Exploring the feasibility, acceptability and preliminary effects of a nurse delivered mhealth intervention for women living with HIV in South India: a pilot randomized controlled trial

IF 3.2 3区医学 Q2 PSYCHIATRY Archives of Women's Mental Health Pub Date : 2024-04-17 DOI:10.1007/s00737-024-01462-0

Veena A. Satyanarayana, Mona Duggal, Sangchoon Jeon, Pushpendra Singh, Anita Desai, Prabha S. Chandra, Nancy R. Reynolds

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Abstract

Purpose

We evaluated the feasibility, acceptability and preliminary efficacy of a standardized nurse delivered mobile phone intervention to improve adherence to antiretroviral treatment and clinical outcomes.

Methods

Feasibility and acceptability of the phone intervention was assessed with rates of eligibility, completed visits, and attritions. Intervention fidelity was assessed by checking recorded calls and feedback. Efficacy was assessed using a randomized controlled trial in which 120 women living with HIV and psychosocial vulnerabilities, were randomized to Treatment as Usual (TAU = 60) or TAU plus the mobile phone intervention (N = 60). Trained basic nurses delivered the theory-guided, standardized mobile phone intervention for mental health issues and psychosocial risk factors to improve antiretroviral treatment (ART) adherence and retention in care and improve clinical outcomes. Blind raters performed the assessments at 6, 12 and 24 weeks post-randomization.

Results

Adherence diminished over time in the TAU only group, while it was sustained in the TAU Plus group, only dropping at 24 weeks after the intervention had been discontinued. Among participants with depressive symptoms (CESD ≥ 16), the intervention had significant improvement in adherence rates (p < 0.01), psychological quality of life (p < 0.05) and illness perception (p < 0.05) compared to those in the TAU only group. Greater improvements of quality of life subscales were observed in the TAU Plus group among participants with less psychological vulnerability (PSV < 2). HIV RNA was not significantly different between the groups at week 24.

Conclusions

The mobile-delivered counseling intervention was feasible and acceptable and shows promise among women living with HIV and psychosocial vulnerabilities in rural South India.

Trial Registration

ClinicalTrials.gov Identifier: NCT02319330 [Registered on: December 18, 2014].

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探索护士为南印度女性艾滋病感染者提供移动医疗干预的可行性、可接受性和初步效果：随机对照试验。

目的我们评估了标准化护士手机干预的可行性、可接受性和初步疗效，以改善抗逆转录病毒治疗的依从性和临床结果。方法通过合格率、完成就诊率和流失率评估手机干预的可行性和可接受性。通过检查电话录音和反馈来评估干预的忠实性。通过随机对照试验对干预效果进行了评估，在该试验中，120 名感染了艾滋病病毒并存在心理社会脆弱性的妇女被随机分配到 "常规治疗"（TAU = 60）或 "常规治疗 "加手机干预（TAU = 60）。经过培训的基础护士针对心理健康问题和社会心理风险因素提供理论指导下的标准化手机干预，以提高抗逆转录病毒治疗（ART）的依从性和持续性，并改善临床效果。结果仅使用TAU组的依从性随时间推移而降低，而使用TAU Plus组的依从性则保持不变，只是在干预停止后的24周才有所下降。在有抑郁症状（CESD≥16）的参与者中，与单纯TAU组相比，干预对依从率（p < 0.01）、心理生活质量（p < 0.05）和疾病感知（p < 0.05）都有显著改善。在心理脆弱程度较低的参与者（PSV <2）中，TAU Plus组的生活质量分量表有更大的改善。在第 24 周时，各组之间的 HIV RNA 无明显差异。结论：在印度南部农村地区，移动提供的咨询干预是可行的、可接受的，并有望在感染 HIV 且心理脆弱的妇女中推广：NCT02319330 [注册日期：2014 年 12 月 18 日]。

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来源期刊

Archives of Women's Mental Health 医学-精神病学

CiteScore

8.00

自引率

4.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.