Evidence map›Paper›PMID 37725419›Full record

ArticleJMIR formative research2023

An mHealth Platform for People With HIV Receiving Care in Washington, District of Columbia: Qualitative Analysis of Stakeholder Feedback.

Sylvia Caldwell, Tabor Flickinger, Jacqueline Hodges, Ava Lena D Waldman, Chloe Garofalini, Wendy Cohn, Rebecca Dillingham, Amanda Castel, Karen Ingersoll

Open access · goldAbstract read
In one paragraph

Article in JMIR formative research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Sylvia Caldwell *Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Science, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0003-3222-9355
Tabor Flickinger *Division of General Medicine, Geriatrics and Palliative Care, Department of Medicine, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0001-8820-2536
Jacqueline HodgesDivision of Infectious Disease and International Health, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0001-9879-7502
Ava Lena D Waldman *Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Science, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0002-7784-3159
Chloe Garofalini *Milken Institute School of Public Health, George Washington University, Washingon, DC, United States.ORCID https://orcid.org/0000-0002-5246-3811
Wendy Cohn *Public Health Sciences, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0002-4351-8497
Rebecca Dillingham *Division of Infectious Disease and International Health, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0001-9748-1215
Amanda Castel *Milken Institute School of Public Health, George Washington University, Washingon, DC, United States.ORCID https://orcid.org/0000-0002-9095-2413
Karen Ingersoll *Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Science, University of Virginia, Charlottesville, VA, United States.ORCID https://orcid.org/0000-0001-8115-2548
University of Virginia · USMilken Institute · US

Funding

The DC Cohort: A Longitudinal Population-Based Cohort Study of People Living with HIV in Washington, DCR24AI152598 · NIAID · GEORGE WASHINGTON UNIVERSITY · PI Amanda Derryck Castel, Marinella Temprosa · 2020 to 2026
$37.9M
Pragmatic Efficacy Trial of mHealth to Improve HIV Outcomes in the DC CohortR01MH122375 · NIMH · GEORGE WASHINGTON UNIVERSITY · PI CASTEL, AMANDA DERRYCK, INGERSOLL, KAREN S · 2020 to 2024
$3.5M
NIAID NIH HHS R24 AI152598NIMH NIH HHS R01 MH122375
6 · The paper itself

Abstract

backgroundHIV viral suppression and retention in care continue to be challenging goals for people with HIV in Washington, District of Columbia (DC). The PositiveLinks mobile app is associated with increased retention in care and viral load suppression in nonurban settings. The app includes features such as daily medication reminders, mood and stress check-ins, an anonymized community board for peer-to-peer social support, secure messaging to care teams, and resources for general and clinic-specific information, among other features. PositiveLinks has not been tailored or tested for this distinct urban population of people with HIV.

objectiveThis study aimed to inform the tailoring of a mobile health app to the needs of people with HIV and their providers in Washington, DC.

methodsWe conducted a 3-part formative study to guide the tailoring of PositiveLinks for patients in the DC Cohort, a longitudinal cohort of >12,000 people with HIV receiving care in Washington, DC. The study included in-depth interviews with providers (n=28) at study clinics, focus groups with people with HIV enrolled in the DC Cohort (n=32), and a focus group with members of the DC Regional Planning Commission on Health and HIV (COHAH; n=35). Qualitative analysis used a constant comparison iterative approach; thematic saturation and intercoder agreement were achieved. Emerging themes were identified and grouped to inform an adaptation of PositiveLinks tailored for patients and providers.

resultsEmerging themes for patients, clinic providers, and COHAH providers included population needs and concerns, facilitators and barriers to engagement in care and viral suppression, technology use, anticipated benefits, questions and concerns, and suggestions. DC Cohort clinic and COHAH provider interviews generated an additional theme: clinic processes. For patients, the most commonly discussed potential benefits included improved health knowledge and literacy (mentioned n=10 times), self-monitoring (n=7 times), and connection to peers (n=6 times). For providers, the most common anticipated benefits were improved communication with the clinic team (n=21), connection to peers (n=14), and facilitation of self-monitoring (n=11). Following data review, site principal investigators selected core PositiveLinks features, including daily medication adherence, mood and stress check-ins, resources, frequently asked questions, and the community board. Principal investigators wanted English and Spanish versions depending on the site. Two additional app features (messaging and documents) were selected as optional for each clinic site. Overall, 3 features were not deployed as not all participating clinics supported them.

conclusionsPatient and provider perspectives of PositiveLinks had some overlap, but some themes were unique to each group. Beta testing of the tailored app was conducted (August 2022). This formative work prepared the team for a cluster randomized controlled trial of PositiveLinks' efficacy. Randomization of clinics to PositiveLinks or usual care occurred in August 2022, and the randomized controlled trial launched in November 2022. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/37748.

Indexed as

adaptationcluster randomized controlled trialformativeHIVmHealthmobile healthmobile phonequalitative methodssmartphone

Identifiers

PMID37725419
PMCPMC10548330
OpenAlexW4385499359

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.