Shan-Estelle Brown1,2, Archana Krishnan2,3, Yerina S Ranjit2,4, Ruthanne Marcus2,5, Frederick L Altice2,5,6. 1. Department of Anthropology, Rollins College, Winter Park, FL, USA. 2. Center for Interdisciplinary Research on AIDS, Yale University, New Haven, CT, USA. 3. Department of Communication, University at Albany, State University of New York, Albany, NY, USA. 4. Department of Communication, University of Missouri, Columbia, MO, USA. 5. AIDS Program, Section of Infectious Diseases, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA. 6. Division of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, USA.
Abstract
BACKGROUND: Mobile health (mHealth) can provide innovative, cost-effective strategies to improve medication adherence and optimize HIV treatment outcomes. Very little, however, is known about the acceptability and feasibility of mHealth among people with HIV (PWH) who use drugs. Our study objective was to assess feasibility, acceptability, and barriers and facilitators of implementing an mHealth intervention among PWH who are cocaine users, a group for whom no pharmacological treatment to reduce cocaine use is available. METHODS: Five focus groups (FGs) (N=20) were conducted with PWH who self-reported cocaine use in the past 30 days, with 3 groups (N=8) of healthcare providers. Topics included previous experience with smartphones; barriers and facilitators of mobile technology for health purposes; and attitudes toward receiving types of feedback about adherence. RESULTS: Patients preferred text reminders over phone calls for reasons of privacy, accessibility and economizing phone minutes. Direct communication via text messages and phone calls was considered more appropriate for social workers and case managers, who have greater frequency of communication and deeper relationships with patients, and less so for doctors, who see patients less regularly than community health workers. Patients seem particular about who has what information, and overall, they seem to prefer that their medical information, especially HIV-related, stay within the confines of patient-provider relationships. CONCLUSIONS: HIV still provokes stigma and makes health information particularly sensitive for both providers and patients. The rise of mobile technology and related applications such as mHealth, means that new norms have to be established for its use. Participants' suggestions and feedback informed the design of a subsequent mHealth pilot randomized control trial to improve medication adherence. 2020 mHealth. All rights reserved.
BACKGROUND: Mobile health (mHealth) can provide innovative, cost-effective strategies to improve medication adherence and optimize HIV treatment outcomes. Very little, however, is known about the acceptability and feasibility of mHealth among people with HIV (PWH) who use drugs. Our study objective was to assess feasibility, acceptability, and barriers and facilitators of implementing an mHealth intervention among PWH who are cocaine users, a group for whom no pharmacological treatment to reduce cocaine use is available. METHODS: Five focus groups (FGs) (N=20) were conducted with PWH who self-reported cocaine use in the past 30 days, with 3 groups (N=8) of healthcare providers. Topics included previous experience with smartphones; barriers and facilitators of mobile technology for health purposes; and attitudes toward receiving types of feedback about adherence. RESULTS: Patients preferred text reminders over phone calls for reasons of privacy, accessibility and economizing phone minutes. Direct communication via text messages and phone calls was considered more appropriate for social workers and case managers, who have greater frequency of communication and deeper relationships with patients, and less so for doctors, who see patients less regularly than community health workers. Patients seem particular about who has what information, and overall, they seem to prefer that their medical information, especially HIV-related, stay within the confines of patient-provider relationships. CONCLUSIONS: HIV still provokes stigma and makes health information particularly sensitive for both providers and patients. The rise of mobile technology and related applications such as mHealth, means that new norms have to be established for its use. Participants' suggestions and feedback informed the design of a subsequent mHealth pilot randomized control trial to improve medication adherence. 2020 mHealth. All rights reserved.
Entities:
Keywords:
HIV; Mobile health (mHealth); cocaine; feedback; focus groups (FGs)
Authors: Duncan Smith-Rohrberg Maru; Robert Douglas Bruce; Mary Walton; Sandra A Springer; Frederick L Altice Journal: J Acquir Immune Defic Syndr Date: 2009-02-01 Impact factor: 3.731
Authors: Jane M Simoni; John S Wiebe; John A Sauceda; David Huh; Giselle Sanchez; Virginia Longoria; C Andres Bedoya; Steven A Safren Journal: AIDS Behav Date: 2013-10
Authors: Irene Kuo; Carol E Golin; Jing Wang; Danielle F Haley; James Hughes; Sharon Mannheimer; Jessica Justman; Anne Rompalo; Paula M Frew; Adaora A Adimora; Lydia Soto-Torres; Sally Hodder Journal: Drug Alcohol Depend Date: 2014-03-19 Impact factor: 4.492
Authors: Caroline Asiimwe; David Gelvin; Evan Lee; Yanis Ben Amor; Ebony Quinto; Charles Katureebe; Lakshmi Sundaram; David Bell; Matt Berg Journal: Am J Trop Med Hyg Date: 2011-07 Impact factor: 2.345
Authors: Karen Dunn Lopez; Claire Cravero; Archana Krishnan; Vanessa E Carvalho de Sousa Freire; Gabriel J Culbert Journal: Res Nurs Health Date: 2020-12-20 Impact factor: 2.228
Authors: Tabor E Flickinger; Jacqueline E Sherbuk; Kristen Petros de Guex; Diego Añazco Villarreal; Michelle Hilgart; Kathleen A McManus; Karen Ingersoll; Rebecca Dillingham Journal: Telemed Rep Date: 2021-02-03