scholarly journals Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Virginia A Fonner ◽  
Samuel Kennedy ◽  
Rohan Desai ◽  
Christie Eichberg ◽  
Lisa Martin ◽  
...  
Keyword(s):  
Mobile Health ◽  
Text Messaging ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Adherence Support ◽  
Patient Provider Communication ◽  
Communication Modalities ◽  
Video Calling ◽  
Living With Hiv

BACKGROUND Patient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized. OBJECTIVE The purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina. METHODS We conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses. RESULTS Most patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload. CONCLUSIONS Patients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients. CLINICALTRIAL

scholarly journals Patient-Provider Text Messaging and Video Calling Among Case-Managed Patients Living With HIV: Formative Acceptability and Feasibility Study

10.2196/22513 ◽  
2021 ◽  
Vol 5 (5) ◽  
pp. e22513
Author(s):  
Virginia A Fonner ◽  
Samuel Kennedy ◽  
Rohan Desai ◽  
Christie Eichberg ◽  
Lisa Martin ◽  
...  
Keyword(s):  
Mobile Health ◽  
Text Messaging ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Adherence Support ◽  
Patient Provider Communication ◽  
Communication Modalities ◽  
Video Calling ◽  
Living With Hiv

Background Patient-provider communication is critical for engaging and retaining people living with HIV in care, especially among medically case-managed patients in need of service coordination and adherence support. Expanding patient-provider communication channels to include mobile health modalities, such as text messaging and video calling, has the potential to facilitate communication and ultimately improve clinical outcomes. However, the implementation of these communication modalities in clinical settings has not been well characterized. Objective The purpose of this study is to understand patient and provider perspectives on the acceptability of and preferences for using text messaging and video calling as a means of communication; perceived factors relevant to adoption, appropriateness, and feasibility; and organizational perspectives on implementation within an HIV clinic in South Carolina. Methods We conducted 26 semistructured in-depth interviews among patients receiving case management services (n=12) and clinic providers (n=14) using interview guides and content analysis informed by the Proctor taxonomy of implementation outcomes and the Consolidated Framework for Implementation Research. Participants were purposefully sampled to obtain maximum variation in terms of age and gender for patients and clinic roles for providers. The data were analyzed using quantitative and qualitative content analyses. Results Most patients (11/12, 92%) and providers (12/14, 86%) agreed that they should have the capacity to text message and/or video call each other. Although consensus was not reached, most preferred using a secure messaging app rather than standard text messaging because of the enhanced security features. Perceived benefits to adoption included the added convenience of text messaging, and potential barriers included the cost and access of smartphone-based technology for patients. From an organizational perspective, some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload. Conclusions Patients and providers perceived text messaging and video calling as acceptable, appropriate, and feasible and felt that these expanded modes of communication could help meet patients’ needs while being safe and not excessively burdensome. Although patients and providers mostly agreed on implementation barriers and facilitators, several differences emerged. Taking both perspectives into account when using implementation frameworks is critical for expanding mobile health–based communication, especially as implementation requires active participation from providers and patients.

scholarly journals Healthcare Providers’ Perspectives and Role in Improving Patient Engagement in HIV Treatment and Care in Almaty, Kazakhstan

2021 ◽  
Vol 18 (22) ◽  
pp. 12138
Author(s):  
Elizabeth J. King ◽  
Ainur Zh. Kussainova ◽  
Jangul Erlon-Baurjan ◽  
Zhamilya S. Nugmanova
Keyword(s):  
Healthcare Providers ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Provider Communication ◽  
Patient Provider Communication ◽  
Living With Hiv ◽  
Communication Interventions ◽  
The City ◽  
Depth Interviews ◽  
Improve Patient

