A Single-Blind, Parallel Design RCT to Assess the Effectiveness of SMS Reminders in Improving ART Adherence Among Adolescents Living with HIV (STARTA Trial)

Abiodun, Olumide; Ladi-Akinyemi, Babatunde; Olu-Abiodun, Oluwatosin; Sotunsa, John; Bamidele, Fikayo; Adepoju, Akinmade; David, Nkiru; Adekunle, Motunrayo Oluwabukola; Ogunnubi, Adetutu; Imhonopi, Gloria; Yinusa, Idayat; Erinle, Charles; Soetan, Olufemi; Arifalo, Gregory; Adeyanju, Olusoji; Alawode, Olusegun; Omodunbi, Tolulope

doi:10.1016/j.jadohealth.2020.11.016

Cited by 35 publications

(89 citation statements)

References 26 publications

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“…The intervention with the highest number of techniques was by Dworkin et al [ 97 - 99 ] utilizing 17 different ones. The lowest number of BCTs was found in Abiodun et al [ 101 ], using 1 technique. A complete list of details on how many techniques each intervention has applied is provided in Multimedia Appendix 4 .…”

Section: Resultsmentioning

confidence: 95%

“…The median number of design features was 4. The intervention with the highest number of design features (n=15) was Hightow-Weidman et al [ 93 ], while the interventions with the lowest number of features (n=1) were Puccio et al [ 90 ] and Abiodun et al [ 101 ] ( Multimedia Appendix 5 ).…”

Section: Resultsmentioning

confidence: 99%

“…A closer look at Table 6 suggests mixed results; we cannot unambiguously conclude that more extensive grounding of design features in theory related to health behavior or behavior change is associated with better (significant) effectiveness on outcomes with good evidence quality (compare studies with footnotes c and e). However, the results suggest that 10/16 (Whiteley et al [ 77 , 78 ], Tanner et al [ 79 , 80 ], Hightow-Weidman et al [ 93 ], Dworkin et al [ 97 - 99 ], Dowshen et al [ 94 , 95 ], Garofalo et al [ 96 ], Shegog et al [ 83 ], Belzer et al [ 84 - 86 ], Dulli et al [ 100 ], Abiodun et al [ 101 ]) of the included eHealth apps report a positive impact on ART adherence or on its mediators.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 16 eHealth systems, 10 (Whiteley et al [ 77 , 78 ], Tanner et al [ 79 , 80 ], Hightow-Weidman et al [ 93 ], Dworkin et al [ 97 - 99 ], Dowshen et al [ 94 , 95 ], Garofalo et al [ 96 ], Shegog et al [ 83 ], Belzer et al [ 84 - 86 ], Dulli et al [ 100 ], Abiodun et al [ 101 ]) reported positive effect on 1 or more of the outcomes measured, yet 7 (Whiteley et al [ 77 , 78 ], Dworkin et al [ 97 - 99 ], Dowshen et al [ 94 , 95 ], Garofalo et al [ 96 ], Belzer et al [ 84 - 86 ], Dulli et al [ 100 ], Abiodun et al [ 101 ])out of these 10 also reported no effect on 1 or more of other outcomes. Six out of 16 (Stankievich et al [ 81 ], Spratt et al [ 82 ], Saberi et al [ 87 ], Linnemayr et al [ 88 , 89 ], Puccio et al [ 90 ], Naar-King et al [ 91 , 92 ]) reported purely no effect in all the outcomes measured.…”

Section: Discussionmentioning

confidence: 99%

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Behavioral Theories and Motivational Features Underlying eHealth Interventions for Adolescent Antiretroviral Adherence: Systematic Review

