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首页> 外文期刊>JMIR public health and surveillance. >A Gamified Smartphone App to Support Engagement in Care and Medication Adherence for HIV-Positive Young Men Who Have Sex With Men (AllyQuest): Development and Pilot Study
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A Gamified Smartphone App to Support Engagement in Care and Medication Adherence for HIV-Positive Young Men Who Have Sex With Men (AllyQuest): Development and Pilot Study

机译：一款经过智能化处理的智能手机应用程序，可支持与男性发生性关系的HIV阳性年轻人的护理和药物依从性研究（AllyQuest）：开发和试点研究

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Background: HIV disproportionately impacts young men who have sex with men (YMSM) who experience disparities across the HIV care continuum. Addressing antiretroviral therapy (ART) adherence among YMSM is an urgent public health priority. Technology-based interventions—particularly mobile health platforms—can provide tailored adherence interventions and allow YMSM to engage and connect with others. Objective: The objective of this study was to describe the development of AllyQuest , a novel, theoretically-based, smartphone app designed to improve engagement in care and ART adherence and social support among HIV-positive YMSM. Methods: AllyQuest was built on an established platform for patient engagement that embeds social networking and fundamental game mechanics, such as challenges, points, and rewards. A medication tracker provides reminders to promote ART adherence via personalized adherence strategies that are user and context specific; a calendar allows for reflection on adherence over time. After iterative development with input from two youth advisory boards, usability testing was conducted to assess app functionality, comprehension of the educational content, use of intervention features, and overall impressions of app relevance and appeal. A 28-day pilot trial was conducted with 20 HIV+ YMSM to evaluate intervention feasibility and acceptability. Results: Mean age of participants was 21.8 years (range 19-24), and 95% (19/20) of the participants were nonwhite. The mean time of app use was 158.4 min (SD 114.1), with a range of 13 to 441 min. There was a mean of 21.2 days of use (out of a total possible 28 days). There were 222 posts to the daily discussion social wall. Feasibility and acceptability ratings were high. Overall, participants found the app easy to use and navigate, not intrusive, and had few reported technical issues. Higher levels of app usage were positively correlated with HIV self-management outcomes, and there was a statistically significant ( P .05) positive association between the number of days logged into the app and knowledge and confidence in ability to reliably take HIV medications. Conclusions: AllyQuest represents a new, highly scalable solution that is well-suited to meet the specific prevention and care needs of HIV+ YMSM. The development of this intervention is both timely and vital, given the urgency of the ongoing HIV epidemic among YMSM.
机译：背景：艾滋病毒对与男性有性行为的年轻人（YMSM）的影响不成比例。解决YMSM之间的抗逆转录病毒疗法（ART）依从性是当务之急。基于技术的干预措施，尤其是移动医疗平台，可以提供量身定制的依从性干预措施，并允许YMSM参与并与他人建立联系。目的：本研究的目的是描述AllyQuest的发展，这是一种新颖的，基于理论的智能手机应用程序，旨在改善HIV阳性YMSM对护理和抗逆转录病毒依从性以及社会支持的参与度。方法：AllyQuest建立在已建立的患者参与平台上，该平台嵌入了社交网络和基本的游戏机制，例如挑战，积分和奖励。药物跟踪器可通过用户和上下文特定的个性化依从策略，提醒您促进ART依从性;日历可以反映出一段时间后的遵守情况。在两个青年顾问委员会的投入下进行迭代开发之后，进行了可用性测试，以评估应用程序的功能，对教育内容的理解，干预功能的使用以及应用程序相关性和吸引力的总体印象。用20个HIV + YMSM进行了为期28天的试验性试验，以评估干预的可行性和可接受性。结果：参与者的平均年龄为21.8岁（范围为19-24），其中95％（19/20）的参与者为非白人。应用程序的平均使用时间为158.4分钟（SD 114.1），范围为13至441分钟。平均使用21.2天（总共28天）。每日讨论社交墙上有222个帖子。可行性和可接受性等级很高。总体而言，参与者发现该应用程序易于使用和导航，不会造成干扰，并且报告的技术问题很少。应用程序使用的较高水平与HIV自我管理的结果呈正相关，并且登录到应用程序的天数与对可靠服用HIV药物的能力的了解和信心之间存在统计学上的显着正相关（P <.05）。结论：AllyQuest代表了一种新的，高度可扩展的解决方案，非常适合满足HIV + YMSM的特定预防和护理需求。考虑到YMSM中持续不断的HIV流行，制定这种干预措施既及时又至关重要。

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