The HIV epidemic continues to grow in Eastern Europe and Central Asia. At the same time, there are major gaps in engagement in HIV treatment and care among people living with HIV (PLHIV) in the region, including Kazakhstan. Healthcare providers may have the potential to improve patients’ initiation of and adherence to HIV treatment; however, their perspectives and experiences are often overlooked in the research from Kazakhstan. The purpose of our study was to gain an in-depth understanding of how providers perceive the factors influencing PLHIV’s engagement in HIV treatment and care and to identify opportunities for expanding the role that providers can have in improving patient initiation and adherence to treatment in Kazakhstan. Through purposive sampling, we conducted in-depth interviews with 14 healthcare providers at the City AIDS Center in Almaty. We used team-based coding and thematic analysis in order to analyze the data. Quotes from providers were translated from Kazakh and Russian to English to illustrate the themes. Our results show that providers currently view their role as the need to break down myths around ART medications, and to educate and motivate patients to accept their diagnosis and learn to live with HIV. The need to address stigma and social isolation among PLHIV, the risk of overworked providers, and the need to improve patient-provider communication strategies are areas to consider for further interventions. Patient-provider communication interventions are needed in Kazakhstan in order to help meet the country’s 90-90-90 HIV targets.

scholarly journals Mobile health (mhealth) interventions for treatment adherence and outcomes of care for cardio-metabolic disease among adults living with HIV: A systematic review (Preprint)

2020 ◽  
Author(s):  
Kemi Odukoya ◽  
Maxwell Akanbi ◽  
Linda O'Dwyer ◽  
Chidumga Ohazurike ◽  
Brenda Isikekpei ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Mobile Health ◽  
Metabolic Diseases ◽  
People Living With Hiv ◽  
Web Based ◽  
Outcomes Of Care ◽  
Patterns Of Use ◽  
Adherence Support ◽  
Telephone Calls ◽  
Living With Hiv

BACKGROUND The success of antiretroviral therapy (ART) has led to an increase in the risk of cardio-metabolic diseases (CMD) among people living with HIV (PLHIV). OBJECTIVE To examine the patterns of use of mobile health (mhealth) interventions to improve treatment adherence or outcomes of care of CMD among PLHIV. METHODS Studies were included if they had at least one component that used a mobile intervention to address treatment adherence and/or one or more of the stated outcomes of care for CMD among PLHIV RESULTS Ten studies were included in the review, four of which had published results. The remaining six were articles that described mhealth interventions for PLHIV. The categories of mhealth interventions ranged from short messaging, telephone calls and wearable devices to smartphone and desktop web-based mobile applications, with short messaging and telephone calls being the most common. Several of the outcomes in this review were only indirectly linked to CMD, with most studies reporting the effectiveness of the interventions CONCLUSIONS Due to the limited number of published studies, no definitive conclusions can be made on the effectiveness of mhealth interventions for adherence support in PLHIV with CMD CLINICALTRIAL The study protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) CRD86940 (http://www.crd.york.ac.uk/prospero).

scholarly journals A pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Elexis C. Kierstead ◽  
Emily Harvey ◽  
Denisse Sanchez ◽  
Kimberly Horn ◽  
Lorien C. Abroms ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Smoking Cessation ◽  
Self Efficacy ◽  
Text Messaging ◽  
Controlled Trial ◽  
P Value ◽  
People Living With Hiv ◽  
Randomized Controlled ◽  
Living With Hiv ◽  
Pilot Randomized Controlled Trial

Abstract Objective Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. Results The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. Clinical trial: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.

scholarly journals Implementation of social protection schemes for people living with HIV in three districts of Rajasthan state, India – a mixed methods study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 248
Author(s):  
B Gowthamghosh ◽  
Rosenara Huidrom ◽  
Visvanathan Arumugam ◽  
Neeraj Pathak ◽  
Neetu Purohit ◽  
...  
Keyword(s):  
Social Protection ◽  
Secondary Data ◽  
People Living With Hiv ◽  
Implementation Barriers ◽  
Application Process ◽  
Provider Perspectives ◽  
Pension Schemes ◽  
Care And Support ◽  
Important Barrier ◽  
Living With Hiv

