mhealth for cancer prevention among HIV+ African Americans - Abstract
HIV+ individuals are several thousand times more likely to be diagnosed with Kaposi sarcoma, 70 times
more likely to be diagnosed with non-Hodgkin lymphoma, and five times more likely to be diagnosed with
cervical cancer than uninfected people. They are also more likely to be diagnosed with anal, liver, and lung
cancer, and Hodgkin lymphoma. African Americans are disproportionately affected by HIV and cancer. They
represent 13% of the population, yet accounted for 43% of HIV cases in 2014. NCI recommends antiretroviral
therapy (ART) as a key cancer prevention strategy among HIV+ individuals, yet many HIV+ people, especially
African Americans, have difficulty adhering to ART. According to NCI, regular screenings and a healthy lifestyle
may also help reduce cancer rates— but only if used consistently.
A growing literature of randomized controlled trials has demonstrated mhealth to be successful for
promoting cancer prevention, healthy lifestyle behaviors and medication adherence—including among African
Americans. However, no cancer prevention mhealth intervention has yet been developed that targets HIV+
African Americans, despite this group being disproportionately affected by BOTH cancer and HIV.
To address this critical gap, the research team, which includes a health psychologist and experts in
oncology, infectious disease, health disparities, and pharmacology, will develop a culturally-sensitive mhealth
intervention that includes a patient app and care provider team (CPT) platform to promote cancer prevention
behaviors among HIV+ African American adults. This research will be guided by three specific aims: 1)
Develop an individually-tailored, culturally-sensitive mhealth intervention, comprised of a patient app and CPT
platform to promote cancer prevention behaviors among HIV+ African American adults. 2) Implement 12-week
pre-post test design pilot to evaluate short-term effectiveness for promoting cancer prevention behaviors, i.e.
self-efficacy for healthy eating, self-efficacy for walking, cancer screening intention, and ART adherence among
HIV+ African Americans. 3) Evaluate feasibility. At 12 wks, we will evaluate feasibility via focus groups with all
pre-post participants and interviews with CPT members involved in implementation. The primary and
secondary hypotheses are that HIV+ African American adults who receive tailored cancer prevention texts plus
daily pill reminders for 12 weeks will show 1) greater self-efficacy for healthy eating and greater self-efficacy for
walking and 2) greater cancer screening intention and greater ART adherence at 12 weeks compared to
baseline.
Long-term, if proven to be effective in a Phase II SBIR application, the proposed research will help to
reduce the cancer rates and increase early diagnoses of cancer among African Americans who are HIV
positive, while simultaneously improving ART adherence rates.
