Exploring the consequences of food insecurity and harnessing the power of peer navigation and mHealth to reduce food insecurity and cardiometabolic comorbidities among persons with HIV: protocol for development and implementation trial of weCare/Secure

Trials

Study Protocol

Scott Isom¹  Elena Wright²  Ajay Dharod³  Deepak Palakshappa⁴  Amanda E. Tanner⁵  Jorge Alonzo⁶  Lucero Refugio Aviles⁶  Manuel Garcia⁶  Ana D. Sucaldito⁶  Lilli Mann-Jackson⁶  Caryn G. Morse⁷  Scott D. Rhodes⁸ 

[1] Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Internal Medicine, Informatics and Analytics, Wake Forest University School of Medicine, Winston-Salem, USA;Wake Forest Center for Healthcare Innovation, Wake Forest University School of Medicine, Winston-Salem, USA;Wake Forest Center for Biomedical Informatics, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Public Health Education, University of North Carolina Greensboro, Coleman 437E, 27402, Greensboro, NC, USA;Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA;Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA;Section on Infectious Diseases, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, USA;Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, USA;

关键词: HIV;    Food insecurity;    Diabetes;    Peer navigation;    mHealth;    Feasibility studies;    United States;   

DOI  :  10.1186/s13063-022-06924-3

 received in 2022-09-20, accepted in 2022-11-12,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundFood insecurity, or the lack of consistent access to nutritionally adequate and safe foods, effects up to 50% of people living with HIV (PWH) in the United States (US). PWH who are food insecure have lower antiretroviral adherence, are less likely to achieve viral suppression, and are at increased risk developing of serious illnesses, including cardiometabolic comorbidities. The objectives of this study are to better understand how food insecurity contributes to the development of cardiometabolic comorbidities among PWH and to test a novel bilingual peer navigation-mHealth intervention (weCare/Secure) designed to reduce these comorbidities in food-insecure PWH with prediabetes or Type 2 diabetes (T2DM).MethodsIn Aim 1, we will recruit a longitudinal cohort of 1800 adult (≥18 years) PWH from our clinic-based population to determine the difference in the prevalence and incidence of cardiometabolic comorbidities between food-secure and food-insecure PWH. Food insecurity screening, indicators of cardiometabolic comorbidities, and other characteristics documented in the electronic health record (EHR) will be collected annually for up to 3 years from this cohort. In Aim 2, we will conduct a randomized controlled trial among a sample of food-insecure PWH who have prediabetes or T2DM to compare changes in insulin sensitivity over 6 months between participants in weCare/Secure and participants receiving usual care. In Aim 3, we will conduct semi-structured individual in-depth interviews to explore the effect of the intervention among intervention participants with varying insulin sensitivity outcomes.Trial statusAim 1 (longitudinal cohort) recruitment began in May 2022 and is ongoing. Aim 2 (intervention) recruitment is planned for spring 2023 and is expected to be completed in spring 2024. Aim 3 (process evaluation) data collection will occur after sufficient completion of the 6-month assessment in Aim 2. Final results are anticipated in fall 2025.ConclusionsThis research seeks to advance our understanding of how food insecurity impacts the development of cardiometabolic comorbidities among PWH and how food insecurity interventions may alleviate relevant comorbidities. Given the growing interest among health systems in addressing food insecurity, if the intervention is found to be efficacious, it could be broadly disseminated across HIV clinical care settings.Trial registrationClinicalTrials.gov NCT04943861. Registered on June 29, 2021.

【 授权许可】

CC BY   
© The Author(s) 2022

【 图 表 】

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