Preliminary Evidence for Feasibility, Use, and Acceptability of Individualized Texting for Adherence Building for Antiretroviral Adherence and Substance Use Assessment among HIV-Infected Methamphetamine Users
The feasibility, use, and acceptability of text messages to track methamphetamine use and promote antiretroviral treatment (ART) adherence among HIV-infected methamphetamine users was examined. From an ongoing randomized controlled trial, 30-day text response rates of participants assigned to the intervention (individualized texting for adherence building (iTAB), n = 20) were compared to those in the active comparison condition (n = 9). Both groups received daily texts assessing methamphetamine use, and the iTAB group additionally received personalized daily ART adherence reminder texts. Response rate for methamphetamine use texts was 72.9% with methamphetamine use endorsed 14.7% of the time. Text-derived methamphetamine use data was correlated with data from a structured substance use interview covering the same time period ( ). The iTAB group responded to 69.0% of adherence reminder texts; among those responses, 81.8% endorsed taking ART medication. Standardized feedback questionnaire responses indicated little difficulty with the texts, satisfaction with the study, and beliefs that future text-based interventions would be helpful. Moreover, most participants believed the intervention reduced methamphetamine use and improved adherence. Qualitative feedback regarding the intervention was positive. Future studies will refine and improve iTAB for optimal acceptability and efficacy. This trial is registered with ClinicalTrials.gov NCT01317277. 1. Introduction Mobile health (mHealth) interventions aiming to enhance health behaviors have recently proliferated [1]. mHealth strategies are designed to be integrated into the everyday lives of patients in order to minimize barriers to intervention implementation and facilitate use and generalizability [2]. Both the mobility and popularity of cell phones make it possible to remotely deliver services to assist people with behavior modification and disease self-management [3], thereby improving health outcomes. Short-message service (SMS; i.e., text messaging), in particular, represents a low-cost route to promoting health behaviors, such as treatment adherence, due to the ubiquitous nature of this technology on mobile devices. Furthermore, SMS technology supports interactivity (e.g., two-way communication) and can be personalized at the individual level [4, 5]. Thoughtful mHealth interventions grounded in behavior change theory may therefore be particularly advantageous in advancing aspects of health care (e.g., delivery and assessment). Despite relatively few high-quality randomized controlled trials (RCTs)
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