远程医疗和短信干预以改善 HIV 感染者青少年的 HIV 护理参与度、心理健康和物质使用结果：一项试点可行性和可接受性研究方案。
Telehealth and texting intervention to improve HIV care engagement, mental health and substance use outcomes in youth living with HIV: a pilot feasibility and acceptability study protocol.
机构信息
Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, San Francisco, California, USA.
Department of Psychiatry, University of California, San Francisco, San Francisco, USA.
出版信息
BMJ Open. 2019 Jul 16;9(7):e028522. doi: 10.1136/bmjopen-2018-028522.
INTRODUCTION
Youth and young adults living with HIV (YLWH) experience worse clinical outcomes than adults and high rates of behavioural health challenges that impact their engagement in care and adherence to antiretroviral therapy. This study in the San Francisco Bay area aims to evaluate the feasibility, acceptability and preliminary clinical outcomes of a 12-session telehealth counselling series provided to 80 YLWH, including education, motivational enhancement and problem-solving around HIV care, mental health, substance use and other challenges. Findings will provide information about benefits and challenges of telehealth counselling for YLWH and will guide the development of new technology-based strategies for care.
METHODS AND ANALYSIS
The Youth to Telehealth and Text to Improve Engagement in Care study is a pilot randomised, crossover trial examining the feasibility and acceptability of a telehealth counselling intervention consisting of twelve 20-30 min weekly sessions focused on identifying and problem-solving around barriers to HIV care access and adherence and on addressing mental health, substance use and/or other issues. Participants also receive text messages for check-ins, appointment reminders and to improve engagement. Participants complete quantitative online surveys at baseline, 4 and 8 months and qualitative exit interviews. Clinical outcomes, including plasma HIV RNA and CD4+ cell count, are collected from medical records. Study staff will explore outcomes of the intervention using quantitative and qualitative methods.
ETHICS AND DISSEMINATION
This study and its protocols have been approved by the University of California, San Francisco (UCSF) Institutional Review Board. Study staff will work with the UCSF Center for AIDS Prevention Studies' Community Engagement Core and the Youth Advisory Panel to disseminate results to the community, participants and the academic community.
TRIAL REGISTRATION
NCT03681145.
简介
与 HIV 共存的青年和年轻成年人（YLWH）比成年人经历更差的临床结果，并且存在高比例的行为健康挑战，这影响他们参与护理和坚持抗逆转录病毒治疗。本项在旧金山湾区进行的研究旨在评估 80 名 YLWH 接受 12 节基于远程医疗的咨询系列的可行性、可接受性和初步临床结果，该系列包括 HIV 护理、心理健康、药物使用和其他挑战方面的教育、动机增强和解决问题。研究结果将提供有关远程医疗咨询对 YLWH 的益处和挑战的信息，并将指导开发新的基于技术的护理策略。
方法和分析
“青年到远程医疗和文本以改善护理参与度”研究是一项试点随机交叉试验，旨在检查由十二节 20-30 分钟每周一次的咨询组成的远程医疗咨询干预的可行性和可接受性，重点是确定和解决 HIV 护理获取和依从的障碍，以及解决心理健康、药物使用和/或其他问题。参与者还会收到用于签到、预约提醒和提高参与度的短信。参与者在基线、4 个月和 8 个月时完成在线定量调查和定性退出访谈。从病历中收集临床结果，包括血浆 HIV RNA 和 CD4+细胞计数。研究人员将使用定量和定性方法探索干预的结果。
伦理和传播
本研究及其方案已获得加利福尼亚大学旧金山分校（UCSF）机构审查委员会的批准。研究人员将与 UCSF 艾滋病预防研究中心的社区参与核心和青年咨询小组合作，向社区、参与者和学术界传播研究结果。
试验注册
NCT03681145。
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