Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

Remien, Robert H.; Mellins, Claude A.; Robbins, Reuben N; Kelsey, Ryan; Rowe, Jessica; Warne, Patricia; Chowdhury, Jenifar; Lalkhen, Nuruneesa; Hoppe, Lara; Abrams, Elaine J.; El‐Bassel, Nabila; Witte, Susan S.; Stein, Dan J.

doi:10.1007/s10461-013-0438-8

Cited by 38 publications

(52 citation statements)

References 48 publications

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“…Masivukeni (“Let’s wake up” in isiXhosa), a multimedia, laptop-based, lay counselor-delivered intervention adapted from SMART Couples [52, 53], demonstrated high acceptability by patients, lay counselors, and clinic staff, as well as feasibility of use in a busy resource-limited, public healthcare setting in the Western Cape Region of South Africa [52]. In a pilot RCT among clinic identified non-adherent adult HIV patients, Masivukeni participants’ pharmacy pill count adherence rates improved by 10%, while standard care (SOC) patients’ adherence declined by 8% at post-intervention, though the difference was not significant [54].…”

Section: Resultsmentioning

confidence: 99%

Optimizing ART Adherence: Update for HIV Treatment and Prevention

et al. 2014

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Optimal adherence to antiretroviral therapy (ART) is central to achieving viral suppression and positive health outcomes in HIV-infected individuals. Virally suppressed individuals can also reduce the risk of HIV transmission to uninfected partners. Hence, adherence to ART has become both an HIV treatment and an HIV prevention strategy. However, achieving optimal ART adherence can be challenging, especially over the long term. It is increasingly important for clinicians and researchers to be abreast of the most recent developments in the field as new biomedical approaches to treatment emerge, and as guidelines for the use of pre-exposure prophylaxis (PrEP) are disseminated to providers serving HIV affected populations. Several reviews have described numerous ART adherence interventions that have been developed and/or tested with the most recent review including literature up to 2012. To augment the literature, we present a review of ART adherence interventions from 2013 – present. We included peer-reviewed journals as well as abstracts from two key conferences.

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Section: Resultsmentioning

confidence: 99%

Optimizing ART Adherence: Update for HIV Treatment and Prevention

et al. 2014

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“…The clinic policy at that time followed the City of Cape Town Department of Health (DOH) requirements requiring all patients receiving ART adherence counseling to bring a treatment support partner to counseling sessions. This often meant that patients would ask another available patient they met in the waiting room to attend their session with them [34]. In practice, counselors were able to counsel some patients if they did not bring a buddy.…”

Section: Methodsmentioning

confidence: 99%

“…They were trained in the use of Masivukeni (i.e., how to operate the program and navigate through the intervention) and how to integrate their current adherence counseling skills and knowledge with Masivukeni. We have described in detail the content of the six-session Masivukeni intervention previously [34], and Table 1 provides an overview of the content and curriculum. In the first Masivukeni session, the counselor was guided by the computerized program in administering standardized screening assessments for psychiatric distress and problems with alcohol and substance use.…”

Section: Methodsmentioning

confidence: 99%

“…Elsewhere, we have extensively described the process of adaptation and development of the intervention for the South African context and reported its high acceptability by patients, counselors, and clinic administrators, as well as the feasibility of its use in a busy resource-constrained healthcare setting [34]. Table 1 shows the curriculum, objectives, and activities for each session of Masivukeni.…”

Section: Introductionmentioning

confidence: 99%

“…We have previously reported that lay counselors using Masivukeni indicated that it helped them engage patients better than the standard counseling methods and procedures; stay on track with the intervention content, curriculum and health messages; and remember to cover important information and material [34]. In this report, we present a first analysis of the impact of Masivukeni on ART adherence outcomes and the behavior change mediators hypothesized within our theoretical framework, Social Action Theory [35], in a pilot sample of HIV-infected patients taking antiretroviral medication (ARVs) at one public health clinic in South Africa.…”

Section: Introductionmentioning

confidence: 99%

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Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology

et al. 2015

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Multimedia technologies offer powerful tools to increase capacity of health workers to deliver standardized, effective, and engaging antiretroviral medication adherence counseling. Masivukeni is an innovative multimedia-based, computer-driven, lay counselor-delivered intervention designed to help people living with HIV in resource-limited settings achieve optimal adherence. This pilot study examined medication adherence and key psychosocial outcomes among 55 non-adherent South African HIV+ patients, on ART for at least 6 months, who were randomized to receive either Masivukeni or standard of care (SOC) counseling for ART non-adherence. At baseline, there were no significant differences between the SOC and Masivukeni groups on any outcome variables. At post-intervention (approximately 5–6 weeks after baseline), clinic-based pill count adherence data available for 20 participants (10 per intervention arm) showed a 10% improvement for Masivukeni participants and a decrease of 8% for SOC participants. Masivukeni participants reported significantly more positive attitudes towards disclosure and medication social support, less social rejection, and better clinic-patient relationships than did SOC participants. Masivukeni shows promise to promote optimal adherence and provides preliminary evidence that multimedia, computer-based technology can help lay counselors offer better adherence counseling than standard approaches.

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A scoping review: The utility of participatory research approaches in psychology

Levac

Ronis

Cowper-Smith

et al. 2019

Journal Community Psychology

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Consistent with community psychology's focus on addressing societal problems by accurately and comprehensively capturing individuals’ relationships in broader contexts, participatory research approaches aim to incorporate individuals’ voices and knowledge into understanding, and responding to challenges and opportunities facing them and their communities. Although investigators in psychology have engaged in participatory research, overall, these approaches have been underutilized. The purpose of this review was to examine areas of research focus that have included participatory research methods and, in turn, highlight the strengths and ways that such methods could be better used by researchers. Nearly 750 articles about research with Indigenous Peoples, children/adolescents, forensic populations, people with HIV/AIDS, older adults, and in the area of industrial‐organizational psychology were coded for their use of participatory research principles across all research stages (i.e., research design, participant recruitment and data collection, analysis and interpretation of results, and dissemination). Although we found few examples of studies that were fully committed to participatory approaches to research, and notable challenges with applying and reporting on this type of work, many investigators have developed creative ways to engage respectfully and reciprocally with participants. Based on our findings, recommendations and suggestions for researchers are discussed.

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Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

Cited by 38 publications

References 48 publications

Optimizing ART Adherence: Update for HIV Treatment and Prevention

Optimizing ART Adherence: Update for HIV Treatment and Prevention

Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology

A scoping review: The utility of participatory research approaches in psychology

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