mHealth Messaging to Motivate Quitline use and Quitting among Persons Living With HIV in Vietnam (M2Q2-HIV)

7.项目总结/摘要 我们建议M2 Q2-HIV [移动健康信息，以激励戒烟热线的使用和戒烟的人生活在一起 越南的艾滋病毒（PLWH）（M2 Q2-HIV）]，我们目前的计算机定制戒烟的适应 干预越南。我们寻求促进未充分利用的政府公共卫生资源（退出线）， 尼古丁替代疗法（NRT）在PLWH中以可持续的方式。吸烟和 艾滋病毒/艾滋病对越南的公共卫生构成严重威胁。越南正在应对这两个挑战， 平行而不是综合计划。越南目前有431个艾滋病病毒检测门诊部，其中188个诊所 提供抗逆转录病毒治疗，费用由公共保险支付。越南已设立电话“退出线” 与受过训练的烟草治疗专家进行咨询，他们也提供NRT。这些临床（艾滋病毒）和公共 卫生资源（退出热线）没有连接起来，降低了这两个方案的影响。为了连接这些资源，我们 我将调整我们目前的干预，为计算机定制，基于文本的戒烟在越南是具体的 艾滋病毒感染者吸烟行为，例如，通过制定动机和量身定制的 吸烟者写的信。为了进一步增加对PLWH吸烟者的信息相关性，我们将添加 计算机定制创新：机器学习，集体智慧系统。像亚马逊这样的公司 集体智能系统不断学习和适应用户反馈（例如，喜欢的页面或产品 购买），从而增加消息的相关性。我们开发了第一个集体智能系统， 吸烟者。我们的试验数据表明，持续学习的能力可能对吸烟者更有益。 不太愿意戒烟的人比如艾滋病病毒携带者我们将通过随机对照试验检测M2 Q2-HIV 在越南北方的两个省，有600名艾滋病毒携带者和艾滋病病毒携带者吸烟者（26个诊所; 9，877名艾滋病毒患者）。在目标1中，我们 开展形成性工作，为艾滋病毒携带者和艾滋病病毒携带者吸烟者准备M2 Q2-艾滋病毒系统。在目标2中，我们将随机化， 跟踪吸烟者六个月。我们的有效性假设将评估一氧化碳（CO）验证，6- 月、七天时点流行停止。过程假设将评估自我效能，退出线和NRT 使用，并测试我们的假设模型，具体的测量过程将部分介导观察 干预效果。通过对主要利益相关者和艾滋病毒携带者吸烟者进行定性访谈，目标3将 支持在全国范围内进行M2 Q2-艾滋病毒传播， 实用、稳健的实施和可持续性模型（PRISM）。这个项目建立在一个长期的， 越南卫生部、Bach Mai Quitline、 人口健康与发展，河内医科大学）和UMMS。我们的团队在吸烟方面有专业知识 戒烟、艾滋病毒干预，包括与伴随药物使用有关的污名化，以及 复杂的干预措施。越南卫生部致力于将M2 Q2-HIV作为一种永久的 国家基础设施的一部分，如果证明有效。

7. PROJECT SUMMARY/ABSTRACT We propose M2Q2-HIV [mHealth Messaging to Motivate Quitline use and Quitting among Persons Living with HIV (PLWH) in Vietnam (M2Q2-HIV)], an adaptation of our current computer-tailored smoking cessation intervention in Vietnam. We seek to promote underused government resources for public health (quitline) and nicotine replacement therapy (NRT) among PLWH in a sustainable manner. The intersection of smoking and HIV/AIDS poses a serious public health threat in Vietnam. Vietnam is dealing with these two challenges with parallel rather than integrated plans. Vietnam currently has 431 outpatient clinics for HIV testing, with 188 clinics providing antiretroviral (ARV) treatment, covered by public insurance. Vietnam has setup telephone “quitline” counseling with trained tobacco treatment specialists who also provide NRT. These clinical (HIV) and public health resources (quitlines) are not connected, reducing both programs’ impact. To connect these resources, we will adapt our current intervention for computer-tailored, text-based smoking cessation in Vietnam to be specific to PLWH smoking behavior, for example, by addressing HIV stigma via developing motivational and tailored messages written by PLWH smokers. To further increase message relevance for PLWH smokers, we will add a computer-tailoring innovation: a machine-learning, collective intelligence system. Companies like Amazon use collective intelligence systems to continuously learn and adapt to user feedback (e.g., pages liked, or products purchased), thus, increasing message relevance. We developed the first collective intelligence system for smokers. Our pilot data indicates that the ability to continuously learn may be even more beneficial for smokers who are less ready to quit, such as like PLWH. We will test M2Q2-HIV by conducting a randomized control trial with 600 PLWH smokers in two provinces in Northern Vietnam (26 clinics; 9,877 HIV patients). In Aim 1, we will conduct formative work to prepare the M2Q2-HIV system for PLWH smokers. In Aim 2, we will randomize and follow smokers for six months. Our effectiveness hypothesis will evaluate carbon monoxide (CO) verified, six- month, seven-day point prevalence cessation. Process hypotheses will evaluate self-efficacy, quitline and NRT use, and test our hypothesized model that specific measured processes will partially mediate observed intervention effectiveness. Using qualitative interviews with key stakeholders and PLWH smokers, Aim 3 will support nationwide M2Q2-HIV dissemination assessing acceptability and contextual factors guided by the Practical, Robust Implementation and Sustainability Model (PRISM). This project builds upon a long-standing, successful collaboration between institutions in Vietnam (Ministry of Health, Bach Mai Quitline, Institute of Population Health and Development, Hanoi Medical University) and UMMS. Our team has expertise in smoking cessation, HIV intervention including stigma related to concomitant substance use, and implementation of complex interventions. The Vietnam Ministry of Health is committed to incorporating M2Q2-HIV as a permanent part of the national infrastructure if proven effective.