- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02921516
Growing Up: Intervening With HIV-Positive Adolescents in Resource-Poor Settings
July 10, 2018 updated by: jessy g devieux, Florida International University
Despite overall declines in HIV incidence and mortality since ART scale-up in low and middle income countries, both have risen among youth.
In addition, HIV-infected youth achieve inferior treatment outcomes compared to their adult counterparts in both high- and low-income countries, and these poorer outcomes are generally attributed to suboptimal adherence.
Thus, there is a critical need for the development of adherence and risk reduction interventions for the growing cohort of these youth, and the proposed cognitive behavioral N'ap Grandi is one such intervention.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
As pediatric HIV infection has shifted from being a fatal disease to a chronic illness, a growing cohort of young people are moving through adolescence with all the challenges of the adult HIV-infected population but largely without comparable treatment outcomes or an evidence base to improve adherence to antiretroviral treatment (ART) and preventive behavior.
Despite overall declines in HIV incidence and mortality since the ART scale-up, both have risen among youth.
The goal of the proposed 3-year R34 developmental study is to respond to this need for tailored research, in particular among HIV+ older adolescents, and contribute to understanding the added value in resource-limited settings of including caregivers in an adherence and risk reduction program.
Although caregiver involvement is a recognized correlate of outcomes in HIV+ youth, there are no rigorous studies of the role of caregivers in outcomes among HIV+ older adolescents.This project will integrate caregiver involvement and cognitive behavioral intervention (CBI) elements to improve ART adherence and HIV risk reduction for HIV+ older adolescents treated in resource-poor clinical settings.Our proposed study population will include caregivers and 15 to 19 year-old HIV+ youth who know their status and are receiving ART in Port-au-Prince, Haiti.
Guided by the theoretical framework of the developmentally sensitive Information-Motivation-Behavioral Skills for Pediatric Adherence (IMB-PED), we will develop Growing Up (N'ap Grandi, in Haitian Creole) as a collaborative model of caregiver-adolescent engagement in the key informational, motivational, and behavioral skills antecedents of ART adherence and risk reduction.
The study will utilize qualitative and quantitative methods to: identify barriers and facilitators to adherence and risk reduction (Aim 1); develop and pretest N'ap Grandi, including developmentally-appropriate manuals, training materials, procedures, and psychometric adequacy of measures (Aim 2); and assess feasibility and preliminary efficacy in a 3-arm randomized controlled trial (RCT), in which 120 youth will be assigned to three groups: the experimental caregiver-adolescent N'ap Grandi, an adolescent-only version (N'ap Grandi-A) and an adolescent-only health promotion group (HP-A), examining ART adherence and virologic response, HIV risk behaviors, positive communication and monitoring, stress and mood, and costs from the health center perspective (Aim 3).
Study Type
Interventional
Enrollment (Actual)
278
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
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Port-au-Prince, Haiti
- GHESKIO Centers
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-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
15 years to 19 years (Child, Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- youth aged 15-19 years receiving 1st-line ART for at least 3 months;
- exhibiting risk factors of detectable Viral Load and/or unprotected vaginal/anal intercourse in the previous 6 months;
- fluent in spoken Haitian Creole which is required to complete assessments and to participate in the intervention groups;
- willing to a) assent to study participation if under 18, and b) having a parent or caregiver aged >18 years provide informed consent and participate in the caregiver workshops.
Exclusion Criteria:
- cognitively impaired, as determined by the Test of Nonverbal Intelligence (TONI), since such impairment may compromise the ability to comprehend and participate in the assessment and intervention;
- exhibits bipolar disorder, psychosis, or current need for inpatient psychiatric hospitalization.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: N'ap Grandi
Both Adolescent and Caregiver participate in assessment and intervention groups.
Adolescent assessments will be administered at baseline, 3 months- and 6 months-post intervention.
Caregiver assessments will be administered at baseline and 6 months-post intervention.
|
Eight 90-minute adolescent cognitive behavioral modules and four 90-minute caregiver cognitive behavioral modules, delivered in weekend workshops over a 1 month period, with the last two modules for joint participation of adolescents and caregivers.
|
Active Comparator: N'ap Grandi - A
Adolescents participate in assessment and intervention groups, Caregivers participate in assessment only.
Adolescent assessments will be administered at baseline, 3 months- and 6 months-post intervention.
Caregiver assessments will be administered at baseline and 6 months-post intervention.
|
Eight 90-minute adolescent cognitive behavioral modules delivered in weekend workshops over a 1 month period.
|
Placebo Comparator: Health Promotion - A
Adolescents participate in assessment and intervention groups, Caregivers participate in assessment only.
Adolescent assessments will be administered at baseline, 3 months- and 6 months-post intervention.
Caregiver assessments will be administered at baseline and 6 months-post intervention.
|
Eight 90-minute adolescent health promotion modules delivered in weekend workshops over a 1 month period.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
ART Adherence and response
Time Frame: 6 months
|
Data from self report questionnaire (percent medications taken), medication possession ratio (percent completed), and virologic suppression (percent improvement) will be aggregated into a composite measure of adherence.
|
6 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
HIV sexual transmission risk reduction
Time Frame: 6 months
|
Increase in self-reported safer sex behavior via questionnaire
|
6 months
|
Caregiver supportive communication
Time Frame: 6 months
|
Increase in self-reported positive caregiver-adolescent communication and monitoring via questionnaire
|
6 months
|
Psychosocial health
Time Frame: 6 months
|
Improvement in self-reported stress and mood via questionnaire
|
6 months
|
Cost of intervention from the health center perspective
Time Frame: 6 months
|
Provide data on the economic feasibility of broader scale up of these interventions
|
6 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
September 1, 2016
Primary Completion (Actual)
May 1, 2018
Study Completion (Actual)
May 1, 2018
Study Registration Dates
First Submitted
September 24, 2016
First Submitted That Met QC Criteria
September 29, 2016
First Posted (Estimate)
October 3, 2016
Study Record Updates
Last Update Posted (Actual)
July 11, 2018
Last Update Submitted That Met QC Criteria
July 10, 2018
Last Verified
July 1, 2018
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- NIMH R34MH107335
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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