基于社交媒体的干预措施对改善 HIV 感染者长期生活质量的中介效应：一项随机对照试验的二次分析。

Mediating Effects of Stigma and Depressive Symptoms in a Social Media-Based Intervention to Improve Long-term Quality of Life Among People Living With HIV: Secondary Analysis of a Randomized Controlled Trial.

机构信息

Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Sun Yat-sen Center for Global Health, Guangzhou, China.

出版信息

J Med Internet Res. 2021 Nov 9;23(11):e27897. doi: 10.2196/27897.

DOI:10.2196/27897

PMID:34751654

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8663519/

Abstract

BACKGROUND

Mobile health (mHealth) interventions have been shown to effectively improve the quality of life (QOL) among people living with HIV. However, little is known about the long-term effects of mHealth interventions.

OBJECTIVE

This study aims to explore the intervention mechanisms of a social media-based intervention, Run4Love, on the QOL of people with HIV over across a 9-month follow-up period.

METHODS

We recruited people living with HIV who were concurrently experiencing elevated depressive symptoms from an HIV outpatient clinic in South China. A total of 300 eligible participants were randomized either to the intervention group or the control group in a 1:1 ratio after they provided informed consent and completed a baseline survey. The intervention group received a 3-month WeChat-based intervention, comprising cognitive-behavioral stress management (CBSM) courses and physical activity promotion. The control group received a printed brochure on nutrition guidelines in addition to the usual care for HIV treatment. Neither participants nor the research staff were blinded to group assignment. All patients were followed at 3, 6, and 9 months. The primary outcome was depressive symptoms. Structural equation model (SEM) with longitudinal data was conducted to examine the sequential mediating effects of HIV-related stigma and depressive symptoms on the long-term intervention effects on participants' QOL.

RESULTS

About 91.3% (274/300), 88.3% (265/300), and 86.7% (260/300) of all participants completed follow-up surveys at 3, 6, and 9 months, respectively. Results showed that the intervention had significantly improved participants' QOL at 9 months, via complete mediating effects of reduced HIV-related stigma at 3 months and decreased depressive symptoms at 6 months. No adverse events were reported.

CONCLUSIONS

These findings underscore the critical roles of HIV-related stigma and depressive symptoms in an mHealth intervention with long-term effects on QOL improvements. We call for targeted mHealth interventions to improve QOL among people living with HIV, especially social media-based interventions that can address HIV-related stigma and alleviate depressive symptoms.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR-IPR-17012606; https://www.chictr.org.cn/showproj.aspx?proj=21019.

摘要

背景

移动医疗（mHealth）干预措施已被证明可有效提高艾滋病毒感染者的生活质量（QOL）。然而，对于 mHealth 干预措施的长期效果知之甚少。

目的

本研究旨在探讨基于社交媒体的干预措施 Run4Love 在 9 个月的随访期间对艾滋病毒感染者生活质量的干预机制。

方法

我们从中国南方的一家艾滋病门诊招募了同时出现抑郁症状升高的艾滋病毒感染者。在知情同意并完成基线调查后，共有 300 名符合条件的参与者以 1:1 的比例随机分配到干预组或对照组。干预组接受了为期 3 个月的基于微信的干预，包括认知行为应激管理（CBSM）课程和促进身体活动。对照组除了接受艾滋病毒治疗的常规护理外，还收到了一本关于营养指南的印刷小册子。参与者和研究人员都不知道分组情况。所有患者均在 3、6 和 9 个月时进行随访。主要结局是抑郁症状。对纵向数据进行结构方程模型（SEM）分析，以检验 HIV 相关耻辱感和抑郁症状对参与者生活质量的长期干预效果的顺序中介效应。

结果

约 91.3%（274/300）、88.3%（265/300）和 86.7%（260/300）的所有参与者分别在 3、6 和 9 个月时完成了随访调查。结果显示，干预组在 9 个月时显著改善了参与者的生活质量，这是通过在 3 个月时降低 HIV 相关耻辱感和在 6 个月时降低抑郁症状的完全中介效应实现的。未报告不良事件。