Browsing by Author "Mayer, Kenneth H"
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- ItemDigital adherence technologies for the management of tuberculosis therapy: mapping the landscape and research priorities.(0000-00-00) Subbaraman, Ramnath; de Mondesert, Laura; Musiimenta, Angella; Pai, Madhukar; Mayer, Kenneth H; Thomas, Beena E; Haberer, JessicaPoor medication adherence may increase rates of loss to follow up disease relapse and drug resistance for individuals with active tuberculosis TB While TB programmes have historically used directly observed therapy DOT to address adherence concerns have been raised about the patient burden ethical limitations effectiveness in improving treatment outcomes and long term feasibility of DOT for health systems Digital adherence technologies DATs which include feature phone based and smartphone based technologies digital pillboxes and ingestible sensors may facilitate more patient centric approaches for monitoring adherence though available data are limited Depending on the specific technology DATs may help to remind patients to take their medications facilitate digital observation of pill taking compile dosing histories and triage patients based on their level of adherence which can facilitate provision of individualised care by TB programmes to patients with varied levels of risk Research is needed to understand whether DATs are acceptable to patients and healthcare providers accurate for measuring adherence effective in improving treatment outcomes and impactful in improving health system efficiency In this article we describe the landscape of DATs that are being used in research or clinical practice by TB programmes and highlight priorities for research
- ItemEmpowering With PrEP (E-PrEP), a Peer-Led Social Media-Based Intervention to Facilitate HIV Preexposure Prophylaxis Adoption Among Young Black and Latinx Gay and Bisexual Men: Protocol for a Cluster Randomized...(0000-00-00) Patel, Viraj V; Ginsburg, Zoë; Golub, Sarit A; Horvath, Keith J; Rios, Nataly; Mayer, Kenneth H; Kim, Ryung S; Arnsten, Julia HBACKGROUND Young black and Latinx gay bisexual and other men who have sex with men YBLGBM aged 18 29 years have among the highest rates of new HIV infections in the United States and are not consistently reached by existing prevention interventions Preexposure prophylaxis PrEP an oral antiretroviral regimen taken daily by HIV uninfected individuals to prevent HIV acquisition is highly efficacious in reducing HIV acquisition and could help stop the HIV epidemic in YBLGBM Use of social media eg Facebook Twitter online dating sites is ubiquitous among young people providing an efficient avenue to engage YBLGBM to facilitate PrEP adoption OBJECTIVE Our overall goal was to develop and pilot test a theoretically grounded social media based peer led intervention to increase PrEP uptake in YBLGBM We used diffusion of innovation and information motivation behavioral skills frameworks to 1 identify potential factors associated with interest in and adoption of PrEP among YBLGBM 2 develop Empowering with PrEP E PrEP a social media based peer led intervention to increase PrEP uptake in YBLGBM and 3 pilot test the feasibility and acceptability of E PrEP and determine its preliminary efficacy for increasing adoption of PrEP by YBLGBM We describe the development and protocol for E PrEP METHODS Using a participatory research approach we partnered with YBLGBM intervention development partners to develop a social media based behavioral intervention to facilitate PrEP uptake which involved an online messaging campaign disseminated by YBLGBM peer leaders to their existing online networks We designed the 6 week campaign to provide education about PrEP increase motivation to use PrEP and facilitate access to PrEP We then conducted a cluster randomized trial of E PrEP compared with an attention matched general health control condition E Health among YBLGBM aged 18 to 29 years to assess E PrEP s feasibility acceptability preliminary efficacy for increasing self reported intention to use PrEP PrEP uptake and impact on knowledge and attitudes about PrEP at 12 week follow up 6 weeks after the end of the online campaign RESULTS From October 2016 to March 2017 we developed pretested and refined E PrEP with 6 YBLGBM intervention development partners From May to June 2017 we recruited enrolled and randomly assigned 10 peer leaders n 5 for each condition The 10 peer leaders then recruited and enrolled 152 participants from their existing online networks range 3 33 per peer leader during June and July 2017 Intervention follow up was completed after 12 weeks in November 2017 with analyses underway CONCLUSIONS We hypothesize that compared with E Health participants randomly assigned to E PrEP will be more likely to express intention to use PrEP and greater PrEP uptake and will also show changes in potential mediators of PrEP uptake knowledge attitudes stigma and access A Web based biobehavioral intervention model such as E PrEP could be rapidly scaled even with limited resources and have significant population level impact TRIAL REGISTRATION ClinicalTrials gov NCT03213366 https clinicaltrials gov ct2 show NCT03213366 Archived by WebCite at http www webcitation org 71onSdcXY REGISTERED REPORT IDENTIFIER RR1 10 2196 11375
