TY - JOUR
T1 - Development of a Directly Observed Therapy Adherence Intervention for Adolescents with Human Immunodeficiency Virus-1
T2 - Application of Focus Group Methodology to Inform Design, Feasibility, and Acceptability
AU - Garvie, Patricia A.
AU - Lawford, Joanne
AU - Flynn, Patricia M.
AU - Gaur, Aditya H.
AU - Belzer, Marvin
AU - McSherry, George D.
AU - Hu, Chengcheng
N1 - Funding Information:
This project was supported in part by Grant No. U01AI068632 from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, and in part by the American Lebanese-Syrian Associated Charities (ALSAC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Allergy and Infectious Diseases or the National Institutes of Health. The authors thank the adolescents who participated in this study, whose input was invaluable. Sincere gratitude is extended to Audrey Rogers, Ph.D., M.P.H., for her valuable contributions and unrelenting support in seeing this study to fruition. Finally, the authors thank the study site Principal Investigators and focus group faciliators, respectively, at each participating site: Los Angeles, CA: James Homans, M.D., Charles Hilliard, Ph.D., Gloria Lopez-Glass, M.P.H.; Memphis, TN: Patricia Garvie, Ph.D., Mary Dillard, B.S.N., and Marion Donohoe, M.S.N., C.P.N.P.; Miami, FL: Lawrence Friedman, M.D., Anita Cody, A.R.N.P., and Helen Gutierrez, M.S.W.
PY - 2009/2
Y1 - 2009/2
N2 - Purpose: To obtain input from adolescents with human immunodeficiency virus-1 (HIV-1) infection to inform the design of a community-based modified directly observed therapy (MDOT) antiretroviral adherence intervention. Methods: Pediatric AIDS Clinical Trials Group (PACTG) protocol 1036A conducted three focus groups with 17 adolescents aged 17-22 years (10 female, 65% African-American) from three geographically distinct US PACTG sites. Focus group sessions were scripted, audio-taped, and transcribed verbatim. A coding dictionary was developed and validated; Ethnograph version 5.08 was used to summarize coded data across and within the three sites. Prevalent themes were identified via frequencies and are reported as percentages. Results: Adolescents provided the following specific input: the MDOT provider should be familiar with the participant and empathic; the MDOT location should be mutually agreed on, flexible, and private; and participant and provider communication should be bidirectional, preferably by phone. Ideally the MDOT program should be continued until adolescents independently demonstrate adherence and should include a weaning phase as a test of skill acquisition. The most commonly endorsed barrier to the proposed program was that MDOT would be an invasion of privacy. Initially, after introduction to the purpose of the focus group, all but one adolescent expressed the belief that MDOT could benefit persons other than themselves; however, at the conclusion of the focus group discussion, a significant shift in openness to the intervention occurred, in that 11 participants indicated they would consider participation in an MDOT program if such a program were offered. Conclusions: Focus group feedback clarified the feasibility, logistics, and patient concerns about the design and implementation of a proposed MDOT intervention for adolescents with HIV-1 infection who struggle with medication adherence.
AB - Purpose: To obtain input from adolescents with human immunodeficiency virus-1 (HIV-1) infection to inform the design of a community-based modified directly observed therapy (MDOT) antiretroviral adherence intervention. Methods: Pediatric AIDS Clinical Trials Group (PACTG) protocol 1036A conducted three focus groups with 17 adolescents aged 17-22 years (10 female, 65% African-American) from three geographically distinct US PACTG sites. Focus group sessions were scripted, audio-taped, and transcribed verbatim. A coding dictionary was developed and validated; Ethnograph version 5.08 was used to summarize coded data across and within the three sites. Prevalent themes were identified via frequencies and are reported as percentages. Results: Adolescents provided the following specific input: the MDOT provider should be familiar with the participant and empathic; the MDOT location should be mutually agreed on, flexible, and private; and participant and provider communication should be bidirectional, preferably by phone. Ideally the MDOT program should be continued until adolescents independently demonstrate adherence and should include a weaning phase as a test of skill acquisition. The most commonly endorsed barrier to the proposed program was that MDOT would be an invasion of privacy. Initially, after introduction to the purpose of the focus group, all but one adolescent expressed the belief that MDOT could benefit persons other than themselves; however, at the conclusion of the focus group discussion, a significant shift in openness to the intervention occurred, in that 11 participants indicated they would consider participation in an MDOT program if such a program were offered. Conclusions: Focus group feedback clarified the feasibility, logistics, and patient concerns about the design and implementation of a proposed MDOT intervention for adolescents with HIV-1 infection who struggle with medication adherence.
KW - Adherence
KW - Adolescents
KW - Focus group
KW - HIV
KW - Modified directly observed therapy (MDOT)
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U2 - 10.1016/j.jadohealth.2008.05.006
DO - 10.1016/j.jadohealth.2008.05.006
M3 - Article
C2 - 19167660
AN - SCOPUS:58649098328
SN - 1054-139X
VL - 44
SP - 124
EP - 132
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
IS - 2
ER -