HIV-infection/AIDS Clinical Trial
— ACCESSOfficial title:
Adherence Connection for Counseling, Education, and Support (ACCESS): A Proof of Concept Study
This Mentored Patient-Oriented Research Career Development Award - (K23) seeks to provide
the advanced knowledge, skills, and experience for the candidate's career transition to an
independent nurse scientist. Her long term goal is to become a leading nurse scientist in
designing, implementing, and evaluating technology supported behavioral interventions
targeted for improved disease self-management (i.e. medication adherence, retention in care)
among human immunodeficiency virus (HIV)-infected, ethnic minority adolescents and young
adults. With an extensive background in pediatric HIV nursing and completed NIH funded pre
and post-doctoral interdisciplinary research traineeships, the candidate has begun to
develop the knowledge-base and skills necessary for this goal.
This award details a 3-year scope of mentored career development through which she will gain
the foundation for future research endeavors. Specifically, the goals of this proposal are
to: 1) conduct a novel research project under the mentorship of an interdisciplinary team of
expert researchers; 2) acquire expertise in health informatics for implementation of
technology supported behavioral interventions, health disparities, and advanced qualitative
and mixed methods design and analysis through firsthand experience, didactic interactions
with mentors, and graduate level coursework; 3) build a network of colleagues and
collaborators within New York University and elsewhere through this research and
participation at national and international meetings; and 4) prepare and submit a federal
research grant (R-21) based upon the skills and findings from this award period.
The specific research project through which she will accomplish these goals is a proof of
concept study, Adherence Connection for Counseling, Education, and Support (ACCESS), and
addresses the challenge of adherence to antiretroviral treatment among HIV-infected
adolescents and young adults. A mixed method design is proposed and the specific aims are
to: 1) Characterize the feasibility and acceptability of a peer led, mHealth cognitive
behavioral intervention delivered via remote videoconferencing using smartphones; 2) Obtain
initial estimates of the biobehavioral impact of ACCESS on HIV virologic outcomes and
self-reported ART adherence, beliefs and knowledge about antiretroviral treatment, adherence
self-efficacy, and healthcare utilization (retention in HIV care). In summary, the ACCESS
adherence intervention is consistent with the National Institute of Nursing Research (NINR)
call for the development of novel interventions to deliver personalized care and real-time
health information for patients.
Status | Recruiting |
Enrollment | 50 |
Est. completion date | August 2018 |
Est. primary completion date | January 2018 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 16 Years to 29 Years |
Eligibility |
1. HIV seropositive status (perinatally and behaviorally infected youth) 2. Ages 16-29 years 3. English speaking 4. Current ART with a prescribed regimen 5. Evidence of virologic failure or (detectable quantitative HIV serum viral load>200 copies/ml) 6. No neuro-cognitive deficits which would impede participation in videoconferencing sessions or completion of study measures. [Screening with the Folstein Mini-Mental State Exam (MMSE) will be performed to assess for the presence of neurocognitive deficits. Participants with a score of 24 or greater will be eligible for study participation.] |
Country | Name | City | State |
---|---|---|---|
United States | Bellevue Hospital Center | New York | New York |
Lead Sponsor | Collaborator |
---|---|
New York University | New York University School of Medicine |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in Beliefs about antiretroviral treatment | Beliefs about ART will be assessed with the Beliefs about Medication Scale (BAMS)- a 59 item health beliefs questionnaire using a 7-point Likert scale to assess perceived threat, positive outcome expectancy, negative outcome expectancy, and intent regarding oral medication adherence [Riekert K. et al. 2002; J Clinical Psychol Med Settings]. Changes in scores of beliefs about medications will be compared pre and post the ACCESS intervention using Chi-Square or Fisher's Exact Test for discrete variables, and paired t-tests for continuous variables. | Beliefs about antiretroviral treatment will be measured at baseline and 24 weeks. | |
Other | Change in Knowledge about antiretroviral treatment | Knowledge about antiretroviral treatment will be measured with the HIV Treatment Knowledge Scale. This 21 item instrument uses true and false questions to assess knowledge of adherence, side effects and antiretroviral resistance [Balfour L. et al. 2007; AIDS Care]. Changes in scores of knowledge about ART will be compared pre and post the ACCESS intervention using Chi-Square or Fisher's Exact Test for discrete variables, and paired t-tests for continuous variables. | Knowledge about antiretroviral therapy will be measured at baseline and 24 weeks. | |