Background: In India, public social protection schemes for marginalized populations are extended to people living with HIV (PLHIV) and their households. Care and Support Centres (CSCs) linked to antiretroviral therapy (ART) centres play a key role in linking PLHIV to the schemes. In three districts of Rajasthan, India, we assessed the linkage of PLHIV registered at CSCs (2016–18) to social protection schemes and explored PLHIV and provider perspectives into barriers and suggested solutions for improving linkage. Methods: This was an explanatory mixed method study involving a descriptive quantitative phase using secondary data, followed by a descriptive qualitative phase involving face-to-face in-depth (five PLHIV) and key informant (three CSC staff) interviews. Results: Of 1123 registered PLHIV at CSCs, 1026 (91%) expressed willingness to avail social protection schemes. Of 1026, 94% were linked to any one scheme; 52% to Palanhar, 51% to bus fare concession and 42% to widow pension schemes. The perceived barriers were: authenticating Aadhaar number (unique identification number provided to all Indians using their registered mobile phone number), cumbersome application processes for each scheme, limited utility of travel concession, delayed and/or irregular disbursement of benefits and non-availability of comprehensive information, education and communication material with details of all schemes and their application processes. Reaching out to all PLHIV in the designated district was a huge task for outreach workers. Another important barrier was the potential disclosure of positive status to various stakeholders in order to avail the schemes. Suggested solutions were a single window default application process at ART centres with a smart card and a single pamphlet at ART centres with all the required details. Conclusions: Bus fare concession, Palanhar and widow pension schemes were the most widely accepted and linked schemes by PLHIV. Implementation barriers were identified that need to be addressed to improve the linkage.

scholarly journals Provider perspectives on patient-provider communication for adjuvant endocrine therapy symptom management

2016 ◽  
Vol 25 (4) ◽  
pp. 1055-1061 ◽  
Author(s):  
Kea Turner ◽  
Cleo A Samuel ◽  
Heidi AS Donovan ◽  
Ellen Beckjord ◽  
Alexandra Cardy ◽  
...  
Keyword(s):  
Endocrine Therapy ◽  
Symptom Management ◽  
Adjuvant Endocrine Therapy ◽  
Provider Communication ◽  
Provider Perspectives ◽  
Patient Provider Communication

scholarly journals Efficacy and Impact of Digital HIV Care Navigation in Young People Living With HIV in San Francisco, California: Prospective Study (Preprint)

2020 ◽  
Author(s):  
Sean Arayasirikul ◽  
Caitlin Turner ◽  
Dillon Trujillo ◽  
Victory Le ◽  
Erin C Wilson
Keyword(s):  
Primary Care ◽  
Young People ◽  
San Francisco ◽  
Text Messaging ◽  
Hiv Care ◽  
Computer Assisted ◽  
People Living With Hiv ◽  
Hiv Care Continuum ◽  
Care Continuum ◽  
Living With Hiv

BACKGROUND Young people are disproportionately impacted by HIV infection and exhibit poor HIV care continuum outcomes. Mobile health (mHealth) interventions are promising approaches to meet the unique needs of young people living with HIV. Youth-focused interventions are needed to improve HIV care continuum outcomes. OBJECTIVE This study assessed the preliminary efficacy and impact of a digital HIV care navigation intervention among young people living with HIV in San Francisco. Health electronic navigation (eNavigation or eNav) is a 6-month, text message–based, digital HIV care navigation intervention, in which young people living with HIV are connected to their own HIV care navigator through text messaging to improve engagement in HIV primary care. METHODS This study had a single-arm, prospective, pre-post design. The analysis included 120 young men who have sex with men or transwomen living with HIV aged between 18 and 34 years. We analyzed self-reported sociobehavioral information pre- and postintervention at baseline and 6 months, which was collected using computer-assisted self-interviewing surveys. We characterized the sample and built generalized estimating equation (GEE) models to assess differences in HIV care continuum outcomes at baseline and 6 months. RESULTS The characteristics according to the intervention completion status were not different from those of the overall sample. The mean age of the participants was 27.75 years (SD 4.07). Most participants (103/120, 85.8%) identified as men, and the sample was racially/ethnically diverse. At baseline, majority (99/120, 82.5%) of the participants had recently received primary HIV care, yet this was more likely in those who completed the intervention than in those who did not (54/60, 90% vs 45/60, 75%; χ<sup>2</sup><sub>1</sub>=4.68, <i>P</i>=.03). More than half of the sample reported taking antiretroviral therapy (92/120, 76.7%) and having an undetectable viral load (65/120, 54.2%). The 6-month follow-up surveys were completed by 73.3% (88/120) of participants, and these participants were not characteristically different from the overall sample at baseline. GEE models indicated that participants had increased odds of viral suppression at 6 months as compared with baseline. No relevant additive or multiplicative interactions were noted on comparing outcome effects over time according to intervention completion. CONCLUSIONS Digital HIV care navigation fills a critical gap in public health and HIV care systems, making these systems more responsive and accountable to the needs of the most vulnerable individuals. Our intervention bridges the time between primary care visits with interactive, tailored, personalized, and peer-delivered social support; information; and motivational interviewing to scaffold behavioral change. This study is part of the next wave of system-informed mHealth intervention research that will offer potentially disruptive solutions to traditional in-person delivered interventions and improve the health of the most vulnerable individuals. INTERNATIONAL REGISTERED REPORT RR2-10.2196/16406

