HIV has changed from an acute illness to a chronic disease. The success of HIV medications and treatments has significantly altered the course of the disease. While AIDS-related illnesses are no longer the primary threat, a new set of HIV-associated complications have emerged, resulting in a chronic disease that for many will span several decades of life. The ability to self-manage adverse symptoms of HIV illness has been shown to improve patient-centered outcomes. In response to this need a team at UCSF developed a paper-based symptom management manual with self-management strategies for 21 common HIV/AIDS adverse symptoms (PCOR evidence). The efficacy of the manual was demonstrated in a 775-person RCT over three months at 12 sites. However, subsequent use of these strategies has been very limited; mHealth offers an ideal platform for the implementation and dissemination of evidence-based strategies for HIV symptom management. Due to the high incidence of HIV among racial and ethnic minority populations, it is appropriate to develop mHealth tools tailored to the needs of these populations. mHealth technology has the potential to address many of the health care needs of persons living with HIV/AIDS (PLWH) including symptom management. In response to these current issues, our application seeks to inform the development and testing of a mHealth application that will incorporate findings from PCOR studies to improve the outcomes of PLWH. To improve outcomes for those most in need, our study activities are focused on communities with the greatest burden of HIV in the US, including racial and ethnic minorities and those of low socioeconomic status.
The aims of this project are to: 1) Apply participatory design methods to incorporate PCOR evidence for HIV symptom management into a mobile health application (mVIP) for use in patient self-management; 2) Using a randomized design, examine the effect of mVIP as compared to an attention control group on primary outcomes of symptom frequency and intensity; 3) Guided by the PRECEDE-PROCEED model of health program planning and evaluation, examine PLWH's perceptions of the predisposing, enabling, and reinforcing factors for mVIP use. The tool developed using this research has the potential to extend the impact and reach of health care for PLWH. Findings from this study have the potential to make scientific evidence more accessible to patients through the use of mHealth technology. Ultimately the incorporation of HIV symptom management strategies into patients' lives through the use of mHealth technologies has the potential to advance the effective dissemination and implementation of PCOR findings.
The goal of this study is to facilitate the dissemination and implementation of PCOR using mHealth technology to improve self-management of adverse symptoms in persons living with HIV/AIDS (PLWH). Symptom management in PLWH is especially important because the US HIV epidemic continues to exact a huge toll, especially among AHRQ priority populations including racial, ethnic, and sexual minorities and low-income persons. The incorporation of HIV symptom management strategies into patients' lives through the use of mHealth technologies has the potential to advance the effective dissemination and implementation of PCOR findings.
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| Schnall, Rebecca; Cho, Hwayoung; Mangone, Alexander et al. (2018) Mobile Health Technology for Improving Symptom Management in Low Income Persons Living with HIV. AIDS Behav 22:3373-3383 |
| Cho, Hwayoung; Iribarren, Sarah; Schnall, Rebecca (2017) Technology-Mediated Interventions and Quality of Life for Persons Living with HIV/AIDS. A Systematic Review. Appl Clin Inform 8:348-368 |
| Schnall, Rebecca; Cho, Hwayoung; Webel, Allison (2017) Predictors of willingness to use a smartphone for research in underserved persons living with HIV. Int J Med Inform 99:53-59 |
| Ramos, S Raquel; Gordon, Peter; Bakken, Suzanne et al. (2016) Sociotechnical Analysis of Health Information Exchange Consent Processes in an HIV Clinic. J Assoc Nurses AIDS Care 27:792-803 |
