Mobile Augmented Screening Tool to Increase Adolescent HIV Testing and Linkage to Care

摘要 青少年面临的艾滋病毒风险增加，检测不频繁，与护理的联系不一致，以及缺乏预防 相关知识。我们建议通过完成和评估移动的增强筛查来解决这一问题 (MAS)通过在临床环境中使用平板电脑进行干预，增加青年艾滋病毒检测的工具，然后使用文本 信息，以促进联系，以照顾那些谁测试呈阳性，并提供持续的预防教育，通过 给那些检测结果为阴性的人发短信 许多面临艾滋病毒最大风险的青少年和年轻人不太可能获得初级保健， 因此，获得艾滋病毒检测和预防教育的机会有限。当年轻人接受检测时， 许多人拒绝，因为他们相信（也许是错误的）他们没有风险，或者因为他们害怕被 被污名化我们提议的MAS将使护理提供者能够私下和谨慎地提供常规艾滋病毒检测 和咨询，包括预防教育，以高需求，不同的青少年和年轻的成年人群体， 以低成本。此外，由于联邦法律要求公共和私人保险公司承保常规艾滋病毒检测， 使用我们提出的MAS来测试越来越多的年轻人的医疗保健提供者可能会产生 通过增加保险报销，实现了可观的额外收入。 MAS将由3个组件组成。基于平板电脑的干预，包括简短的视频（约5 旨在增加青少年艾滋病毒检测，自动短信，以促进联系， 测试结果为阳性的人，测试结果为阴性或拒绝测试的人接受基于文本的教育。 我们的团队已经创建了多个NIH资助的干预措施，以增加艾滋病毒检测患者中的高 城市紧急部门（ED）。患者，包括最初拒绝测试的年轻人，引用了 隐私和我们基于技术的方法的清晰度是他们最终同意检测艾滋病毒的原因。期间 在第一阶段资助期间，我们对年轻的艾德患者进行了形成性研究，然后制作了视频 部分MAS。初步评估表明，该视频是高度可接受的，导致重要的知识 增加，并鼓励测试。我们现在计划在第二阶段进行有效性试验。 数字健康赋权是一个少数和妇女拥有的SBC。吴素英校长和伊恩大卫校长 Aronson博士拥有超过10年的技术产品开发经验，包括视频- 基于健康干预措施和其他数字内容，为商业，非营利和大学客户。我们寻求 沿着我们第一阶段工作的初步成功，在这一专业知识的基础上：完成全面干预 开发;并通过对13 - 24岁的艾德患者进行随机对照试验来评估产品 （N = 350），以及定性访谈的一个子集的年轻患者（n = 40）和艾德工作人员（n = 10）。

ABSTRACT Adolescents face increased HIV risk, infrequent testing, inconsistent linkage to care, and a lack of prevention related knowledge. We propose to address this by completing and evaluating the Mobile Augmented Screening (MAS) tool to increase youth HIV testing via a tablet-based intervention in clinical settings, and then use text messages to facilitate linkage to care for those who test positive, and deliver ongoing prevention education via text message to those who test negative. Many adolescents and young adults at greatest risk for HIV are unlikely to have access to primary care, and therefore have limited access to HIV testing and prevention education. When young people are offered testing, many decline because they believe (perhaps incorrectly) they are not at risk or because they fear being stigmatized. Our proposed MAS will enable care providers to privately and discretely offer routine HIV testing and counseling, including prevention education, to high need, diverse adolescent and young adult populations at a low cost. Further, because federal law requires public and private insurers to cover routine HIV testing, healthcare providers who use our proposed MAS to test an increased number of youth can potentially generate significant additional revenue through increased insurance reimbursements. The MAS will consist of 3 components. A tablet-based intervention including a brief video (approximately 5 minutes) designed to increase adolescent HIV testing, automated text-messages to facilitate linkage to care for those who test positive, and text-based education for those who test negative or decline testing. Our team has created multiple NIH-funded interventions to increase HIV testing among patients in high volume, urban emergency departments (EDs). Patients, including youth who initially declined testing, cited the privacy and clarity of our technology-based approach as reasons they ultimately agreed to test for HIV. During the Phase I grant period we conducted formative research with young ED patients, and then created the video portion of the MAS. Preliminary evaluations indicate the video was highly acceptable, led to significant knowledge increases, and encouraged testing. We now plan an effectiveness trial during the Phase II period. Digital Health Empowerment is a minority and woman owned SBC. Principals So-Young Oh and Ian David Aronson, Ph.D. have more than 10 years experience developing technology products together, including video- based health interventions and other digital content, for commercial, non-profit, and university clients. We seek to build upon this expertise, along with the initial success of our Phase I work, to: complete full intervention development; and evaluate the product through a randomized controlled trial with ED patients aged 13 – 24 (N=350), as well as qualitative interviews with a subset of young patients (n=40) and ED staff (n=10).