Digital Health Technology Use Among Methadone Maintenance Patients

 描述(由申请人提供)：注射吸毒者感染丙型肝炎病毒的风险很高，与人类免疫缺陷病毒(HIV)和丙型肝炎病毒混合感染在这一人群中非常普遍。然而，很少有人接受丙型肝炎病毒的评估和治疗。对丙型肝炎病毒的认识和知识水平低对注射吸毒者的预防和治疗是一个重大挑战。丙型肝炎病毒教育与特定疾病知识的增加、接受治疗的兴趣和意愿以及肝脏诊所就诊率的增加有关。互联网提供了以方便和及时的方式向注射吸毒者提供丙型肝炎预防和治疗信息的机会。然而，关于互联网和基于手机的干预措施对注射吸毒者传播健康干预措施的使用和影响的数据很少。这项研究将进行形成性评估，并将设计和评估一个理论指导的移动网站传播丙型肝炎病毒和艾滋病毒健康信息的可行性和可接受性。该网站旨在通过提供教育支持服务来补充药物滥用治疗服务，包括关于丙型肝炎病毒和艾滋病毒的信息，纳入个人丙型肝炎病毒风险评估，并整合搜索功能，使用户能够找到丙型肝炎病毒和艾滋病毒的医疗保健提供者。在高危人群中提高对丙型肝炎病毒的知识和认识符合预防和控制丙型肝炎病毒的国家战略。第一阶段(N=200)的目标是：(1)确定美沙酮维持治疗(MMT)患者获得和使用移动电话技术和互联网活动的特征；(2)衡量MMT患者对使用数字模式(短信、电子邮件和互联网)接收包括丙型肝炎病毒和艾滋病毒预防、检测和治疗信息在内的健康信息的态度；(3)确定MMT患者出于健康或医疗目的获得和使用移动技术和互联网的预测因素。根据第一阶段的结果，第二阶段的目标是：(1)设计和完善一个移动优化网站，用于传播丙型肝炎和艾滋病毒的预防、检测和治疗信息，其中包括数字技术专家的投入和MMT患者的反馈；以及(2)进行随机试点研究，以确定定制的励志短信是否会增加MMT患者对移动网站的使用。我们将随机将40名拥有手机的MMT患者分为两种情况：1)定制励志短信；或2)不发短信。评估将在研究开始时和随机化后30天进行。我们假设，与那些没有收到定制励志短信的参与者相比，随机进入定制励志短信条件的参与者对丙型肝炎病毒的了解将显著增加，重复访问网站的频率更高，并且更有可能完成个人丙型肝炎风险评估调查，并在30天的随访中接受丙型肝炎病毒检测。如果可行和可接受，该网站将提供可靠、高效和高质量的针对吸毒者的丙型肝炎病毒健康信息，具有广泛传播的潜力。

 DESCRIPTION (provided by applicant): Injection drug users (IDUs) are at high risk of acquiring hepatitis C virus (HCV) infection, and co-infection with human immunodeficiency virus (HIV) and HCV is highly prevalent among this population. Yet few are evaluated and treated for HCV. Low levels of awareness and knowledge about HCV represent a significant challenge to prevention and treatment among IDUs. HCV education is associated with increased disease- specific knowledge, interest in and willingness to accept treatment, and increased liver clinic attendance. The Internet offers the opportunity to deliver HCV prevention and treatment information to IDUs in a convenient and timely fashion. However, little data is available about the use and impact of Internet and mobile phone-based interventions to disseminate health interventions for IDUs. This study will conduct a formative evaluation and will design and evaluate the feasibility and acceptability of a theory-guided mobile website to disseminate HCV and HIV health information. The website is intended to complement drug abuse treatment services by offering educational support services including information about HCV and HIV, incorporating a personal HCV risk assessment, and integrating a search feature to enable users to locate HCV and HIV health care providers. Increasing knowledge and awareness of HCV among at-risk populations is consistent with the national strategy for prevention and control of HCV. Aims for the first phase (N = 200) are: (1) To characterize access to and the use of mobile phone technology and Internet activity among methadone maintenance treatment (MMT) patients; (2) To measure attitudes regarding the use of digital modalities (text messaging, e-mail, and Internet) to receive health information including HCV and HIV prevention, testing, and treatment information among MMT patients; and (3) To identify predictors of access to and the use of mobile technology and the Internet for health or medical purposes among MMT patients. Based on results obtained in the first phase, the aims for the second phase are: (1) To design and refine a mobile optimized website for the dissemination of HCV and HIV prevention, testing, and treatment information with input from digital technology experts and feedback from MMT patients; and (2) To conduct a randomized pilot study to determine whether tailored motivational text messages will increase the use of the mobile website among MMT patients. We will randomly assign 40 MMT patients who own a mobile phone to one of two conditions: 1) tailored motivational text messages; or 2) no text messages. Assessments will occur at study entry and 30 days post-randomization. We hypothesize that participants randomized to the tailored motivational text message condition will have significantly increased knowledge of HCV, a higher frequency of repeat visits to the website, and will be more likely to complete a personal HCV risk assessment survey and to be tested for HCV at the 30-day follow up than those who do not receive tailored motivational text messages. If feasible and acceptable, the website will provide reliable, efficient, and high-quality HCV health information targeting drug users with the potential for wide dissemination.