NCT02128087

Brief Summary

In this project the investigators develop and test a short message service (SMS) intervention based on the Information Motivation and Behavior skills (IMB) model. Reminding Adolescents To Adhere (RATA) prompts youths at two clinics in Uganda to take their medications and offers social support via weekly text messages. The investigators propose to adapt their previous successful SMS-intervention to the specific needs of youths and to evaluate the relative effectiveness of one-way versus two-way text messages (where two-way messages allow youths to respond to messages and we hypothesize that this may increase perceived social support that may be important for youth populations). We will also test the effectiveness of SMS messages over the longer-term (2 years), for which currently no information is available.

Trial Health

90
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
330

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Feb 2013

Longer than P75 for not_applicable

Geographic Reach
2 countries

3 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

February 1, 2013

Completed
1.2 years until next milestone

First Submitted

Initial submission to the registry

April 15, 2014

Completed
16 days until next milestone

First Posted

Study publicly available on registry

May 1, 2014

Completed
1.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 31, 2016

Completed
1.2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2017

Completed
Last Updated

April 14, 2017

Status Verified

April 1, 2017

Enrollment Period

3 years

First QC Date

April 15, 2014

Last Update Submit

April 12, 2017

Conditions

Keywords

HIVAntiretroviral (ARV)co-trimoxazoleSMSmobile Health (mHealth)AdolescentsUgandaAdherence

Outcome Measures

Primary Outcomes (3)

  • Medication adherence rates using electronically monitored adherence (MEMS cap) data

    Medication Event Monitoring System (MEMS)-cap data will be collected continuously over the course of the 24-month study period allowing us to investigate daily adherence and its timing. MEMS caps data indicating the date and time when the participant opened their pill bottle (either one of the ART medications or prophylaxis if not on ART yet) will be used to calculate the primary outcome variable of adherence (# of actual bottle openings / # of prescribed bottle openings).

    6 months after enrollment

  • Medication adherence rates using electronically monitored adherence (MEMS cap) data

    Medication Event Monitoring System (MEMS)-cap data will be collected continuously over the course of the 24-month study period allowing us to investigate daily adherence and its timing. MEMS caps data indicating the date and time when the participant opened their pill bottle (either one of the ART medications or prophylaxis if not on ART yet) will be used to calculate the primary outcome variable of adherence (# of actual bottle openings / # of prescribed bottle openings).

    12 months after enrollment

  • Medication adherence rates using electronically monitored adherence (MEMS cap) data

    Medication Event Monitoring System (MEMS)-cap data will be collected continuously over the course of the 24-month study period allowing us to investigate daily adherence and its timing. MEMS caps data indicating the date and time when the participant opened their pill bottle (either one of the ART medications or prophylaxis if not on ART yet) will be used to calculate the primary outcome variable of adherence (# of actual bottle openings / # of prescribed bottle openings).

    24 months after enrollment

Secondary Outcomes (7)

  • Fraction of clients displaying adherence of 90% or more

    At 6, 12, 18 and 24 months

  • Indicator for treatment interruptions of more than 48 hours

    At 6, 12, 18 and 24 months

  • Viral load assays

    At month 12

  • Self-reported adherence

    At baseline, 6, 12, 18 and 24 months

  • Pharmacy Refill Adherence

    Months 6, 12, 18 and 24

  • +2 more secondary outcomes

Study Arms (3)

Control group

NO INTERVENTION

This study arm will receive care as usual.

Two-way SMS intervention group

EXPERIMENTAL

Two-way messages allow the recipient of the SMS message (the patient) to respond to the messages ("We hope you are feeling well today. Reply 1 if well, 2 if unwell") to request a follow-up call from the clinic.

Behavioral: Two-way SMS intervention

One-way SMS intervention group

EXPERIMENTAL

Clients will receive a weekly one-way SMS with the message "We hope you are feeling well today." There will be no prompt for response.

Behavioral: One-way SMS intervention group

Interventions

Clients will receive a weekly two-way SMS, meaning that the clients in this group will receive the same message as in the one-way SMS study arm, but in addition will be asked how they feel. Clients are required to either press 1 or respond "well" or press 2 or write 'Unwell" in response in the language of their choice within 48 hours. A missing response after 48 hours triggers a second SMS to remind the client to respond. If after 24 more hours the participant still does not respond or if at any point s/he responds "unwell" then the study coordinator will follow up with a call within 24 hours.

Two-way SMS intervention group

Clients will receive a weekly one-way SMS message. There will be no prompt for any response.

One-way SMS intervention group

Eligibility Criteria

Age15 Years - 24 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • age 15-24
  • have been in HIV care at the clinic for at least three months
  • are currently taking HIV-related medication (ART or co-trimoxazole)
  • have demonstrated adherence problems (defined as having missed at least one medication dose per week on average)
  • either own a phone or have regular access to one
  • intend to stay at the clinic for the study period
  • are not in boarding school (where phones are forbidden)

You may not qualify if:

  • does not speak or understand either English or Luganda

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

RAND

Santa Monica, California, 90407, United States

Location

Infectious Diseases Institute

Kampala, Uganda

Location

Mildmay Uganda

Kampala, Uganda

Location

MeSH Terms

Conditions

Acquired Immunodeficiency Syndrome

Condition Hierarchy (Ancestors)

HIV InfectionsBlood-Borne InfectionsCommunicable DiseasesInfectionsSexually Transmitted Diseases, ViralSexually Transmitted DiseasesLentivirus InfectionsRetroviridae InfectionsRNA Virus InfectionsVirus DiseasesSlow Virus DiseasesGenital DiseasesUrogenital DiseasesImmunologic Deficiency SyndromesImmune System Diseases

Study Officials

  • Sebastian Linnemayr, PhD

    RAND

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
FACTORIAL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Economist

Study Record Dates

First Submitted

April 15, 2014

First Posted

May 1, 2014

Study Start

February 1, 2013

Primary Completion

January 31, 2016

Study Completion

March 31, 2017

Last Updated

April 14, 2017

Record last verified: 2017-04

Locations