Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 24, 2024
Date Accepted: Apr 23, 2025
Given Two Types of mHealth Interventions to Support Self-Management among People Living with HIV: Randomized Clinical Trial
ABSTRACT
Background:
Mobile health (mHealth) has been continuously developed to support the HIV care continuum for people living with HIV (PLWH). Individuals have diverse acceptability and preferences for digital health; therefore, it is important to introduce varied and effective delivery methods.
Objective:
This study aimed to assess the effectiveness of two mHealth interventions among PLWH. We compared the HIV self-management impact of two non-face-to-face interventions: mobile link access information (Link group) and a mobile app to explore information and self-record health outcomes such as medication adherence, symptoms, mental score, and sexual safety (App group).
Methods:
A two-arm, prospective, randomized clinical trial was conducted, involving 83 PLWH aged ≥19, who were assigned to the App group (n=42) or Link group (n=41). The primary outcome was self-reported self-efficacy for HIV management (HIV-SE), which comprised six domains: managing depression/mood, medication, symptoms, and fatigue; communicating with healthcare providers; and getting support/help. A paired t-test and generalized estimating equation (GEE) were used to analyze the outcomes at baseline, 4 weeks after the completion of the intervention, and 8 weeks after an additional 4 weeks of voluntary use.
Results:
Total HIV-SE score increased for both groups at 4 weeks compared with baseline. All domain scores improved in the App group, including significant changes in total HIV-SE and managing fatigue. Additionally, the Link group showed a significant increase in managing depression/mood, fatigue, and getting support/help domains. The GEE analysis indicated that the App group had significant differential changes with a positive effect on managing symptoms at 4 weeks (β=0.635, p=.042) and a negative effect on managing depression/mood at 8 weeks (β=-0.824, p=.010) compared to the Link group. Only 9.5% of participants in the App group maintained daily visits for a voluntary use period of 4 to 8 weeks.
Conclusions:
Both types of informational mHealth interventions, through mobile apps or link access, contributed to improving self-efficacy for HIV management. Providing links in individual text messages could be considered for PLWHs who resist using HIV-related apps. Self-recording health outcomes and self-reflection through mobile apps influence symptom management; however, further strategies are needed to ensure long-term app use. User-customized psychiatric content beyond mental health recordings has been suggested for managing depressed moods in mHealth interventions. Clinical Trial: Clinical Research Information Service, KCT0008014; https://trialsearch.who.int/Trial2.aspx?TrialID=KCT0008014
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