title: Activation of persons living with HIV for treatment, the great study.
abstract: BACKGROUND
  Patient empowerment represents a potent tool for addressing racial, ethnic and socioeconomic disparities in health care, particularly for chronic conditions such as HIV infection that require active patient engagement. This multimodal intervention, developed in concert with HIV patients and clinicians, aims to provide HIV patients with the knowledge, skills, attitudes and tools to become more activated patients.
  
  
  METHODS
  Randomized controlled trial of a multimodal intervention designed to activate persons living with HIV. The intervention includes four components: 1) use of a web-enabled hand-held device (Apple iPod Touch) loaded with a Personal Health Record (ePHR) customized for HIV patients; 2) six 90-minute group-based training sessions in use of the device, internet and the ePHR; 3) a pre-visit coaching session; and 4) clinician education regarding how they can support activated patients. Outcome measures include pre- post changes in patient activation measure score (primary outcome), eHealth literacy, patient involvement in decision-making and care, medication adherence, preventive care, and HIV Viral Load.
  
  
  CONCLUSIONS
  We hypothesize that participants receiving the intervention will show greater improvement in empowerment and the intervention will reduce disparities in study outcomes. Disparities in these measures will be smaller than those in the usual care group. Findings have implications for activating persons living with HIV and for other marginalized groups living with chronic illness.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT02165735, 6/13/2014.
authors.affiliation: Public Health Sciences and Community Health, Department of Family Medicine, University of Rochester Medical Center, 1381 South Ave, Rochester, NY, 14620, USA. kevin_fiscella@urmc.rochester.edu.|Public Health Sciences, University of Rochester Medical Center, Rochester, USA. kevin_fiscella@urmc.rochester.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.affiliation: Public Health Sciences and Community Health, Department of Family Medicine, University of Rochester Medical Center, 1381 South Ave, Rochester, NY, 14620, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Boyd
authors.affiliation: Trillium Health, Rochester, USA.
authors.forename: Julian
authors.initials: J
authors.lastname: Brown
authors.affiliation: Department of Family Medicine, University of Colorado, Denver, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Carroll
authors.affiliation: Clinical Directors Network, New York, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Cassells
authors.affiliation: Trillium Health, Rochester, USA.
authors.forename: Roberto
authors.initials: R
authors.lastname: Corales
authors.affiliation: Department of Psychiatry, University of Rochester Medical Center, Rochester, USA.
authors.forename: Wendi
authors.initials: W
authors.lastname: Cross
authors.affiliation: Rochester Regional Health System, Unity Family Medicine at St. Mary's and Unity Infectious Disease, Rochester, USA.
authors.forename: Nayef
authors.initials: N
authors.lastname: El'Daher
authors.affiliation: Public Health Sciences and Community Health, Department of Family Medicine, University of Rochester Medical Center, 1381 South Ave, Rochester, NY, 14620, USA.
authors.forename: Subrina
authors.initials: S
authors.lastname: Farah
authors.affiliation: Department of Medicine, Infectious Diseases (SMD), University of Rochester, Rochester, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Fine
authors.affiliation: Trillium Health, Rochester, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Fowler
authors.affiliation: Rochester Regional Health System, Unity Family Medicine at St. Mary's and Unity Infectious Disease, Rochester, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Hann
authors.affiliation: Department of Medicine, Infectious Diseases (SMD), University of Rochester, Rochester, USA.
authors.forename: Amneris
authors.initials: A
authors.lastname: Luque
authors.affiliation: Clinical Directors Network, New York, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rodriquez
authors.affiliation: Public Health Sciences and Community Health, Department of Family Medicine, University of Rochester Medical Center, 1381 South Ave, Rochester, NY, 14620, USA.|Public Health Sciences, University of Rochester Medical Center, Rochester, USA.
authors.forename: Mechelle
authors.initials: M
authors.lastname: Sanders
authors.affiliation: Clinical Directors Network, New York, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Tobin
mesh_terms: D000328:Adult; D002908:Chronic Disease; D034201:Computers, Handheld; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D054625:Healthcare Disparities; D006801:Humans; D020407:Internet; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010358:Patient Participation; D011209:Power, Psychological; D012107:Research Design; D012648:Self Care; D017216:Telemedicine; D019562:Viral Load