游戏，以包含与信息-动机-行为技能(IMB)模型一致的内容。创作和改编将来自对青瓦台的深入访谈(n=25)和干预的公开试验(n=20)。在游戏中，参与者将体验以行动为导向的冒险，这些冒险增加了关于他们健康的信息(例如，关于艾滋病毒治疗的知识)，提高了动力(例如，动作人物体验了坚持下去对健康的好处)，并培养了技能(例如，将临床医生作为合作伙伴)。在60名YLWH中进行的一项小型随机对照试验研究(24周)将检验IMB游戏坚持干预(活力帽与IMB知情应用程序/游戏的整合)的初步疗效，并与接受活力帽和智能手机但不接受IMB游戏的对照组进行比较，观察依从性和生物指标。 公共卫生相关性：这项研究将开发和测试一种新的、基于技术的干预措施，以提高正在服用抗逆转录病毒药物的艾滋病毒感染者青年的治疗依从性。在干预中，年轻人将通过打开药瓶，在他们的智能手机上访问一个引人入胜的身临其境的应用程序/游戏。有关打开药瓶的数据将从瓶盖无线传输到参与者的智能手机应用程序/游戏中。在游戏中，参与者将获得关于自己健康的信息，提高对抗逆转录病毒药物和医疗预约的遵守动机，并实践健康的行为。如果干预被发现是有效的，它可以在一项更大的研究中进行测试，然后通过抗逆转录病毒药物传播给其他年轻人。

DESCRIPTION (provided by applicant): Despite need for consistent adherence to medical care, youth living with HIV (YLWH) have suboptimal rates of retention in care and adherence to antiretroviral medication (ARV) treatment. There are few adherence studies with YLWH and the results are mixed, so there is a great need for the development of novel interventions. Results of adult HIV adherence studies indicate that participants are interested in using technology-based methods and are most receptive toward interventions that couple technological devices with motivational components. Pill taking monitoring devices have been found to be a sensitive measure of adherence to ARV medications, but do not lead to sustained improvements in adherence or intrinsic motivation when used alone. Building on this knowledge, this study will examine a multi-level technology that integrates a medication monitoring device (Vitality Cap) WITH an interactive smartphone based app/game that is attractive and engaging to YLWH. This multi-level approach will integrate theory driven content with novel, but intuitive, technology to improve HIV treatment adherence. In this study, each opening of the pill bottle will allow access to the app/game on the smartphone via data transferred wirelessly from the bottle cap (Vitality Cap) to the phone. This developmental project will adapt and refine a smartphone app/game to include content consistent with the Information-Motivation-Behavioral Skills (IMB) Model. Creation and adaptation will occur from in-depth interviews with YLWH on ART (n=25) and an open trial of the Intervention (n=20). While gaming, participants will experience absorbing action-oriented adventures that increase information about their health (e.g. knowledge about HIV treatment), improve motivation (e.g. action-figures experience health benefits of adherence), and build skills (e.g. utilize clinicians as partners). A small randomized controlled pilot study (24 weeks) among 60 YLWH will examine the preliminary efficacy of the IMB Gaming Adherence Intervention (integration of the Vitality Cap with the IMB informed app/game) compared to a comparison group who receive the Vitality Cap and smartphone but no IMB game, on adherence and biological measures. PUBLIC HEALTH RELEVANCE: This study will develop and test a novel, technology based intervention to improve treatment adherence among youth living with HIV who are taking antiretroviral medication. In the intervention youth will gain access to an engaging and immersive app/game on their smartphone by opening their medication bottle. Data about the opening of the pill bottle will be transferred from the bottle cap to the participant's smartphone app/game wirelessly. While gaming, participants will gain information about their health, improve motivation for ARV and medical appointment adherence, and practice healthy behaviors. If the Intervention is found to be effective, it can be tested in a larger study and then disseminated to other youth on antiretroviral medications.