dc.contributor.author | Mulvaney, Shelagh A. | |
dc.date.accessioned | 2023-02-13T22:04:19Z | |
dc.date.available | 2023-02-13T22:04:19Z | |
dc.date.issued | 2022-11 | |
dc.identifier.other | eISSN 2561-326X | |
dc.identifier.uri | http://hdl.handle.net/1803/17999 | |
dc.description | Only Vanderbilt University affiliated authors are listed on VUIR. For a full list of authors, access the version of record at https://formative.jmir.org/2022/11/e39357 | en_US |
dc.description.abstract | Background: Advances in medical treatments in recent years have contributed to an overall decline in HIV-related opportunistic infections and deaths in youth; however, mortality and morbidity rates in perinatally and nonperinatally infected adolescents and young adults (AYA) living with HIV remain relatively high today. Objective: The goal of this project was to assess the use, utility, and cost-effectiveness of PlusCare, a digital app for HIV case management in AYA living with HIV. The app supports routine case management tasks, such as scheduling follow-up visits, sharing documents for review and signature, laboratory test results, and between-visit communications (eg, encouraging messages). Methods: We conducted a single-group mixed methods pre-post study with HIV case management programs in 2 large urban hospitals in the Boston metro area. Case management staff (case managers [CMs], N=20) and AYA living with HIV participants (N=45) took part in the study with access to PlusCare for up to 15 and 12 months, respectively. Results: The CMs and AYA living with HIV reported mean System Usability Scale scores of 51 (SD 7.9) and 63 (SD 10.6), respectively. Although marginally significant, total charges billed at 1 of the 2 sites compared with the 12 months before app use (including emergency, inpatient, and outpatient charges) decreased by 41% (P=.046). We also observed slight increases in AYA living with HIV self-reported self-efficacy in chronic disease management and quality of life (Health-Related Quality of Life-4) from baseline to the 12-month follow-up (P=.02 and P=.03, respectively) and increased self-efficacy from the 6-to 12-month follow-up (P=.02). There was no significant change in HIV viral suppression, appointment adherence, or medication adherence in this small-sample pilot study.Conclusions: Although perceived usability was low, qualitative feedback from CMs and use patterns suggested that direct messaging and timely, remote, and secure sharing of laboratory results and documents (including electronic signatures) between CMs and AYA living with HIV can be particularly useful and have potential value in supporting care coordination and promoting patient self-efficacy and quality of life. | en_US |
dc.description.sponsorship | The authors would like to thank all the case managers and patients who participated in the study and made it possible. The authors also thank Dr Cathryn Samples, Meryn Robinson, and Honora Einhorn for their contributions to the critical early stages of this project. This project was funded by the National Institutes of Health, National Institute of Mental Health, grant R44 MH117956. Drs Woods and Guss were also funded in part by the Health Resources and Services Administration of the US Department of Health and Human Services as part of an MCHB T71MC00009 LEAH training grant. The contents are those of the authors and do not necessarily represent the official views of, nor an endorsement, by the Health Resources and Services Administration, Health and Human Services, or the US government. | en_US |
dc.language.iso | en_US | en_US |
dc.publisher | JMIR FORMATIVE RESEARCH | en_US |
dc.rights | Originally published in JMIR Formative Research (https://formative.jmir.org), 21.11.2022. This
is an open-access article distributed under the terms of the Creative Commons Attribution License
(https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information,
a link to the original publication on https://formative.jmir.org, as well as this copyright and license information must be included. | |
dc.source.uri | https://formative.jmir.org/2022/11/e39357 | |
dc.subject | HIV | en_US |
dc.subject | case management | en_US |
dc.subject | youth | en_US |
dc.subject | young adult | en_US |
dc.subject | mobile health | en_US |
dc.subject | mHealth | en_US |
dc.subject | digital health | en_US |
dc.subject | mobile phone | en_US |
dc.title | A Digital Platform to Support HIV Case Management for Youth and Young Adults: Mixed Methods Feasibility Study | en_US |
dc.type | Article | en_US |
dc.identifier.doi | 10.2196/39357 | |