scholarly journals Technical and Psychosocial Challenges of mHealth Usage for Antiretroviral Therapy Adherence Among People Living With HIV in a Resource-Limited Setting: Case Series

10.2196/14649 ◽  
2020 ◽  
Vol 4 (6) ◽  
pp. e14649
Author(s):  
Kennedy Michael Ngowi ◽  
Furaha Lyamuya ◽  
Blandina T Mmbaga ◽  
Eva Muro ◽  
Zawadiel Hillu ◽  
...  
Keyword(s):  
Text Messaging ◽  
Text Message ◽  
Case Series ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Resource Limited ◽  
Psychosocial Barriers ◽  
Adherence Monitoring ◽  
Living With Hiv ◽  
Sms Text Messaging

Background Mobile communication has been found to improve antiretroviral therapy (ART) adherence among people living with HIV. In an ongoing randomized clinical trial, 2 mobile communication strategies (ie, sending SMS text messages and real-time medication monitoring [RTMM]) were used to improve adherence to ART among people living with HIV in Tanzania. We noticed remarkable discrepancies between self-reported adherence and adherence recorded by SMS text messaging or RTMM among some of the first trial participants. Objective Our objective was to describe these cases and the observed discrepancies in more detail, to serve as a useful illustration of some of the challenges in using mobile health in resource-limited settings. Methods In an ongoing randomized trial, adults living with HIV from two HIV treatment centers in Tanzania who were suspected of low levels of adherence were randomly assigned in a 1:1:1 ratio to receive (1) SMS text message reminders, (2) an RTMM device, or (3) no additional intervention to standard HIV care. During bimonthly study visits, the participants self-reported their level of adherence, received feedback about their level of adherence based on SMS text messaging or RTMM, and discussed strategies to overcome adherence problems with nurses providing HIV care. For the purpose of this report, we selected people living with HIV who had completed 5 follow-up visits and consistently reported more than 95% adherence, while SMS text messaging or RTMM recorded lower than 75% adherence. The participants were invited for a short, face-to-face in-depth interview to explore reasons for this discrepancy. Results At the time of this analysis, 26 participants had completed follow-up. Six of these evidenced the above-mentioned discrepancies, with an average adherence of 46% based on SMS text messaging or RTMM, while self-reported adherence was 98%. Five of these 6 participants insisted that their adherence to ART was good, with 4 reporting that their adherence to properly using the monitoring device was low. Three participants mentioned concerns about involuntary disclosure of HIV status as a main reason for low adherence to using the device. Two participants were still depending on other reminder cues despite receiving SMS text message or RTMM reminders. Poor network coverage caused low adherence in 1 participant. Conclusions Psychosocial barriers were reported as importantly contributing to low adherence, both with respect to use of ART and proper use of the adherence-monitoring device. This case series illustrates that when introducing new digital adherence monitoring technology, researchers should consider psychosocial barriers and distinguish between adherence to device use and adherence to treatment. Trial Registration Pan African Clinical Trials Registry PACTR201712002844286; https://tinyurl.com/y98q4p3l

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