Other | Change in Adherence Self-Efficacy | Adherence self-efficacy will be measured with the Adherence Self-Efficacy Scale - a 12 item survey measure that uses a 10 point scale (0=cannot do it all;10=completely certain can do it) to assess confidence in ability to carry out important treatment related behaviors [Johnson M. et al. 2007; J Behav Med]. Changes in scores of self-efficacy will be compared pre and post the ACCESS intervention using Chi-Square or Fisher's Exact Test for discrete variables, and paired t-tests for continuous variables. |
Adherence self-efficacy will be measured at baseline and 24 weeks. | |
Other | Change in 3-day adherence estimate | An average missed dose calculation will be computed and operationalized as: # of doses missed per medication multiplied by dosing schedule during the past 3 days/ divided by total number of prescribed doses over past 3 days. This percentage will be subtracted from 100% to obtain the 3-day adherence estimate [Garvie P. et al. 2010; J Adol Health] | 3-day adherence estimates will be measured at baseline, and 8 weeks, 16 weeks, and 24 weeks | |
Other | Change in health care utilization (retention in care) | For the purposes of this proof of concept study, retention in HIV care will be calculated as a proportion of kept to scheduled visits (range 0-100%). Changes in scores of healthcare utilization (retention) will be compared pre and post the ACCESS intervention using Chi-Square or Fisher's Exact Test for discrete variables, and paired t-tests for continuous variables. | Retention in care will be measured at baseline and 24 weeks | |
Primary | Change in Serum HIV RNA quantitative viral load | Serum HIV RNA quantitative viral load results will be available for medical record data extraction at four time points, baseline (pre-intervention), and weeks 8, 16 & 24 post-intervention. The primary outcome variable of adherence as measured with serum HIV-RNA will be dichotomized as a binary variable (< 48 copies/ml; > 48 copies/ml), indicating viral suppression. An interval estimate of the odds ratio will indicate the potential impact of ACCESS on viral suppression, with Chi-Square or Fisher's Exact Test for statistical significance. | Serum HIV RNA quantitative viral load will be measured at baseline and at 8 weeks, 16 weeks, and 24 weeks post-intervention. |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
NCT00787696 -
Healthy Teen Girls: HIV Risk Reduction
|
Phase 1/Phase 2 | |
Completed |
NCT03403569 -
Safety and Efficacy of Triptolide Wilfordii in New Onset HIV-1 Infection
|
Phase 3 | |
Completed |
NCT02433743 -
Impact of RUTF on Body Composition, Anemia and Zinc Status of PLWHA
|
N/A | |
Completed |
NCT01360762 -
Prophylaxis of Visceral Leishmaniasis Relapses in HIV Co-infected Patients With Pentamidine: a Cohort Study
|
Phase 3 | |
Recruiting |
NCT03147859 -
Vedolizumab Treatment in Antiretroviral Drug Treated Chronic HIV Infection
|
Phase 2 | |
Recruiting |
NCT04297488 -
Probiotic Supplementation for Those Immune Non-responders With HIV-1 Infection
|
N/A | |
Completed |
NCT01827540 -
Study of Dolutegravir (DTG) on PK of Cenicriviroc (CVC), and CVC on PK of DTG & on a Single Dose of Midazolam
|
Phase 1 | |
Completed |
NCT01475890 -
Vitamin D Supplementation in HIV
|
Phase 2/Phase 3 | |
Recruiting |
NCT05947539 -
Improving HIV Care Engagement Among Ugandan Adolescent Girls and Young Women: The Kisoboka Mukwano Intervention
|
N/A | |
Withdrawn |
NCT01442428 -
Paradoxical Tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) Treatment Trial
|
Phase 2/Phase 3 | |
Completed |
NCT02496793 -
Community-Based Peer Facilitator Intervention (Zimbabwe)
|
N/A | |
Completed |
NCT03069235 -
Promoting Exclusive Breastfeeding Among HIV Infected Women in a PMTCT Program
|
N/A | |
Completed |
NCT03794648 -
The Effectiveness of a Mobile Interactive Supervised Therapy (MIST) Intervention for Improving Adherence to HIV Medication
|
N/A | |
Withdrawn |
NCT04183738 -
Inflammation and Co-Infections in D²EFT
|
Phase 4 | |
Enrolling by invitation |
NCT03919695 -
Development of an Intervention to Reduce Heavy Drinking and Improve HIV Care Engagement Among Fisherfolk in Uganda
|
N/A | |
Recruiting |
NCT04215926 -
NAFLD in HIV-infected Patients
|
||
Completed |
NCT01406626 -
Effectiveness of Peer Navigation to Link Released HIV+ Jail Inmates to HIV Care
|
N/A | |
Completed |
NCT04371835 -
COHIVE: Coronavirus (COVID-19) Outcomes in HIV Evaluation in Resource Limited Settings
|
||
Completed |
NCT01140633 -
Novel Measures and Theory of Pediatric Antiretroviral Therapy Adherence in Uganda
|
N/A | |
Enrolling by invitation |
NCT04373551 -
WeExPAnd: PrEP Demonstration Project Among Women at Risk for HIV Infection - Preexposure Prophylaxis (PrEP)
|
N/A |