当前时间研究中的暴露评估:在非法药物使用者社区队列中进行实时数据收集的实施、可行性和可接受性。
The exposure assessment in current time study: implementation, feasibility, and acceptability of real-time data collection in a community cohort of illicit drug users.
作者信息
Kirk Gregory D, Linas Beth S, Westergaard Ryan P, Piggott Damani, Bollinger Robert C, Chang Larry W, Genz Andrew
机构信息
Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21205, USA ; Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
出版信息
AIDS Res Treat. 2013;2013:594671. doi: 10.1155/2013/594671. Epub 2013 Nov 6.
Objective. We describe the study design and evaluate the implementation, feasibility, and acceptability of an ecological momentary assessment (EMA) study of illicit drug users. Design. Four sequential field trials targeting observation of 30 individuals followed for a four week period. Participants. Participants were recruited from an ongoing community-cohort of current or former injection drug users. Of 113 individuals enrolled, 109 completed study procedures during four trials conducted from November 2008 to May 2013. Methods. Hand-held electronic diaries used in the initial trials were transitioned to a smartphone platform for the final trial with identical data collection. Random-prompts delivered five times daily assessed participant location, activity, mood, and social context. Event-contingent data collection involved participant self-reports of illicit drug use and craving. Main Outcome Measures. Feasibility measures included participant retention, days of followup, random-prompt response rates, and device loss rate. Acceptability was evaluated from an end-of-trial questionnaire. Sociodemographic, behavioral, clinical, and trial characteristics were evaluated as correlates of weekly random-prompt response rates ≥80% using logistic regression with generalized estimating equations. Results. Study participants were a median of 48.5 years old, 90% African American, 52% male, and 59% HIV-infected with limited income and educational attainment. During a median followup of 28 days, 78% of 11,181 random-prompts delivered were answered (mean of 2.8 responses daily), while 2,798 participant-initiated events were reported (30% drug use events; 70% craving events). Self-reported acceptability to study procedures was uniformly favorable. Device loss was rare (only 1 lost device every 190 person-days of observation). Higher educational attainment was consistently associated with a higher response rate to random-prompts, while an association of HIV infection with lower response rates was not observed after accounting for differences in trial recruitment procedures. Conclusion. Near real-time EMA data collection in the field is feasible and acceptable among community-dwelling illicit drug users. These data provide the basis for future studies of EMA-informed interventions to prevent drug relapse and improve HIV treatment outcomes in this population.
目的。我们描述了一项针对非法药物使用者的生态瞬时评估(EMA)研究的研究设计,并评估其实施情况、可行性和可接受性。设计。四项连续的现场试验,目标是观察30名个体,为期四周。参与者。参与者从一个正在进行的现役或曾用注射药物者社区队列中招募。在2008年11月至2013年5月进行的四项试验中,113名登记个体中有109名完成了研究程序。方法。最初试验中使用的手持式电子日记在最后一次试验中转换为智能手机平台,数据收集相同。每天随机提示五次,评估参与者的位置、活动、情绪和社会背景。事件相关的数据收集包括参与者对非法药物使用和渴望的自我报告。主要结局指标。可行性指标包括参与者保留率、随访天数、随机提示回复率和设备丢失率。通过试验结束时的问卷评估可接受性。使用广义估计方程的逻辑回归,将社会人口统计学、行为、临床和试验特征评估为每周随机提示回复率≥80%的相关因素。结果。研究参与者的年龄中位数为48.5岁,90%为非裔美国人,52%为男性,59%感染艾滋病毒,收入和教育程度有限。在中位随访28天期间,11181次随机提示中有78%得到了回复(平均每天2.8次回复),同时报告了2798起参与者发起的事件(30%为药物使用事件;70%为渴望事件)。对研究程序的自我报告可接受性一致良好。设备丢失很少见(每190人日观察仅丢失1台设备)。较高的教育程度始终与对随机提示的较高回复率相关,而在考虑试验招募程序的差异后,未观察到艾滋病毒感染与较低回复率之间的关联。结论。在社区居住的非法药物使用者中,现场近实时EMA数据收集是可行且可接受的。这些数据为未来基于EMA的干预措施研究提供了基础,以预防该人群的药物复发并改善艾滋病毒治疗结果。