학술논문

CareConekta: study protocol for a randomized controlled trial of a mobile health intervention to improve engagement in postpartum HIV care in South Africa
Document Type
article
Source
Trials. 21(1)
Subject
Clinical Trials and Supportive Activities
Clinical Research
Behavioral and Social Science
Pediatric
Prevention
HIV/AIDS
Infectious Diseases
Health Services
Management of diseases and conditions
7.1 Individual care needs
Reproductive health and childbirth
Infection
Good Health and Well Being
Anti-HIV Agents
Continuity of Patient Care
Female
HIV Infections
Humans
Infectious Disease Transmission
Vertical
Patient Acceptance of Health Care
Patient Preference
Postpartum Period
Pregnancy
Prospective Studies
Randomized Controlled Trials as Topic
Smartphone
South Africa
Telemedicine
Text Messaging
HIV
AIDS
Postpartum
Women
Retention
Mobile health
mHealth
Cardiorespiratory Medicine and Haematology
Clinical Sciences
Cardiovascular System & Hematology
General & Internal Medicine
Language
Abstract
BackgroundSouth Africa is home to the world's largest antiretroviral therapy program but sustaining engagement along the HIV care continuum has proven challenging in the country and throughout the wider region. Population mobility is common in South Africa, but there are important research gaps in describing this mobility and its impact on engagement in HIV care. Postpartum women and their infants in South Africa are known to be at high risk of dropping out of HIV care after delivery and are frequently mobile.MethodsIn 2017, we developed a beta version of a smartphone application (app) - CareConekta - that detects a user's smartphone location to allow for prospective characterization of mobility. Now we will adapt and test CareConekta to conduct essential formative work on mobility and evaluate an intervention - the CareConekta app plus text notifications and phone calls and/or WhatsApp messages - to facilitate engagement in HIV care during times of mobility. During the 3-year project period, our first objective is to evaluate the feasibility, acceptability, and initial efficacy of using CareConekta as an intervention to improve engagement in HIV care. Our second objective is to characterize mobility among South African women during the peripartum period and its impact on engagement in HIV care. We will enroll 200 eligible pregnant women living with HIV and receiving care at the Gugulethu Midwife Obstetric Unit in Cape Town, South Africa.DiscussionThis work will provide critical information about mobility during the peripartum period and the impact on engagement in HIV care. Simultaneously, we will pilot test an intervention to improve engagement with rigorously assessed outcomes. If successful, CareConekta offers tremendous potential as a research and service tool that can be adapted and evaluated in multiple geographic regions, study contexts, and patient populations.Trial registrationClinicalTrials.gov: NCT03836625. Registered on 8 February 2019.