Global WACh

July 19, 2018

Dr. Brandon Guthrie receives award for mHealth intervention to improve transition from pediatric to adult HIV care

Congratulations to Dr. Brandon Guthrie, PhD, MPH, Assistant Professor of Global Health and Epidemiology, who received a NIH R34 Clinical Trial Planning Grant award to develop and test a mobile health technology (mHealth) based intervention to support youth transitioning from pediatric to adult HIV care in Kenya!  He is leading a team of researchers from the University of Washington, whoinclude Drs. Jennifer Unger, PhD (Assistant Professor, Obstetrics and Gynecology), Keshet Ronen, PhD (Research Scientist, Global Health), and Kristin Beima-Sofie, PhD (Research Scientist, Global Health). The team is also partnering with Dr. Megan Moreno, MD, from the University of Wisconsin School of Medicine and Public Health Pediatrics Department, and with long-time collaborators from Kenyatta National Hospital.

Dr. Guthrie’s award for the mPACT (mHealth strategies for the Pediatric to Adult HIV Care Transition) intervention will pilot a mHealth framework that uses a combination of group peer support and one-to-one communication with a healthcare provider specially trained in youth HIV care.  Youth (ages 10-24) represent a growing proportion of people living with HIV, and they are at high risk of disengagement during the transition of care.  For youth having grown up under the care of pediatric health care providers, they can feel reluctant to lose their relationship with providers.  Youth can also face challenges as they switch to an adult provider who is not knowledgeable about the unique care needs of adolescents living with HIV, nor have the flexibility to help facilitate the transition process.Lastly, youth may not feel prepared to assume independent responsibility for their health as needed in adult HIV care.  To keep youth linked to HIV care, it is important to find ways to provide adequate support that hinges on uninterrupted and successful transition to adult care.  Continuous HIV treatment not only improves the health of people living with HIV (PLWH) and their chances of survival, it is also a highly effective strategy to prevent HIV transmission to others.

mHealth is a promising approach to engage HIV-positive patients beyond the clinic as they are capable of sending medication reminders, educational messages, and opportunities for improved patient-provider communication through mobile devices.  These features have helped PLWH adhere to their treatment and care,and improve physical and psychological well-being.  Dr. Guthrie and his team hope the mPACT intervention will enable a high degree of engagement during the critical period of transition, and tailored communication that is responsive to the concerns of youth and their health care providers.

By April 2021, the team will develop messaging content and pilot mPACT to determine its effects on youth’s transition preparedness, antiretroviral therapy (ART) knowledge, and on psychosocial topics, like stigma, depression, and social and caregiver support.  The results from this project will help the team prepare for a larger trial to assess mPACT’s impact on successful transition and clinical outcomes.  We look forward to following their progress and sharing updates!