A Pilot Gaming Adherence Program for Youth Living With HIV
Condition: Adherence to HIV Treatment and Medication
Study type: Interventional

Summary: 
      This study will develop and test a novel, technology based intervention to improve treatment
      adherence among youth living with HIV who are taking antiretroviral medication. In the
      intervention youth will access an engaging and immersive app/game on their smartphone.Data
      about the opening of the smart pill bottle will be transferred from the bottle cap wirelessly
      and will trigger a text message about their adherence. While gaming, participants will gain
      information about their health, improve motivation for ARV and medical appointment adherence,
      and practice healthy behaviors. If the Intervention is found to be effective, it can be
      tested in a larger study and then disseminated to other youth on antiretroviral medications.
    

Detailed description: 
      Despite need for consistent adherence to medical care, youth living with HIV (YLWH) have
      suboptimal rates of retention in care and adherence to antiretroviral medication (ARV)
      treatment. There are few adherence studies with YLWH and the results are mixed, so there is a
      great need for the development of novel interventions. Results of adult HIV adherence studies
      indicate that participants are interested in using technology-based methods and are most
      receptive toward interventions that couple technological devices with motivational
      components. Pill taking monitoring devices have been found to be a sensitive measure of
      adherence to ARV medications, but do not lead to sustained improvements in adherence or
      intrinsic motivation when used alone. Building on this knowledge, this study will examine a
      multi-level technology that integrates a medication monitoring device WITH an interactive
      smartphone based app/game that is attractive and engaging to YLWH. This multi-level approach
      will integrate theory driven content with novel, but intuitive, technology to improve HIV
      treatment adherence.

      In this study, data on opening of the pill bottle will be transferred wirelessly from the
      bottle cap and a text on adherence sent to the phone. This developmental project will adapt
      and refine a smartphone app/game to include content consistent with the
      Information-Motivation-Behavioral Skills (IMB) Model. Creation and adaptation will occur from
      in-depth interviews with YLWH on ART (n=25) and an open trial of the Intervention (n=20).
      While gaming, participants will experience absorbing action-oriented adventures that increase
      information about their health (e.g. knowledge about HIV treatment), improve motivation (e.g.
      action-figures experience health benefits of adherence), and build skills (e.g. utilize
      clinicians as partners). A small randomized controlled pilot study (24 weeks) among 60 YLWH
      will examine the preliminary efficacy of the IMB Gaming Adherence Intervention (integration
      of the smart cap with the IMB informed app/game) compared to a comparison group who receive
      the smart cap and smartphone but no IMB game, on adherence and biological measures.
    

Intervention name(s): IMB Gaming Adherence Intervention; Enhanced treatment as usual
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Combination of smart pill bottle cap with mobile gaming application tailored for those living with HIV; Smart pill bottle cap and mobile phone but no game
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: HIV; youth; medical adherence