mHealth for ART adherence by HIV+ African Americans age 45 & older

DESCRIPTIONprovided by applicantEnvironment and Health GroupEHGIncin collaboration with a number of Boston MA and Columbia SC based organizationsseeks to enhancetestand commercialize an individually tailoredculturally sensitivepositive psychology and behavioral economics basedmobile health intervention to promote ART adherenceincrease ART self efficacy and reduce feelings of stress burden among HIV positive African Americans ageand olderAfrican Americans represent a growing portionof people living with HIVCDCbythose agewill account for half of all cases of HIV AIDS in the U SNIDAPoor ART adherence contributes to disparities in HIV AIDS outcomes among older African AmericansThe proposed project is based on EHG s previous research with HIVageyears and olderAfrican American adultsThat research revealed personalized pill reminder text messages with positive psychology based motivational and educational messages are effective at addressing two major barriers to ART adherence in this groupmemory deficits resulting from the combined effects of HIVcognitive agingand increased allostatic loadandlow motivation due to lack of ART self efficacy and negative affectFindings showed significant improvement in ART adherence scores and marginally significant improvement in ART selfefficacy scoresWhile affect scores did not changequalitative findings showed the intervention helped reduce feelings of stress burdenSupporting ART adherence is key to reducing health disparities among HIVAfrican AmericansDoing so for thoseageand older who are most vulnerable to cumulativeage accelerating effects of HIV infection and allostatic load is urgentwhich is why we are lowering the age cut off fromtoin Phase IITo dateno ART adherence support intervention has been developed for this highly vulnerable groupThe Phase II project will enhance the existing mobile intervention by offeringa two way communication capability through which participants caniindicate "pill taken" in response to pill remindersand iireceive a positive visual icon as behavioral economics based reinforcement for "pill taken" responseslivereal time pharmacist counseling and medication supportandthe addition of opt in smoking cessation educational and motivational textsOverall aims are toexpand mhealth intervention to incorporate new Phase II featuresevaluate effectiveness in an RCT of HIVAfrican Americans ageand olderandprepare marketing and commercialization plansOur long term goal is to increase ART adherencethus decreasing health disparitiesamong HIVAfrican Americansage