A Mobile Game Intervention for Young Persons Living With HIV and Depression in Nigeria: Protocol for a Pilot Randomized Controlled Trial
Notice bibliographique
Résumé
BACKGROUND: Young people living with HIV bear a disproportionate burden of depression, which is associated with poor HIV outcomes. Problem-solving therapy (PST) has been shown to be effective for depression management and can be delivered with fidelity by nonspecialists, especially in resource-limited settings. PST is designed to equip individuals to manage the impact of stressful life events on their mental health. Change My Story is a narrative digital game designed to improve PST engagement among young people living with HIV in Nigeria. OBJECTIVE: This trial will evaluate the impact of PST alone or PST with Change My Story on mental health outcomes among young people living with HIV in Nigeria. METHODS: We will conduct a pilot hybrid implementation-effectiveness randomized controlled trial with 80 young people living with HIV (aged 16-24 years) in Nigeria with depression (9-item Patient Health Questionnaire [PHQ-9] ≥9) over 3 months. Participants will be randomized to receive PST with or without Change My Story. All participants will engage in weekly PST sessions for 6 weeks delivered by trained nonspecialists (clinic HIV adherence counselors). At 6 and 10-12 weeks, scores on PHQ-9 will determine the frequency of PST sessions during the remaining intervention period. Primary implementation outcomes, including engagement, satisfaction, feasibility, acceptability, and appropriateness from the participant perspective, will be assessed using validated scales, programmatic data, and focus group discussions at 3 months. Secondary clinical outcomes will assess changes in depressive symptoms, psychological distress, functional disability, antiretroviral therapy adherence, and HIV viral suppression at 3 and 6 months. Implementation outcomes (all but engagement and satisfaction) will be assessed through validated scales and focus group discussions from the implementer perspective at baseline and 6 months. RESULTS: This study is funded by the US National Institutes of Health (funding commenced on March 8, 2024), institutional review board approval was received on April 15, 2024, and recruitment and data collection began in June 2025. Thus far, we have screened 103 youths and enrolled 23 participants. Among enrolled participants, 15 (65%) were male; 1 (4%) had a PHQ-9 score ≥17, and 6 (26%) had suicidal thoughts. We anticipate recruitment will be completed by January 2026 and follow-up by June 2026. We will assess our hypotheses that PST with Change My Story is feasible, acceptable, and appropriate and that individuals receiving PST integrated with Change My Story will have greater engagement, satisfaction, and depression remission compared to those receiving PST alone. CONCLUSIONS: This pilot randomized controlled trial attempts to establish preliminary data on the feasibility, acceptability, appropriateness, and efficacy of task-shifted PST and supplementary mobile health technology on improving HIV and mental health outcomes among young people living with HIV in Nigeria. These findings may serve as a basis for future large-scale interventions. TRIAL REGISTRATION: ClinicalTrials.gov NCT06389565; https://clinicaltrials.gov/study/NCT06389565. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/74199.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,021 | 0,016 |
| Méta-épidémiologie (sens strict) | 0,005 | 0,003 |
| Méta-épidémiologie (sens large) | 0,010 | 0,005 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,006 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,068 | 0,008 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».