Use of mHealth Technology for Supporting Symptom Management in Underserved Persons Living with HIV (New York)

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Summary:

The success of HIV medications and treatments has significantly altered the course of the disease. While AIDS-related illnesses are no longer typically fatal, treatment does not fully restore immune health, and chronic co-morbidities create a lifetime of symptom management. The ability to self-manage symptoms of HIV has been shown to improve patient-centered outcomes. Self-management involves helping patients set achievable goals and learn problem-solving techniques that will improve their outcomes and quality of life.

This project tested a mobile health application (app) called mobile Video Information Provider (mVIP) that incorporated findings from patient-centered outcomes research (PCOR). It used smartphones and tablets to provide people living with HIV (PLWH) real-time feedback and access to symptom management strategies. The project focused on communities with the greatest burden of HIV in the United States, including racial and ethnic minorities and those of low socioeconomic status.

The specific aims of the project were as follows:

  • Apply participatory design methods to incorporate PCOR evidence for HIV symptom management into the mVIP app for use in patient self-care. 
  • Using a randomized design, examine the effect of mVIP as compared to a control group on primary outcomes of symptom frequency and intensity. 
  • Guided by the PRECEDE-PROCEED model of health program planning and evaluation, examine perceptions of the predisposing, enabling, and reinforcing factors for mVIP use among PLWH. 

Researchers conducted a 12-week feasibility study with 80 PLWH in New York City. Participants were randomized to either the mVIP intervention, which included self-care strategies for improving 13 commonly experienced symptoms in PLWH, or to the control version of mVIP without self-care strategies. Findings indicated that use of the app was associated with improvement in symptoms and was easy to use. Intervention group participants showed a significantly greater improvement than the control group in five symptoms: anxiety; depression; neuropathy; fever, chills, or sweating; and weight loss or wasting. This group also showed greater improvement in adherence to their antiretroviral medications. Researchers believe that future studies should consider the long-term effect of the intervention to demonstrate sustainability, evaluate implementation across other settings, and examine the use of this intervention in other languages.

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Use of mHealth technology for supporting symptom management in underserved persons living with HIV - final report

Citation:
Schnall, R. Use of mHealth technology for supporting symptom management in underserved persons living with HIV - final report. (Prepared by Columbia University under Grant No. R21 HS023963). Rockville, MD: Agency for Healthcare Research and Quality, 2018. (PDF, 379.67 KB)

The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. (Persons using assistive technology may not be able to fully access information in this report. For assistance, please contact Corey Mackison)
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