Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, United States.
Specialists in Global Health, Encinitas, CA, United States.
JMIR Mhealth Uhealth. 2024 May 3;12:e53596. doi: 10.2196/53596.
A digital health technology's success or failure depends on how it is received by users.
We conducted a user experience (UX) evaluation among persons who used the Food and Drug Administration-approved Digital Health Feedback System incorporating ingestible sensors (ISs) to capture medication adherence, after they were prescribed oral pre-exposure prophylaxis (PrEP) to prevent HIV infection. We performed an association analysis with baseline participant characteristics, to see if "personas" associated with positive or negative UX emerged.
UX data were collected upon exit from a prospective intervention study of adults who were HIV negative, prescribed oral PrEP, and used the Digital Health Feedback System with IS-enabled tenofovir disoproxil fumarate plus emtricitabine (IS-Truvada). Baseline demographics; urine toxicology; and self-report questionnaires evaluating sleep (Pittsburgh Sleep Quality Index), self-efficacy, habitual self-control, HIV risk perception (Perceived Risk of HIV Scale 8-item), and depressive symptoms (Patient Health Questionnaire-8) were collected. Participants with ≥28 days in the study completed a Likert-scale UX questionnaire of 27 questions grouped into 4 domain categories: overall experience, ease of use, intention of future use, and perceived utility. Means and IQRs were computed for participant total and domain subscores, and linear regressions modeled baseline participant characteristics associated with UX responses. Demographic characteristics of responders versus nonresponders were compared using the Fisher exact and Wilcoxon rank-sum tests.
Overall, 71 participants were enrolled (age: mean 37.6, range 18-69 years; n=64, 90% male; n=55, 77% White; n=24, 34% Hispanic; n=68, 96% housed; and n=53, 75% employed). No demographic differences were observed in the 63 participants who used the intervention for ≥28 days. Participants who completed the questionnaire were more likely to be housed (52/53, 98% vs 8/10, 80%; P=.06) and less likely to have a positive urine toxicology (18/51, 35% vs 7/10, 70%; P=.08), particularly methamphetamine (4/51, 8% vs 4/10, 40%; P=.02), than noncompleters. Based on IQR values, ≥75% of participants had a favorable UX based on the total score (median 3.78, IQR 3.17-4.20), overall experience (median 4.00, IQR 3.50-4.50), ease of use (median 3.72, IQR 3.33-4.22), and perceived utility (median 3.72, IQR 3.22-4.25), and ≥50% had favorable intention of future use (median 3.80, IQR 2.80-4.40). Following multipredictor modeling, self-efficacy was significantly associated with the total score (0.822, 95% CI 0.405-1.240; P<.001) and all subscores (all P<.05). Persons with more depressive symptoms reported better perceived utility (P=.01). Poor sleep was associated with a worse overall experience (-0.07, 95% CI -0.133 to -0.006; P=.03).
The UX among persons using IS-enabled PrEP (IS-Truvada) to prevent HIV infection was positive. Association analysis of baseline participant characteristics linked higher self-efficacy with positive UX, more depressive symptoms with higher perceived utility, and poor sleep with negative UX.
数字健康技术的成功或失败取决于它被用户接受的程度。
我们对使用经食品和药物管理局批准的数字健康反馈系统（结合可摄入传感器[IS]）来捕捉药物依从性的预防 HIV 感染的口服暴露前预防（PrEP）处方使用者进行了用户体验（UX）评估。我们进行了一项关联分析，以了解是否出现了与积极或消极 UX 相关的“人物角色”。
对 HIV 阴性、服用口服 PrEP 并使用带有 IS 功能的替诺福韦二吡呋酯和恩曲他滨（IS-Truvada）的数字健康反馈系统的成年人进行前瞻性干预研究，参与者在退出时收集 UX 数据。收集基线人口统计学；尿液毒理学；以及评估睡眠（匹兹堡睡眠质量指数）、自我效能、习惯性自我控制、HIV 风险感知（HIV 风险量表 8 项）和抑郁症状（患者健康问卷-8）的自我报告问卷。在研究中完成 ≥28 天的参与者完成了包含 27 个问题的 27 个问题的李克特量表 UX 问卷，分为 4 个领域类别：整体体验、易用性、未来使用意向和感知效用。计算参与者总分和领域子分数的平均值和 IQR，并对与 UX 反应相关的基线参与者特征进行线性回归建模。使用 Fisher 精确检验和 Wilcoxon 秩和检验比较应答者与非应答者的人口统计学特征。
总体而言，共有 71 名参与者入组（年龄：平均 37.6 岁，范围 18-69 岁；n=64，90%男性；n=55，77%白人；n=24，34%西班牙裔；n=68，96%有住房；n=53，75%有工作）。在使用干预措施进行 ≥28 天的 63 名参与者中，没有观察到人口统计学差异。完成问卷的参与者更有可能有住房（52/53，98%比 10/10，80%；P=.06），尿液毒理学阳性的可能性更小（18/51，35%比 10/10，70%；P=.08），特别是甲基苯丙胺（4/51，8%比 10/10，40%；P=.02），而非完成者。根据 IQR 值，基于总分（中位数 3.78，IQR 3.17-4.20）、整体体验（中位数 4.00，IQR 3.50-4.50）、易用性（中位数 3.72，IQR 3.33-4.22）和感知效用（中位数 3.72，IQR 3.22-4.25），≥75%的参与者具有良好的 UX，并且≥50%的参与者具有良好的未来使用意向（中位数 3.80，IQR 2.80-4.40）。在多预测因子建模后，自我效能与总分（0.822，95%CI 0.405-1.240；P<.001）和所有子分数（均 P<.05）显著相关。报告有更多抑郁症状的人感知效用更好（P=.01）。较差的睡眠与整体体验较差相关（-0.07，95%CI -0.133 至 -0.006；P=.03）。
预防 HIV 感染的 IS 启用 PrEP（IS-Truvada）使用者的 UX 是积极的。对基线参与者特征的关联分析将更高的自我效能与积极的 UX 联系起来，将更多的抑郁症状与更高的感知效用联系起来，将较差的睡眠与负面的 UX 联系起来。