- ItemA Mobile-Based App (MyChoices) to Increase Uptake of HIV Testing and Pre-Exposure Prophylaxis by Young Men Who Have Sex With Men: Protocol for a Pilot Randomized Controlled Trial.(0000-00-00) Biello, Katie B; Marrow, Elliot; Mimiaga, Matthew J; Sullivan, Patrick; Hightow-Weidman, Lisa; Mayer, Kenneth HBACKGROUND HIV incidence is growing most rapidly in the United States among young men who have sex with men YMSM Overwhelming evidence demonstrates that routine testing and expanded use of pre exposure prophylaxis PrEP would dramatically reduce the population burden of HIV however uptake of both interventions is suboptimal among young adults The use of mobile phone apps by YMSM is ubiquitous and may offer unique opportunities for public health interventions MyChoices is a theory driven app to increase HIV testing and PrEP uptake It was developed by an interdisciplinary team based on feedback from a diverse sample of YMSM OBJECTIVE The aim of this paper is to describe the protocol for the refinement beta testing and pilot randomized controlled trial RCT to examine the acceptability and feasibility of the MyChoices app METHODS This 3 phase study includes 4 theater testing groups for app refinement with a total of approximately 30 YMSM for beta testing including quantitative assessments and exit interviews with approximately 15 YMSM over a 2 month period and for a pilot RCT with 60 YMSM The pilot will assess feasibility acceptability and preliminary efficacy of the MyChoices app compared with referrals only in increasing HIV testing and PrEP uptake All participants will be recruited at iTech clinical research sites in Boston MA and Bronx NY RESULTS App refinement is underway Enrollment for the pilot RCT began in October 2018 CONCLUSIONS MyChoices is one of the first comprehensive theory driven HIV prevention apps designed specifically for YMSM If MyChoices demonstrates acceptability and feasibility in this pilot RCT a multicity 3 arm randomized controlled efficacy trial of this app and another youth optimized app LYNX versus standard of care is planned within iTech If shown to be efficacious the app will be scalable with the ability to reach YMSM across the United States as well as be geographically individualized with app content integrated with local prevention and testing activities INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID PRR1 10 2196 10694
- ItemPerspectives and preferences for a mobile health tool designed to facilitate HPV vaccination among young men who have sex with men.(0000-00-00) Fontenot, Holly B; Rosenberger, Joshua G; McNair, Katie T; Mayer, Kenneth H; Zimet, GregoryWe sought to understand young men who have sex with men YMSM perspectives and preferred features for a mobile health mHealth tool designed to facilitate human papillomavirus HPV vaccination YMSM were recruited on a popular social sexual networking app to participate in online focus groups Discussions were designed to elicit what the men would want in a mHealth tool specific for sexual health and HPV Demographic data were analyzed using descriptive statistics and focus group data were analyzed using conventional content analysis Forty eight YMSM participated Mean age was 23 4 years and 70 0 reported their race as Black Qualitative themes included general HPV knowledge and awareness current patterns in technology use desired app qualities and desired app content Youth described varying levels of HPV knowledge utilized apps to engage socially and for travel banking gaming news and entertainment and few used apps to facilitate personal health or engage with healthcare systems Participants desired credible relatable secure and easy to use interfaces that provided sexual health and HPV information in a positive context They described ways to creatively engage and directly connect youth to health providers We identified a culturally relevant youth driven approach to facilitate HPV vaccination and sexual health among YMSM