Adherence Interventions for HIV Youth Via Text & Cell Phone - Sequential Multiple Assignment Randomized Trial (SMART)

NCT ID: NCT03535337

Last Updated: 2024-12-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

83 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-01

Study Completion Date

2022-05-31

Brief Summary

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The purpose of this study is to test an adaptive adherence intervention, which utilizes two mobile health (mHealth) intervention designs, in an effort to promote adherence to antiretroviral therapy (ART) and achieve and maintain viral load (VL) suppression in youth living with HIV (YLH) while increasing understanding of the context for wide-scale implementation of cell phone support (CPS) and text messaging support (SMS), with and without incentives.

Detailed Description

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The study will consist of two points of randomization. The first step involves randomization of participants to receive either CPS or SMS using a 1:1 allocation ratio. Both intervention conditions will receive 3 months of intervention (i.e., 12 weeks of CPS or SMS).

The second step involves a stratified randomization in blocks with 8 possible intervention trajectories. Within each condition, participants are categorized into two groups - responders with VL\<200 (Rsp) and non-responders with VL ≥200 (NRsp). Responders in the CPS condition will be randomly assigned to receive either 3 months of CPS tapered (CPS-T) intervention followed by standard care (SC) or only SC. Similarly, responders in the SMScondition will be randomly assigned to receive either 3 months of SMS tapered (SMS-T) intervention followed by SC or only SC. Non-responders in both CPS and SMS conditions will be randomly assigned to receive either 3 months of incentivized CPS (CPS-I) followed by 3 months of CPS-T and 3 months of SC or 3 months of incentivized SMS (SMS-I) followed by 3 months of SMS-T and 3 months of SC.

Conditions

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HIV Infections

Keywords

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Interventions youth living with HIV mHealth ART adherence adaptive intervention cell phone text messaging

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Multiple Assignment Randomized Trial
Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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CPS-Rsp-T

After 3 months of intervention, this group of CPS Rsp will receive 3 months of CPS-T intervention followed by SC.

Group Type ACTIVE_COMPARATOR

CPS

Intervention Type BEHAVIORAL

Assessment of participant's medication adherence and barrier problem solving via phone conversation

CPS-Rsp-SC

After 3 months of intervention, this group of CPS Rsp's intervention will discontinue and they'll receive SC only

Group Type ACTIVE_COMPARATOR

CPS

Intervention Type BEHAVIORAL

Assessment of participant's medication adherence and barrier problem solving via phone conversation

CPS-NRsp-I

After 3 months of intervention, this group of CPS NRsp will receive 3 months of CPS-I followed by 3 months of CPS-T and 3 months of SC.

Group Type ACTIVE_COMPARATOR

CPS

Intervention Type BEHAVIORAL

Assessment of participant's medication adherence and barrier problem solving via phone conversation

CPS-NRsp-SMS-I

After 3 months of intervention, this group of CPS NRsp will receive 3 months of SMS-I followed by 3 months of SMS-T and 3 months of SC

Group Type ACTIVE_COMPARATOR

CPS

Intervention Type BEHAVIORAL

Assessment of participant's medication adherence and barrier problem solving via phone conversation

SMS-Rsp-T

After 3 months of intervention, this group of SMS Rsp will receive 3 months of SMS tapered (SMS-T) intervention followed by SC.

Group Type ACTIVE_COMPARATOR

SMS

Intervention Type BEHAVIORAL

Participants will receive a text message, which will be an electronic reminder regarding medication adherence. Participants will then text back a confirmatory response.

SMS-Rsp-SC

After 3 months of intervention, this group of SMS Rsp, intervention will discontinue and they'll receive SC only

Group Type ACTIVE_COMPARATOR

SMS

Intervention Type BEHAVIORAL

Participants will receive a text message, which will be an electronic reminder regarding medication adherence. Participants will then text back a confirmatory response.

SMS-NRsp-CPS-I

After 3 months of intervention, this group of SMS NRsp will receive 3 months of CPS-I followed by 3 months CPS-T and 3 months SC

Group Type ACTIVE_COMPARATOR

SMS

Intervention Type BEHAVIORAL

Participants will receive a text message, which will be an electronic reminder regarding medication adherence. Participants will then text back a confirmatory response.

SMS-NRsp-I

After 3 months of intervention, this group of SMS NRsp will receive 3 months of SMS-I followed by 3 months of SMS-T and 3 months of SC

Group Type ACTIVE_COMPARATOR

SMS

Intervention Type BEHAVIORAL

Participants will receive a text message, which will be an electronic reminder regarding medication adherence. Participants will then text back a confirmatory response.

Interventions

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CPS

Assessment of participant's medication adherence and barrier problem solving via phone conversation

Intervention Type BEHAVIORAL

SMS

Participants will receive a text message, which will be an electronic reminder regarding medication adherence. Participants will then text back a confirmatory response.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* HIV diagnosis
* Viral load ≥ 200 copies/mL within 3 months prior to enrollment or self-reported adherence ≤ 80%
* ART medication regimen prescribed minimum of 3 months prior to eligibility VL or self-reported adherence
* Sole owner of device capable of sending/receiving calls and text messages
* Willingness to permit research team to communicate with their HIV care provider team

Exclusion Criteria

* Mental, physical, or emotional capacity prevents completion of protocol as written
* Inability to understand written/spoken English
* Concurrent participant in any adherence behavioral research intervention
Minimum Eligible Age

15 Years

Maximum Eligible Age

24 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Children's Hospital Los Angeles

OTHER

Sponsor Role collaborator

Hunter College of City University of New York

OTHER

Sponsor Role collaborator

Wayne State University

OTHER

Sponsor Role collaborator

Florida State University

OTHER

Sponsor Role lead

Responsible Party

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Sylvie Naar

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The City University of New York

New York, New York, United States

Site Status

Countries

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United States

References

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Belzer ME, MacDonell KK, Ghosh S, Naar S, McAvoy-Banerjea J, Gurung S, Cain D, Fan CA, Parsons JT. Adaptive Antiretroviral Therapy Adherence Interventions for Youth Living With HIV Through Text Message and Cell Phone Support With and Without Incentives: Protocol for a Sequential Multiple Assignment Randomized Trial (SMART). JMIR Res Protoc. 2018 Dec 20;7(12):e11183. doi: 10.2196/11183.

Reference Type DERIVED
PMID: 30573448 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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ATN 144

Identifier Type: -

Identifier Source: org_study_id