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

摘要 青少年面临艾滋病毒风险增加、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增强筛查来解决这个问题 (MAS)工具，通过临床环境中基于平板的干预增加青年艾滋病毒检测，然后使用文本 信息，以促进联系，以照顾那些检测呈阳性的人，并通过 给那些检测呈阴性的人发短信。 许多感染艾滋病毒风险最高的青少年和年轻人不太可能获得初级保健，以及 因此，获得艾滋病毒检测和预防教育的机会有限。当给年轻人提供测试时， 许多人拒绝是因为他们相信(也许是错误的)他们没有风险，或者是因为他们害怕 被羞辱了。我们建议的MAS将使护理人员能够私下和离散地提供常规艾滋病毒检测 和咨询，包括预防教育，以满足高需求、多样化的青少年和青壮年人口 而且成本很低。此外，由于联邦法律要求公共和私人保险公司承保常规的艾滋病毒检测， 使用我们建议的MAS测试增加的年轻人数量的医疗保健提供商可能会产生 通过增加保险报销大幅增加收入。 MAS将由3个组件组成。基于平板电脑的干预，包括一段简短的视频(约5 分钟)，旨在增加青少年艾滋病毒检测，自动化短信，以促进联系护理 那些检测呈阳性的人，以及对那些检测为阴性或拒绝检测的人进行基于文本的教育。 我们的团队已经创建了多个由NIH资助的干预措施，以提高高血压病患者的艾滋病毒检测 卷，城市急救部门(EDS)。患者，包括最初拒绝检测的年轻人，引用了 他们最终同意检测艾滋病毒的原因是我们以技术为基础的方法的隐私和清晰度。在.期间 在第一阶段资助期间，我们对年轻的ED患者进行了形成性研究，然后制作了视频 MAS的一部分。初步评估表明，这段视频是高度可接受的，导致了大量的知识 增加，并鼓励测试。我们现在计划在第二阶段期间进行一项有效性试验。 数字健康赋权是一家少数族裔和女性拥有的SBC。校长苏英·吴和伊恩·大卫 Aronson博士拥有10多年共同开发技术产品的经验，包括视频- 基于健康干预和其他数字内容，面向商业、非营利和大学客户。我们在寻找 在此专业知识的基础上，随着我们第一阶段工作的初步成功，以：完成全面干预 开发；并通过对13-24岁的ED患者进行随机对照试验来评估该产品 (n=350)，以及对部分年轻患者(n=40)和急诊室工作人员(n=10)的定性访谈。

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).