title: Brief behavioral self-regulation counseling for HIV treatment adherence delivered by cell phone: an initial test of concept trial.
abstract: Affordable and effective antiretroviral therapy (ART) adherence interventions are needed for many patients to promote positive treatment outcomes and prevent viral resistance. We conducted a two-arm randomized trial (n = 40 men and women receiving and less than 95% adherent to ART) to test a single office session followed by four biweekly cell phone counseling sessions that were grounded in behavioral self-management model of medication adherence using data from phone-based unannounced pill counts to provide feedback-guided adherence strategies. The control condition received usual care and matched office and cell phone/pill count contacts. Participants were baseline assessed and followed with biweekly unannounced pill counts and 4-month from baseline computerized interviews (39/40 retained). Results showed that the self-regulation counseling delivered by cell phone demonstrated significant improvements in adherence compared to the control condition; adherence improved from 87% of pills taken at baseline to 94% adherence 4 months after baseline, p < 0.01. The observed effect sizes ranged from moderate (d = 0.45) to large (d = 0.80). Gains in adherence were paralleled with increased self-efficacy (p < 0.05) and use of behavioral strategies for ART adherence (p < 0.05). We conclude that the outcomes from this test of concept trial warrant further research on cell phone-delivered self-regulation counseling in a larger and more rigorous trial.
authors: University of Connecticut, Storrs, Connecticut 06269, USA. seth.k@uconn.edu
authors: Seth C
authors: SC
authors: Kalichman
authors: Moira O
authors: MO
authors: Kalichman
authors: Chauncey
authors: C
authors: Cherry
authors: Connie
authors: C
authors: Swetzes
authors: Christina M
authors: CM
authors: Amaral
authors: Denise
authors: D
authors: White
authors: Mich'l
authors: M
authors: Jones
authors: Tamar
authors: T
authors: Grebler
authors: Lisa
authors: L
authors: Eaton
mesh_terms: D000328:Adult; D000368:Aged; D040421:Cell Phone; D003376:Counseling; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D012648:Self Care; D020377:Self Efficacy; D012927:Social Control, Informal; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D016903:Drug Monitoring