scholarly journals Video-Counseling Intervention to Address HIV Care Engagement, Mental Health, and Substance Use Challenges: A Pilot Randomized Clinical Trial for Youth and Young Adults Living with HIV

2021 ◽  
Vol 2 (1) ◽  
pp. 14-25
Author(s):  
Parya Saberi ◽  
Caravella McCuistian ◽  
Emily Agnew ◽  
Angie R. Wootton ◽  
Dominique A. Legnitto Packard ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Trial ◽  
Substance Use ◽  
Young Adults ◽  
Randomized Clinical Trial ◽  
Hiv Care ◽  
Counseling Intervention ◽  
Hiv Care Engagement ◽  
Youth And Young Adults ◽  
Living With Hiv

scholarly journals Addressing HIV care, mental health and substance use among youth and young adults in the Bay Area: description of an intervention to improve information, motivation and behavioural skills

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e042713
Author(s):  
Caravella McCuistian ◽  
Angie R Wootton ◽  
Dominique Legnitto-Packard ◽  
Valerie A. Gruber ◽  
Carol Dawson-Rose ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young Adults ◽  
San Francisco ◽  
Text Messaging ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Bay Area ◽  
Youth Living With Hiv ◽  
Living With Hiv

ObjectiveYouth represent a population disparately impacted by the HIV epidemic. With most new HIV diagnoses occurring among adolescents and young adults, novel approaches to address this disparity are necessary. The objective of the current study was to describe the Youth to Telehealth and Text to Improve Engagement in Care (Y2TEC) intervention, which aims to fill this gap. The Y2TEC intervention (trial registration NCT03681145) offers an innovative approach to improve HIV treatment engagement among youth living with HIV by focusing on treatment barriers related to mental health and substance use. This allows for a holistic approach to providing culturally informed intervention strategies for this population.Participants and settingThe Y2TEC intervention was developed for youth with HIV in the large metropolitan area of the San Francisco Bay Area. The Y2TEC intervention was developed based on formative interdisciplinary research and is grounded in the information–motivation–behavioural skills model.ResultsThe intervention includes 12 sessions each lasting 20–30 minutes, which are delivered through videoconferencing and accompanying bidirectional text messaging. The intervention sessions are individualised, with session dosage in each major content area determined by participant’s level of acuity.ConclusionsThe Y2TEC intervention is well positioned to help decrease HIV-related disparities in youth living with HIV through its innovative use of video-counselling technologies and an integrated focus on HIV, mental health and substance use.

scholarly journals Scoping review of stepped care interventions for mental health and substance use service delivery to youth and young adults

2021 ◽  
Author(s):  
Mai Berger ◽  
Saranee Fernando ◽  
AnnMarie Churchill ◽  
Peter Cornish ◽  
Joanna Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Young Adults ◽  
Service Delivery ◽  
Scoping Review ◽  
Stepped Care ◽  
Youth And Young Adults

scholarly journals WYZ: Results of a pilot study of a mobile health application for engagement in care and antiretroviral therapy adherence among youth and young adults living with HIV (Preprint)

2020 ◽  
Author(s):  
Parya Saberi ◽  
Nadra E. Lisha ◽  
Xavier A. Erguera ◽  
Estie S. Hudes ◽  
Mallory O. Johnson ◽  
...  
Keyword(s):  
Young Adults ◽  
Antiretroviral Therapy ◽  
San Francisco ◽  
Mobile Health ◽  
Pilot Trial ◽  
Hiv Care ◽  
Art Adherence ◽  
Engagement In Care ◽  
Youth And Young Adults ◽  
Living With Hiv

