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首页> 外文期刊>Patient Preference and Adherence >A counselor in your pocket: feasibility of mobile health tailored messages to support HIV medication adherence
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A counselor in your pocket: feasibility of mobile health tailored messages to support HIV medication adherence

机译：您口袋里的顾问：量身定制的移动健康信息可支持对HIV药物的依从性

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Purpose: Medication adherence is a major challenge in HIV treatment. New mobile technologies such as smartphones facilitate the delivery of brief tailored messages to promote adherence. However, the best approach for tailoring messages is unknown. Persons living with HIV (PLWH) might be more receptive to some messages than others based on their current psychological state.Methods: We recruited 37 PLWH from a parent study of motivational states and adherence. Participants completed smartphone-based surveys at a random time every day for 2 weeks, then immediately received intervention or control tailored messages, depending on random assignment. After 2 weeks in the initial condition, participants received the other condition in a crossover design. Intervention messages were tailored to match PLWH’s current psychological state based on five variables – control beliefs, mood, stress, coping, and social support. Control messages were tailored to create a mismatch between message framing and participants’ current psychological state. We evaluated intervention feasibility based on acceptance, ease of use, and usefulness measures. We also used pilot randomized controlled trial methods to test the intervention’s effect on adherence, which was measured using electronic caps that recorded pill-bottle openings.Results: Acceptance was high based on 76% enrollment and 85% satisfaction. Participants found the hardware and software easy to use. However, attrition was high at 59%, and usefulness ratings were slightly lower. The most common complaint was boredom. Unexpectedly, there was no difference between mismatched and matched messages’ effects, but each group showed a 10%–15% improvement in adherence after crossing to the opposite study condition.Conclusion: Although smartphone-based tailored messaging was feasible and participants had clinically meaningful improvements in adherence, the mechanisms of change require further study. Possible explanations might include novelty effects, increased receptiveness to new information after habituation, or pseudotailoring, three ways in which attentional processes can affect behavior.
机译：目的：坚持药物治疗是艾滋病毒治疗的主要挑战。智能手机等新的移动技术有助于传递简短的量身定制的消息，以促进遵守。但是，裁剪消息的最佳方法尚不清楚。艾滋病病毒感染者（PLWH）基于他们当前的心理状态可能比其他人更容易接受某些信息。方法：我们从父母对动机状态和依从性的研究中招募了37名PLWH。参与者每天随机进行2周的基于智能手机的调查，然后根据随机分配立即接受干预或控制量身定制的消息。在初始状态2周后，参与者通过分频设计获得了其他状态。根据五个变量（控制信念，情绪，压力，应对和社会支持），量​​身定制干预消息，以匹配PLWH当前的心理状态。量身定制的控制消息可以使消息框架与参与者当前的心理状态不匹配。我们根据接受程度，易用性和有用性评估了干预措施的可行性。我们还使用试点随机对照试验方法来测试干预措施对依从性的影响，这是通过记录药瓶开度的电子帽测量的。结果：基于76％的入学率和85％的满意度，接受度很高。参与者发现硬件和软件易于使用。但是，损耗率很高，为59％，有用等级略低。最常见的抱怨是无聊。出乎意料的是，不匹配消息和匹配消息的效果没有区别，但是在相反的研究条件下，每组的依从性都提高了10％–15％。结论：尽管基于智能手机的量身定制的消息传递是可行的，并且参与者具有临床意义遵守的改善，变化的机制需要进一步研究。可能的解释可能包括新颖性效应，习惯后对新信息的接受程度增加或伪装，这是注意力过程影响行为的三种方式。

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