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The objective of the proposed research is to conduct formative work to develop, pilot and refine a smartphone delivered intervention for violence affected people living with HIV utilizing a novel spatial-temporal methodology, geographical ecological momentary assessment (GEMA), to first identify the activity spaces and daily psychosocial experiences (mental health symptoms, substance use, self-efficacy, coping) impacting adherence and viral suppression, and apply them to intervention. Guided by an ecological perspective, the investigators will adapt Living in the Face of Trauma to a mobile platform with GEMA informed intervention targets. The resulting app shall be referred to as NOLA GEM. Our long-term goal is delivering accessible interventions informed by daily experiences that affect health for PLWH. The investigators will test feasibility, acceptability and preliminary efficacy of the GEMA-informed NOLA GEM app against GEMA alone on adherence and care, and secondary outcomes of mental health and substance use.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention | Experimental | This arm will include daily diary assessment and GPS phone tracking, access to psychoeducational modules, skills practice, and tools to help with coping and stress reduction. Enhancements include geofencing alerts for risky environments; progress tracking and feedback reports; self-initiated tool engagement (e.g. push button to engage in coping exercise), robust JITAI programming that recommends skills for participants to use in the moment based on daily diary responses, positive mood building exercises, and support. |
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| GEMA | No Intervention | This arm will include daily diary and phone tracking. Participants in this arm will also respond to daily diary assessments twice daily but will not receive the psychoeducation interactive components such as tracking and feedback, alerts, or capacity to send alerts that connect them to tools. This arm will have access to resources. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NOLA GEM | Behavioral | This is a mobile application that has 6 psychoeducational sessions and related skills, local resources, and a way for participants to track their progress. Further information is in the arm descriptions. |
| Measure | Description | Time Frame |
|---|---|---|
| Adherence | Self report taking all HIV-related medication and treatment in past 30 days | 30 day post-assessment |
| Viral Load | Self report last blood draw was under 50 copies of HIV/mL in past 90 days | 90 days post assessment |
| Care Engagement | Self report % of missed appointments in past 90 days | 90 days post assessment |
| Care Engagement | HIV Treatment Adherence Self-Efficacy Scale; 0-120; higher score means more self-efficacy for care engagement | 30 days post assessment |
| Acceptability of intervention | User Experience Questionnaire-Short Form | 30 day post-assessment |
| Acceptability of intervention | Net Promotor Score; 0-10; higher score means more likely to recommend to a friend | 30 day post-assessment |
| Feasibility of intervention | App usage paradata | 30 day post-assessment |
| Feasibility of intervention | Participation rates | 30 day post-assessment |
| Measure | Description | Time Frame |
|---|---|---|
| PTSD | PTSD Checklist for DSM-5; higher scores indicate higher levels of PTSD symptomology | 30 day post-assessment |
| Depression, anxiety | Hospital Anxiety Depression Scale; 0-21; higher scores indicate higher levels of anxiety and/or depression |
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Inclusion Criteria:
Exclusion Criteria:
-
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Access Health Louisiana | New Orleans | Louisiana | 70112 | United States | ||
| Women With A Vision |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41575709 | Derived | Gasik RE, Skeen SJ, Tokarz S, Theall KP, Clum GA. Outcomes of a Pilot Mobile App Just-in-Time-Adaptive-Intervention Supporting Coping Skills in Trauma Affected People with HIV. AIDS Behav. 2026 Jan 23:10.1007/s10461-026-05032-6. doi: 10.1007/s10461-026-05032-6. Online ahead of print. | |
| 37874637 | Derived | Skeen SJ, Tokarz S, Gasik RE, Solano CM, Smith EA, Sagoe MB, Hudson LV, Steele K, Theall KP, Clum GA. A Trauma-Informed, Geospatially Aware, Just-in-Time Adaptive mHealth Intervention to Support Effective Coping Skills Among People Living With HIV in New Orleans: Development and Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc. 2023 Oct 24;12:e47151. doi: 10.2196/47151. |
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| ID | Term |
|---|---|
| D000092862 | Psychological Well-Being |
| D019966 | Substance-Related Disorders |
| ID | Term |
|---|---|
| D010549 | Personal Satisfaction |
| D001519 | Behavior |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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| 30 day post-assessment |
| Stress | Study generated daily stressors severity checklist | 30 day post-assessment |
| Stress | Perceived Stress Scale 4; 0-16; higher score is correlated to more stress | 30 day post-assessment |
| Coping | Brief-COPE; higher scores indicate higher levels of emotion focused, problem focused, and avoidant coping styles | 30 day post-assessment |
| Coping | adapted Coping Self-Efficacy Scale; higher score means more coping self-efficacy | 30 day post-assessment |
| Substance use | Adapted Addiction Severity Index | 30 day post-assessment |
| Substance use | Alcohol Use Disorders Identification Test-C; 0-12; higher score indicates more problematic drinking | 30 day post-assessment |
| New Orleans |
| Louisiana |
| 70113 |
| United States |
| CrescentCare | New Orleans | Louisiana | 70117 | United States |
| Institute of Women & Ethnic Studies | New Orleans | Louisiana | 70122 | United States |