TY - JOUR
T1 - Adapting the HIV infant tracking system to support prevention of mother-to-child transmission of HIV in Kenya
T2 - Protocol for an intervention development pilot study in two hospitals
AU - Finocchario-Kessler, Sarah
AU - Maloba, May
AU - Brown, Melinda
AU - Gautney, Brad
AU - Goggin, Kathy
AU - Wexler, Catherine
AU - Mabachi, Natabhona
AU - Odeny, Beryne
AU - Lagat, Silas
AU - Koech, Sharon
AU - Dariotis, Jacinda K.
AU - Odeny, Thomas A.
N1 - Funding Information:
All authors’ effort on this project was supported by grant R34MH107337 from the National Institute of Mental Health. The National Institute of Mental Health played no role in the design of the study, data collection, the writing of the manuscript, or the decision to submit for publication. The authors would like to acknowledge the members of the Kenya HITSystem study team: Emmy Kavaya, Philomena Chepchirchir, and Hellen Murei. The authors would also like to acknowledge the critical role of the government partners at the Kenya National AIDS and STI Control Program (NASCOP). The authors thank the director, KEMRI, for permission to publish this manuscript. Without the generous contributions of HITSystem software developers at OnTarget LLC, Terry Oehrke and Matt Coleman, these efforts would not have been possible. This research was funded by the National Institute of Mental Health Grant R34MH107337 (Multimedia Appendix 1; principal investigator: SFK). The datasets used and/or analyzed during this study are available from the corresponding author on reasonable request.
Publisher Copyright:
©Sarah Finocchario-Kessler, May Maloba, Melinda Brown, Brad Gautney, Kathy Goggin, Catherine Wexler, Natabhona Mabachi, Beryne Odeny, Silas Lagat, Sharon Koech, Jacinda K Dariotis, Thomas A Odeny.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: Despite progress to expand access to HIV testing and treatment during pregnancy in Kenya, gaps still remain in prevention of mother-to-child transmission of HIV (PMTCT) services. This study addresses the need for effective and scalable interventions to support women throughout the continuum of care for PMTCT services in low-resource settings. Our research team has successfully implemented the HIV Infant Tracking System (HITSystem), a Web-based, system-level intervention to improve early infant diagnosis (EID) outcomes. Objective: This study will expand the scope of the HITSystem to address PMTCT services to bridge the gap between maternal and pediatric HIV services and improve outcomes. This paper describes the intervention development protocol to adapt and pilot an HITSystem version 2.0 to assess acceptability, feasibility, and preliminary PMTCT outcomes in Kenya. Methods: This is a 3-year intervention development study to adapt the current HITSystem intervention to support a range of PMTCT outcomes including appointment attendance, antiretroviral therapy (ART) adherence, hospital deliveries, and integration of maternal and pediatric HIV services in low-resource settings. The study will be conducted in 3 phases. Phase 1 will elicit feedback from intervention users (patients and providers) to guide development and refinement of the new PMTCT components and inform optimal implementation. In Phase 2, we will design and develop the HITSystem 2.0 features to support key PMTCT outcomes guided by clinical content experts and findings from Phase 1. Phase 3 will assess complete PMTCT retention (before, during, and after delivery) using a matched randomized pilot study design in 2 hospitals over 18 months. A total of N=108 HIV-positive pregnant women (n=54 per site) will be enrolled and followed from their first PMTCT appointment until infant HIV DNA Polymerase Chain Reaction testing at the target age of 6 weeks (<7 weeks) postnatal. Results: Funding for this study was received in August 2015, enrollment in Phase 1 began in March 2016, and completion of data collection is expected by May 2019. Conclusions: This protocol will extend, adapt, and pilot an HITSystem 2.0 version to improve attendance of PMTCT appointments, increase ART adherence and hospital-based deliveries, and prompt EID by 6 weeks postnatal. The HITSystem 2.0 aims to improve the integration of maternal and pediatric HIV services.
AB - Background: Despite progress to expand access to HIV testing and treatment during pregnancy in Kenya, gaps still remain in prevention of mother-to-child transmission of HIV (PMTCT) services. This study addresses the need for effective and scalable interventions to support women throughout the continuum of care for PMTCT services in low-resource settings. Our research team has successfully implemented the HIV Infant Tracking System (HITSystem), a Web-based, system-level intervention to improve early infant diagnosis (EID) outcomes. Objective: This study will expand the scope of the HITSystem to address PMTCT services to bridge the gap between maternal and pediatric HIV services and improve outcomes. This paper describes the intervention development protocol to adapt and pilot an HITSystem version 2.0 to assess acceptability, feasibility, and preliminary PMTCT outcomes in Kenya. Methods: This is a 3-year intervention development study to adapt the current HITSystem intervention to support a range of PMTCT outcomes including appointment attendance, antiretroviral therapy (ART) adherence, hospital deliveries, and integration of maternal and pediatric HIV services in low-resource settings. The study will be conducted in 3 phases. Phase 1 will elicit feedback from intervention users (patients and providers) to guide development and refinement of the new PMTCT components and inform optimal implementation. In Phase 2, we will design and develop the HITSystem 2.0 features to support key PMTCT outcomes guided by clinical content experts and findings from Phase 1. Phase 3 will assess complete PMTCT retention (before, during, and after delivery) using a matched randomized pilot study design in 2 hospitals over 18 months. A total of N=108 HIV-positive pregnant women (n=54 per site) will be enrolled and followed from their first PMTCT appointment until infant HIV DNA Polymerase Chain Reaction testing at the target age of 6 weeks (<7 weeks) postnatal. Results: Funding for this study was received in August 2015, enrollment in Phase 1 began in March 2016, and completion of data collection is expected by May 2019. Conclusions: This protocol will extend, adapt, and pilot an HITSystem 2.0 version to improve attendance of PMTCT appointments, increase ART adherence and hospital-based deliveries, and prompt EID by 6 weeks postnatal. The HITSystem 2.0 aims to improve the integration of maternal and pediatric HIV services.
KW - Diagnosis
KW - EHealth
KW - HIV
KW - Infant
KW - Kenya
KW - Medication adherence
KW - MHealth
KW - Pregnancy
KW - Retention
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U2 - 10.2196/13268
DO - 10.2196/13268
M3 - Article
C2 - 31199305
AN - SCOPUS:85070990572
SN - 1439-4456
VL - 21
JO - Journal of Medical Internet Research
JF - Journal of Medical Internet Research
IS - 6
M1 - e13268
ER -