Computer-Based Intervention in HIV-Positive Young Adults

Emory University

Overview

The purpose of this study is to investigate how working with a computer program may affect mood, feelings, overall health, and markers in blood in young adults with HIV.

Depression frequently occurs in young adults with HIV infection. When young adults with HIV experience depression, they are less likely to take their prescribed antiretroviral therapy (ART). When HIV occurs simultaneously with depression, individuals are more likely to have indicators in their blood that are linked risk for developing other illnesses in the future. The purpose of this project is to examine the ability of an avatar-based intervention, called eSMART-MH, to decrease depressive symptoms in HIV-positive depressed young adults.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Conditions

HIV Depression

Interventions

Electronic Self-Management Resource Training for Mental HealthDEVICE

eSMART-MH is a software, which is set in a 3-D virtual primary care office environment in which a subject interacts with avatar virtual healthcare staff (medical receptionist, medical assistant, providers, and a virtual healthcare coach). The avatars are programed to behave like humans. The subject moves through the 3-D virtual primary care office and encounters virtual healthcare staff and providers. The subject practices discussing depressive symptoms with avatar healthcare providers and practices self-management skills related to symptoms of depression.The subject also interacts with the health care coach. The health care coach provides the subject with real-time strategies to enhance communication with healthcare providers during their virtual office visit. Overtime, coaching is decreased to build the the subject's self-confidence. eSMART-MH will be used once a month, for three months.

Screen-based health educationBEHAVIORAL

Screen-based health education will be used and cover topics like depression, nutrition, physical activity, and sleep hygiene at the same frequency as the eSMART-MH intervention, which is used once a month, for three months.

Eligibility

Sex: ALLMin age: 23 YearsMax age: 35 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 23-53 years of age * Fluent in English * Be able to view images and text on a computer screen and hear audio using a headset * Have a diagnosis of unipolar depression or have significant depressive symptoms noted in the electronic medical record (EMR) or referred to the study by a provider at the Grady Ponce de Leon Clinic because of their depressive symptoms * Receive care at Ponce de Leon Center and at least 1 scheduled HIV medical appointment in the last 6 months * Reside in the Atlanta, Georgia area * Have a valid telephone number and email address * Answer all items correctly on consent post-test Exclusion Criteria: * Diagnosis of bipolar depression * Deaf, blind or unable to understand spoken English * Currently pregnant, history of pregnancy within the last year or plan to become pregnant within the next 4 months * Plan to move from the Atlanta, Georgia area within four months of study enrollment * Taking corticosteroids or disease-modifying anti-rheumatic drugs * If on antidepressant medication, taking it for less than 1 month * Fail to pass post-consent test after three attempt

Outcomes

Primary Outcomes

Change in the Patient Health Questionnaire (PHQ-9)

The PHQ-9 is a 9-item self-report measure of depressive symptoms which asks participants to rate the frequency of depression symptoms over the past 2 weeks from 0 (not at all) to 3 (nearly every day). Scores range from 0 to 27, with higher scores reflecting greater severity of depressive symptoms.