Bezabih¹,

Gerling²,

Abebe³

et al. 2021

JMIR Mhealth Uhealth

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Background eHealth systems provide new opportunities for the delivery of antiretroviral therapy (ART) adherence interventions for adolescents. They may be more effective if grounded in health behavior theories and behavior change techniques (BCTs). Prior reviews have examined the effectiveness, feasibility, and acceptability of these eHealth systems. However, studies have not systematically explored the use of health behavior theories and BCTs in the design of these applications. Objective The purpose of this review was to explore whether health behavior theories and BCTs were considered to ground designs of eHealth systems supporting adolescents’ (10-24 years) ART adherence. More specifically, we examined which specific theories and BCTs were applied, and how these BCTs were implemented as design features. Additionally, we investigated the quality and effect of eHealth systems. Methods A systematic search was performed on IEEE Xplore, ACM, ScienceDirect, PubMed, Scopus, and Web of Science databases from 2000 to 2020. Theory use and BCTs were coded using the Theory Coding Scheme and the Behavior Change Technique Taxonomy version 1 (BCTTv1), respectively. Design features were identified using the lenses of motivational design for mobile health (mHealth). The number of BCTs and design features for each eHealth system and their prevalence across all systems were assessed. Results This review identified 16 eHealth systems aiming to support ART adherence among adolescents. System types include SMS text message reminders (n=6), phone call reminders (n=3), combined SMS text message and phone call reminders (n=1), electronic adherence monitoring devices (n=3), smartphone apps (n=1), smartphone serious games (n=1), gamified smartphone apps (n=1), leveraging existing social media (n=2), web-based applications (n=1), videoconferencing (n=1), and desktop applications (n=1). Nine were grounded in theory, of which 3 used theories extensively. The impact of adolescent developmental changes on ART adherence was not made explicit. A total of 42 different BCTs and 24 motivational design features were used across systems. Ten systems reported positive effects on 1 or more outcomes; however, of these ten systems, only 3 reported exclusively positive effects on all the outcomes they measured. As much as 6 out of 16 reported purely no effect in all the outcomes measured. Conclusions Basic applications (SMS text messaging and phone calls) were most frequent, although more advanced systems such as mobile apps and games are also emerging. This review indicated gaps in the use of theory and BCTs, and particularly the impact of developmental changes on ART adherence was not adequately considered. Together with adopting a developmental orientation, future eHealth systems should effectively leverage health theories and consider developing more advanced systems that open the door to using BCTs more comprehensively. Overall, the impact of eHealth systems on adolescent ART adherence and its mediators is promising, but conclusive evidence on effect still needs to be provided.

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Behavioral Theories and Motivational Features Underlying eHealth Interventions for Adolescent Antiretroviral Adherence: Systematic Review

Bezabih¹,

Gerling²,

Abebe³

et al. 2021

JMIR Mhealth Uhealth

View full text Add to dashboard Cite

show abstract

“…Further, searching other sources led to the inclusion of 3 additional trials [ 48 – 50 ]. In total, we included 31 trials, of which 20 were published [ 19 – 35 , 43 – 45 ] and 11 were unpublished; six of the unpublished trials were finished [ 36 – 38 , 41 , 48 , 49 ] and 5 had an unknown status [ 39 , 40 , 46 , 47 , 50 ].…”

Section: Resultsmentioning

confidence: 99%

Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence

et al. 2022

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Background The growing access to mobile phones in Africa has led to an increase in mobile health interventions, including an increasing number of two-way text message interventions. However, their effect on healthcare outcomes in an African context is uncertain. This systematic review aims to landscape randomized trials involving two-way text message interventions and estimate their effect on healthcare outcomes. Methods We searched Medline, Embase, Cochrane Central Register of Controlled Trials, The Global Health Library (up to 12 August 2021) and trial registries (up to 24 April 2020). Published and unpublished trials conducted in Africa comparing two-way text message interventions with standard care and/or one-way text message interventions were included. Trials that reported dichotomous effect estimates on healthcare appointment attendance and/or medicine adherence were assessed for risk of bias and included in meta-analyses. Results of other outcomes were reported descriptively. Results We included 31 trials (28,563 participants) all set in Sub-Saharan Africa with a wide range of clinical conditions. Overall, ten different trials were included in the primary meta-analyses, and two of these had data on both medicine adherence and appointment attendance. An additional two trials were included in sensitivity analyses. Of the 12 included trials, three were judged as overall low risk of bias and nine as overall high risk of bias trials. Two-way text messages did not improve appointment attendance, RR: 1.03; 95% CI: 0.95–1.12, I2 = 53% (5 trials, 4374 participants) but improved medicine adherence compared to standard care, RR: 1.14, 95% CI: 1.07–1.21, I2 = 8% (6 trials, 2783 participants). Conclusion Two-way text messages seemingly improve medicine adherence but has an uncertain effect on appointment attendance compared to standard care. Systematic review registration PROSPERO CRD42020175810.

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Preferences for a Game-Based SMS Adherence Intervention Among Young People Living with HIV in Ghana: A Qualitative Study

et al. 2022

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A Single-Blind, Parallel Design RCT to Assess the Effectiveness of SMS Reminders in Improving ART Adherence Among Adolescents Living with HIV (STARTA Trial)

Cited by 35 publications

References 26 publications

Behavioral Theories and Motivational Features Underlying eHealth Interventions for Adolescent Antiretroviral Adherence: Systematic Review

Behavioral Theories and Motivational Features Underlying eHealth Interventions for Adolescent Antiretroviral Adherence: Systematic Review

Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence

Preferences for a Game-Based SMS Adherence Intervention Among Young People Living with HIV in Ghana: A Qualitative Study

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