BACKGROUND Youth are globally recognized as being vulnerable to HIV. Younger age has been correlated with worse health outcomes. Mobile health (mHealth) delivered interventions have the potential to meet youth where they are, using a device they already access. OBJECTIVE Using pre-defined benchmarks, we sought to evaluate the feasibility and acceptability of WYZ, an mHealth application, for improved engagement in care and antiretroviral therapy (ART) adherence among youth and young adults living with HIV (YLWH). WYZ was designed and developed with input from YLWH using a Human-Centered Design approach and based on the Information, Motivation, Behavioral Skills framework to address common barriers to care and ART adherence among YLWH. METHODS We recruited YLWH (18–29 years old) in the San Francisco Bay Area to take part in a six-month pilot trial. Their participation included completing a baseline and exit survey and participating in seven phone check-ins about their use of WYZ. RESULTS YLWH (N= 79) reported high levels of feasibility and acceptability with WYZ use. We met pre-defined benchmarks for recruitment, mean log-ins per week, tracking ART adherence, posting chat topics, and app crashes reported. Ease of app download, install, and set up, as well as comfort with security, privacy, and anonymity were highly rated. Additionally, participants reported high satisfaction for a research project that was remotely conducted. Participants used the app for shorter timeframes compared to the pre-defined benchmarks. CONCLUSIONS We noted high feasibility and acceptability with WYZ. Further research to examine the efficacy of WYZ will enable YLWH and their providers to make informed decisions when using, recommending, and prescribing it for improved engagement in HIV care and ART adherence. CLINICALTRIAL NCT03587857

scholarly journals 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

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028522 ◽  
Author(s):  
Angie R Wootton ◽  
Dominique A Legnitto ◽  
Valerie A Gruber ◽  
Carol Dawson-Rose ◽  
Torsten B Neilands ◽  
...  
Keyword(s):  
Mental Health ◽  
Substance Use ◽  
Problem Solving ◽  
Clinical Outcomes ◽  
San Francisco ◽  
Text Messages ◽  
Hiv Care ◽  
Engagement In Care ◽  
Study Staff ◽  
Living With Hiv

IntroductionYouth 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 analysisThe 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 disseminationThis 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 registrationNCT03681145.

scholarly journals WYZ: a pilot study protocol for designing and developing a mobile health application for engagement in HIV care and medication adherence in youth and young adults living with HIV

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e030473 ◽  
Author(s):  
Xavier A. Erguera ◽  
Mallory O. Johnson ◽  
Torsten B. Neilands ◽  
Theodore Ruel ◽  
Beth Berrean ◽  
...  
Keyword(s):  
Young Adults ◽  
Medication Adherence ◽  
San Francisco ◽  
Mobile Health ◽  
Hiv Care ◽  
Mobile Health Application ◽  
Study Staff ◽  
Youth And Young Adults ◽  
Engagement In Hiv Care ◽  
Living With Hiv

IntroductionYouth and young adults bear a disproportionate share of the HIV burden and there is a critical need for interventions to curb health disparities experienced among these age groups. The purpose of our research is to build on our theory-guided model and formative research to develop a mobile health application, called WYZ, for improved engagement in HIV care and antiretroviral therapy adherence, and pilot test it among youth and young adults living with HIV (YLWH). In this paper, we explain the design and development of WYZ for YLWH, describe the design of a forthcoming pilot trial for evaluating the feasibility and acceptability of WYZ and compare WYZ with other mobile health applications being developed to improve engagement in HIV care and antiretroviral medication adherence.Methods and analysisWe used an agile methodology, shown to be useful in software development, and elicited feedback during beta testing to develop WYZ. WYZ is a modular, adaptive and personalised intervention delivered via a mobile phone. It is grounded in the information, motivation, behaviouralskills model which has been valuable for understanding and guiding the development of interventions for complex health behaviours. WYZ was created in collaboration with YLWH aged 18–29 years using a human-centred design approach that emphasises understanding the perspective of the users of the technology. WYZ is intended to improve engagement in HIV care by: (1) enhancing medication adherence self-efficacy, (2) increasing awareness and use of community resources, (3) reducing barriers to communication between youth and their healthcare team, and (4) providing a secure platform for the formation of a private online community of YLWH. We will conduct a 6-month single-arm pilot study to examine feasibility and acceptability of WYZ among 76 YLWH who live or receive care in the San Francisco Bay Area. All study activities, including recruitment, screening, enrolment, study assessments, provision of incentives and exit interviews, will be conducted remotely. We will explore feasibility and acceptability outcomes of the intervention using quantitative and qualitative methods.Ethics and disseminationStudy staff will obtain written consent for study participation from all participants. 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 participants and the community using presentations, community forums, journal publications and/or social media.Trial registration numberNCT03587857; Pre-results.

