![[ Visit Client Website ]](images/banner.gif)
Theoretical Background and research questions/hypothesis: Advancements in the sophistication and affordability of mobile technology have created more opportunities for healthcare providers working with HIV+ youth. Cell phones are increasingly being used as the primary means of communicating, especially among youth. While short message system (SMS) technology has been used to manage other chronic health conditions such as diabetes, few investigations have outlined the challenges inherent with working with adolescents living with HIV/AIDS. Utilizing this technology as an adherence tool may help to improve health outcomes for young people living with HIV. Understanding the barriers to, and promoters of, implementation of SMS-based technology can help provide essential information for future intervention development.
Methods: This study explores how a research team introduced a novel adherence tool to a group of 16-22 year olds during a 30 day feasibility study. Participants were recruited from 2 HIV clinics receiving HIV care in an urban setting. Eligible participants had to own a cell phone; have an unlimited SMS package as part of their service plan; currently be taking ARV medications for at least 3 months; and be able to read and sign a consent form. Each participant received an automated, tailored, SMS message using the CareSpeak adherence monitoring software program to remind them to take their medication on a daily basis. The participant-selected messages ranged from a simple, “Take your meds” to a medication specific, “Take your Atripla” or the non-HIV specific, “Take your multi-vitamin”. After taking their medication, youth replied to the original text via a two-way SMS feature of CareSpeak. Problems were identified in the first ten days of participation and problem solving phone calls were conducted as needed. Participants provided feedback throughout the study through qualitative and quantitative assessments.
Results: During the enrollment process, participants selected their reminder messages as well as the time that they would receive the SMS. Participants assessed the usability, impact on their lifestyle and privacy and whether they felt that the program was helpful in their daily medication taking regimen. All participants felt that the SMS program did not interrupt their lifestyle or daily activities such as work or school. Privacy was not an issue as most individuals reported that they were the only ones that looked at their text messages. Challenges identified included problems receiving and responding to text messages, and cell phone service temporarily disconnected.
Conclusions: Using a two-way text messaging program is a feasible and innovative way to support adherence to HAART medication for adolescents living with HIV. Technical support is necessary within the first week of the study so that participants do not become frustrated with the SMS program as they learn how to use this new resource. Finally, asking for feedback regarding messaging is essential for each individual. This partnership is essential for continued collaboration between the research staff and the study participants.
Implications for research and/or practice: Further exploration is necessary to determine the most effective way to use SMS to support and improve adherence in adolescents living with HIV.