INcentives and ReMINDers to Promote Long-term Medication Adherence (INMIND)

Project: Research project

Project Details

Description

STATEMENT OF WORK

I. Background: INMIND is a novel pilot intervention that addresses the significant problem of poor long-term antiretroviral treatment (ART) adherence and lack of viral suppression among HIV-infected patients initiating ART treatment. This research project will be implemented in an HIV clinic in Uganda in a 12-month randomized controlled trial (RCT) to establish the feasibility, acceptability, and preliminary efficacy of two different methods for supporting the formation of daily ART adherence routines. Participants in the first intervention group (n=50) will receive advice on how to anchor healthy pill-taking to an existing behavioral routine in combination with daily SMS messages reminding participants of this behavioral strategy for 90 days (Message group). In a second intervention group, participants (n=50) will receive that same information and messages but in addition have the chance of winning small monetary rewards conditional on taking ART medications at approximately the same time as their pre-specified existing behavioral routine (Incentive group). Adherence will be measured for the 9 months following the 3-month intervention, and viral load will be taken at baseline and month 12. The control group (n=50) will receive the usual standard of care, along with the same educational materials regarding the value of daily routines and anchoring ART adherence to an existing routine. Assessments will be conducted at baseline, month 3 (end of the intervention), and month 12.

II. Specific Aims: The Specific Aims are to:
SA1. Formative Phase 1: Evaluate the feasibility and acceptability of INMIND. Elicit reactions to the intervention, preferences for behavioral routine information, and feedback on incentives and other intervention design parameters to finalize intervention development in preparation for Phase 2.
SA2a. Intervention Phase 2: Test the preliminary effectiveness of the intervention, including the relative effectiveness of two different implementation approaches. The main hypothesis is: reminder text messages are more effective for anchoring ART adherence to an existing routine than providing one-off information. The secondary hypothesis is: adding incentives to the information-reinforcing messages is more effective for supporting persistent ART medication adherence.
SA2b. Intervention Phase 2: Test the intervention effectiveness on secondary outcomes. Evaluate the main and secondary hypotheses as outlined in SA2a in terms of the secondary outcomes: self-reported medication adherence, retention in care, and viral suppression.
SA3. Adaptation Phase 3: Collect data informing intervention parameters for a subsequent fully-powered R01 application.

III. Services to be Performed: Co-I Chad Stecher will assist PI Sebastian Linnemayr with all stages of this proposed research. This includes the design and construction of the survey instruments, educational materials, and SMS reminder notifications (Message group), as well as the administration of baseline, month 3, and month 12 assessments and the analysis of all study data. In addition, Dr. Stecher will assist in the dissemination of the research findings through oral presentations at public health and behavioral economics conferences, and by preparing manuscripts for publication in peer-reviewed journals. Specifically, Dr. Stecher will provide the behavioral economics theoretical modeling and parameterization based on the behavioral data collected in this pilot study.

StatusActive
Effective start/end date9/1/206/30/23

Funding

  • HHS: National Institutes of Health (NIH): $41,847.00

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