Evaluation of a technology-enhanced intervention for older women with HIV infection: a proof of concept study

ABSTRACT

The syndemic effects of HIV infection, side effects of highly active antiretroviral medications, and age-related changes lead to increased risk for comorbidities and functional decline for older people with HIV. This proof of concept (PoC) study evaluated perceived usefulness, satisfaction, acceptability, intervention processes, resource management, and outcome effect variances of ThE CARE Intervention guided by the Self-Determination Theory. To test the utility of ThE CARE, we conducted a one-group pre/posttest intervention design with a convenience sample of 20 women, 50 years and older. The mean age was 56 years (SD = 11) and years since HIV diagnosis was 23.7 (SD = 8.6). ThE CARE intervention was found useful and participants “felt empowered” utilizing the app. Fourteen participants (70%) reported high-intensity distress and negative impact on life from neuropathic pain, anxiety (55%), fatigue (50%), and depressive symptoms (35%). Self-awareness and self-regulation also improved. Modest results of acceptability, usability, and positive trends in the outcome measures suggest possible effects. The interactivity and cultural relevance of ThE CARE would enhance women’s autonomous motivation and perceived competence to actively engage in self-care. The PoC study provides important foundational information to advance science in mHealth interventions for older women with HIV.

KEYWORDS:

• Community-informed
• mHealth application
• ORBIT model
• self-determination theory

Acknowledgements

We acknowledge funding support from the University of Maryland School of Nursing (UMSON) Dean’s Research Scholar’s Program (PI: Njie-Carr, 2016–2018) and the University of Maryland, Baltimore, ICTR and the National Center for Advancing Translational Sciences (NCATS) Clinical Translational Science Award (CTSA) grant number 1UL1TR003098-01.

Our sincere gratitude to the enthusiastic and hardworking graduate research assistants, Odunola Adeyeye, Crystal Awuah, Mattison Chayhitz, and Haddy Mbow, UMSON, who worked tirelessly during the course of this project. Erik Barr, Biostatistician, UMSON was essential to the design of the study and the analysis of our findings. Most importantly, our heartfelt gratitude to our study participants for their time, commitment, and patience, without whom the study would not have been possible.

Compliance with ethical standards

All procedures, including informed consent processes, were performed in accordance to the ethical standards of the institutional review committee and with the 1964 Helsinki declaration and its’ later amendments. All study participants provided a signed consent form to demonstrate their agreement to participating in the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the University of Maryland School of Nursing Dean's Research Scholar's Program (PI: Njie-Carr, 2016–2018) and the University of Maryland, Baltimore, ICTR and the National Center for Advancing Translational Sciences, grant number 1UL1TR003098-01.