Tarantino Nicholas, Norman Betty, Enimil Anthony, Asibey Shadrack Osei, Martyn-Dickens Charles, O'Neill Kathleen, Guthrie Kate M, Kwara Awewura, Bock Beth, Mimiaga Matthew J, Brown Larry K
Department of Psychology, Providence College, 1 Cunningham Square, Providence, RI, 02908, USA.
Komfo Anokye Teaching Hospital, Kumasi, Ghana.
AIDS Behav. 2025 Mar;29(3):791-803. doi: 10.1007/s10461-024-04560-3. Epub 2024 Dec 24.
This study examined the feasibility, acceptability, and preliminary efficacy of a mobile intervention called the Text-Based Adherence Game (TAG). TAG aimed to improve HIV treatment adherence among young people with HIV (YPWH) in Ghana. Participants, YPWH aged 18 to 24, were recruited from an HIV clinic in Kumasi, Ghana where study procedures were conducted. A randomized controlled pilot trial was conducted to evaluate TAG (ClinicalTrials.gov Identifier NCT03928717). Participants were randomized to receive TAG or a standard-of-care (SOC) control. All completed quantitative assessments on outcomes preintervention and at two follow-up visits at 6- and 12-months. TAG participants received personalized, semi-automated, and game-based text messages over the six-month intervention period. Primary outcomes included viral load, antiretroviral medication adherence, and missed HIV clinic visits. Secondary outcomes were also explored. Two surveys measured intervention acceptability. 60 YPWH were enrolled. 51 completed all assessments. At the 12-month follow-up assessment, TAG had a significant and positive effect on a measure of antiretroviral adherence but not viral load or missed clinic visits. Positive intervention effects were also found at postintervention and 12 months for several secondary outcomes (e.g., adherence-related social support). Intervention acceptability was generally high. TAG is a novel and promising mobile health intervention approach. Results suggest the need to further develop TAG as it may have the potential to reach populations of YPWH and improve HIV continuum of care outcomes in settings where access to more advanced mobile technology (e.g., smartphones) and the internet is not universal.
本研究考察了一种名为基于文本的依从性游戏（TAG）的移动干预措施的可行性、可接受性和初步疗效。TAG旨在提高加纳感染艾滋病毒的年轻人（YPWH）的艾滋病毒治疗依从性。研究参与者为年龄在18至24岁之间的YPWH，他们是从加纳库马西的一家艾滋病毒诊所招募的，研究程序在此进行。开展了一项随机对照试验性研究以评估TAG（ClinicalTrials.gov标识符NCT03928717）。参与者被随机分配接受TAG或标准护理（SOC）对照。所有参与者在干预前以及6个月和12个月的两次随访时完成了关于结局的定量评估。TAG参与者在为期6个月的干预期内收到个性化、半自动且基于游戏的短信。主要结局包括病毒载量、抗逆转录病毒药物依从性以及错过的艾滋病毒诊所就诊次数。还探讨了次要结局。两项调查衡量了干预的可接受性。共有60名YPWH入组，51名完成了所有评估。在12个月的随访评估中，TAG对抗逆转录病毒依从性的一项指标有显著的积极影响，但对病毒载量或错过的诊所就诊次数没有影响。在干预后和12个月时，对于几个次要结局（如与依从性相关的社会支持）也发现了积极的干预效果。干预的可接受性总体较高。TAG是一种新颖且有前景的移动健康干预方法。结果表明有必要进一步开发TAG，因为它可能有潜力覆盖YPWH人群，并在无法普遍使用更先进移动技术（如智能手机）和互联网的环境中改善艾滋病毒连续护理结局。
