A Pilot Gaming Adherence Program for Youth Living With HIV

Age Range:14 - 26
Start Date:September 2012
End Date:August 2017

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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.

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.

Inclusion Criteria:

- English speaking

- in medical care for HIV and receiving antiretroviral treatment

- aware of their HIV status as per clinician and clinical record

- able to give consent/assent and not impaired by cognitive or medical limitations as
per clinical assessment

- detectable viral load

Exclusion Criteria:
We found this trial at
593 Eddy Street
Providence, Rhode Island 02903
Principal Investigator: Larry K Brown, M.D.
Phone: 401-793-8808
Rhode Island Hospital Founded in 1863, Rhode Island Hospital in Providence, RI, is a private,...
Providence, RI
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