Development and Pilot Testing of Daily Interactive Voice Response (IVR) Calls to Support Antiretroviral Adherence in India: A Mixed-Methods Pilot Study
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This two-phase pilot study aimed to design, pilot, and refine an automated interactive voice response (IVR) intervention to support antiretroviral adherence for people living with HIV (PLH), in Kolkata, India. Mixed-methods formative research included a community advisory board for IVR message development, 1-month pre-post pilot, post-pilot focus groups, and further message development. Two IVR calls are made daily, timed to patients’ dosing schedules, with brief messages (<1-min) on strategies for self-management of three domains: medical (adherence, symptoms, co-infections), mental health (social support, stress, positive cognitions), and nutrition and hygiene (per PLH preferences). Three ART appointment reminders are also sent each month. One-month pilot results (n = 46, 80 % women, 60 % sex workers) found significant increases in self-reported ART adherence, both within past three days (p = 0.05) and time since missed last dose (p = 0.015). Depression was common. Messaging content and assessment domains were expanded for testing in a randomized trial currently underway.
KeywordsAntiretroviral adherence Intervention Interactive voice response Mobile phone India
This research was supported by collaborative funding from the Indian Council of Medical Research (ICMR) grant INDO-US/86/9/20 1O-ECD-II and the U.S. National Institutes of Health grant R21AI094666. Additional support was provided by the Center for HIV Identification, Prevention, and Treatment Services (CHIPTS, NIMH Grant MH58107) and NIH grants 5P30AI028697 and UL1TR000124. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or ICMR. We are also grateful to the participants who participated in this study.
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