scholarly journals HIV Care Engagement Among Justice-Involved and Substance Using People of Puerto Rican Origin Who are Living with HIV

2021 ◽  
Author(s):  
Janet J. Wiersema ◽  
Paul A. Teixeira ◽  
Tracy Pugh ◽  
Jacqueline Cruzado-Quiñones ◽  
Alison O. Jordan
Keyword(s):  
Substance Use ◽  
Puerto Rican ◽  
Behavioral Model ◽  
Hiv Care ◽  
Structured Interviews ◽  
Stable Housing ◽  
Antiretroviral Therapy Adherence ◽  
Hiv Care Engagement ◽  
Correctional Settings ◽  
Living With Hiv

AbstractPersons living with diagnosed HIV (PLWDH) are overrepresented in correctional settings, as are Latinx including those of Puerto Rican (PR) origin. Little is known about this population’s HIV care engagement after incarceration. Semi-structured interviews were conducted with 23 PLWDH of PR origin incarcerated in NYC jails using the Behavioral Model for Vulnerable Populations as the theoretical basis. Most participants described a fragile connection to HIV care and inconsistent antiretroviral therapy adherence due to issues including substance use, poverty (e.g. homelessness), and other factors. Most were satisfied with their current communitybased providers and reported that their PR ethnicity and transnational ties to PR did not impact their HIV care, although some preferred Spanish-speaking providers. Greater access to stable housing and HIV care that is convenient to substance use treatment and other services appear to be the greatest needs of PLWDH of PR origin leaving jail.

scholarly journals Promising Approaches for Engaging Youth and Young Adults Living with HIV in HIV Primary Care Using Social Media and Mobile Technology Interventions: Protocol for the SPNS Social Media Initiative (Preprint)

2018 ◽  
Author(s):  
Melissa Medich ◽  
Dallas T Swendeman ◽  
W Scott Comulada ◽  
Uyen H Kao ◽  
Janet J Myers ◽  
...  
Keyword(s):  
United States ◽  
Social Media ◽  
Young Adults ◽  
Health Outcomes ◽  
Mobile Technology ◽  
The United States ◽  
Hiv Care ◽  
Mixed Methods Approach ◽  
Youth And Young Adults ◽  
Living With Hiv

BACKGROUND In the United States, disparities in the rates of HIV care among youth and young adults result from the intersections of factors that include stigma, substance use, homelessness or marginal housing, institutional neglect, and mental health issues. Novel interventions are needed that are geared to youth and young adults. OBJECTIVE In this paper, we aim to describe the interventions used by participating sites for Using Social Media initiative, the process for classifying the intervention components, and the methods for conducting a comprehensive evaluation of the interventions. METHODS In 2015, the Health Resources and Services Administration (HRSA) HIV/AIDS Bureau, Special Projects of National Significance (SPNS) funded the Evaluation and Technical Assistance Center (ETAC) at the University of California, Los Angeles and 10 demonstration projects at sites across the United States that incorporated innovative approaches using a variety of social media and mobile technology strategies designed specifically for youth and young adults living with HIV. The ETAC developed a typology, or a classification system, that systematically summarizes the principal components of the interventions into broader groups and developed a multisite, mixed-methods approach to evaluate them based on the Department of Health and Human Services HIV health outcomes along the HIV care continuum. The mixed-methods approach is key to remove potential biases in assessing the effectiveness of demonstration projects. RESULTS This SPNS project was funded in September 2015, and enrollment was completed on May 31, 2018. A total of 984 participants have been enrolled in the multisite evaluation. Data collection will continue until August 2019. However, data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. CONCLUSIONS This HRSA-funded initiative seeks to increase engagement in HIV medical care, improve health outcomes for people living with HIV, and reduce HIV-related health disparities and health inequities that affect HIV-positive youth and young adults. INTERNATIONAL REGISTERED REPORT RR1-10.2196/10681

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