The effect of a combined mHealth and community health worker intervention on HIV self-management.

IF 4.7 2区 医学 Q1 COMPUTER SCIENCE, INFORMATION SYSTEMS Journal of the American Medical Informatics Association Pub Date : 2025-01-11 DOI:10.1093/jamia/ocae322
Fabiana Cristina Dos Santos, D Scott Batey, Emma S Kay, Haomiao Jia, Olivia R Wood, Joseph A Abua, Susan A Olender, Rebecca Schnall
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Abstract

Objective: To identify demographic, social, and clinical factors associated with HIV self-management and evaluate whether the CHAMPS intervention is associated with changes in an individual's HIV self-management.

Method: This study was a secondary data analysis from a randomized controlled trial evaluating the effects of the CHAMPS, a mHealth intervention with community health worker sessions, on HIV self-management in New York City (NYC) and Birmingham. Group comparisons and linear regression analyses identified demographic, social, and clinical factors associated with HIV self-management. We calculated interactions between groups (CHAMPS intervention and standard of care) over time (6 and 12 months) following the baseline observation, indicating a difference in the outcome scores from baseline to each time across groups.

Results: Our findings indicate that missing medical appointments, uncertainty about accessing care, and lack of adherence to antiretroviral therapy are associated with lower HIV self-management. For the NYC site, the CHAMPS showed a statistically significant positive effect on daily HIV self-management (estimate = 0.149, SE = 0.069, 95% CI [0.018 to 0.289]). However, no significant effects were observed for social support or the chronic nature of HIV self-management. At the Birmingham site, the CHAMPS did not yield statistically significant effects on HIV self-management outcomes.

Discussion: Our study suggests that CHAMPS intervention enhances daily self-management activities for people with HIV at the NYC site, indicating a promising improvement in routine HIV care.

Conclusion: Further research is necessary to explore how various factors influence HIV self-management over time across different regions.

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移动医疗和社区卫生工作者联合干预对艾滋病毒自我管理的影响。
目的:确定与艾滋病毒自我管理相关的人口统计学、社会和临床因素,并评估CHAMPS干预是否与个人艾滋病毒自我管理的变化有关。方法:本研究是一项随机对照试验的辅助数据分析,该试验评估了CHAMPS的效果,CHAMPS是一种带有社区卫生工作者会议的移动健康干预,在纽约市(NYC)和伯明翰对艾滋病毒自我管理的影响。组间比较和线性回归分析确定了与艾滋病毒自我管理相关的人口统计学、社会和临床因素。我们计算了各组(CHAMPS干预和标准护理)在基线观察后随时间(6个月和12个月)的相互作用,表明各组从基线到每次的结果评分存在差异。结果:我们的研究结果表明,缺少医疗预约、获得护理的不确定性以及缺乏抗逆转录病毒治疗的依从性与较低的艾滋病毒自我管理有关。对于纽约市站点,CHAMPS在日常艾滋病毒自我管理方面显示统计学上显著的积极作用(估计= 0.149,SE = 0.069, 95% CI[0.018至0.289])。然而,没有观察到社会支持或艾滋病自我管理的慢性性质的显著影响。在伯明翰地区,CHAMPS在艾滋病自我管理结果上没有产生统计学上显著的效果。讨论:我们的研究表明,CHAMPS干预增强了纽约市HIV感染者的日常自我管理活动,表明常规HIV护理有希望得到改善。结论:需要进一步研究不同地区不同因素对HIV自我管理的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of the American Medical Informatics Association
Journal of the American Medical Informatics Association 医学-计算机:跨学科应用
CiteScore
14.50
自引率
7.80%
发文量
230
审稿时长
3-8 weeks
期刊介绍: JAMIA is AMIA''s premier peer-reviewed journal for biomedical and health informatics. Covering the full spectrum of activities in the field, JAMIA includes informatics articles in the areas of clinical care, clinical research, translational science, implementation science, imaging, education, consumer health, public health, and policy. JAMIA''s articles describe innovative informatics research and systems that help to advance biomedical science and to promote health. Case reports, perspectives and reviews also help readers stay connected with the most important informatics developments in implementation, policy and education.
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