Enbal Shacham, Ph.D., associate professor of behavioral science and health education, has been funded to develop and test innovative smartphone technology to collect detailed, real-time patient data related to alcohol consumption and mood among individuals living with HIV to assess their impact on medication adherence.
Shacham was awarded a $437,845 National Institutes of Health grant to gain a better understanding of the detrimental patterns of alcohol use among populations with HIV.
"Results from this study have the potential to change our understanding of the influential role alcohol plays in medication non-adherence, and thus new HIV infections as well as clinical outcomes for people living with HIV," she said. "I look at this study as the beginning of a research agenda to understand which patterns of alcohol consumption may be more harmful. Understanding these patterns will allow us to develop and test tailored interventions, which are likely to be more effective."
In a previous study published in AIDS and Behavior, Shacham and her multidisciplinary team found that more than four drinks for women and five drinks for men per week was associated with negative health outcomes, possibly due to poor medication adherence. Additional qualitative studies published in AIDS Care identified that health care providers did not routinely discuss alcohol use or advise their patients about potential negative consequences related to their drinking patterns.
The two-year project will recruit 40 participants currently receiving treatment for HIV to understand detrimental patterns of alcohol use on medication adherence.
Participants will record detailed information related to alcohol and mood using an ecological momentary assessment (EMA) app on their smartphone. The EMA smartphone app collects information in real time while the participants are in their natural environments. This data is more reliable than surveys or retrospective self-reports, since it does not depend on the participant's memory.
Most previous studies using EMA have used older technology such as handheld computers, text messaging or mobile phone voice capabilities. Smartphones have potential applications that go well beyond this: location-tracking, bar code scanning and user-friendly interfaces.
Shacham says this innovative technology will be a great asset in collecting reliable data.
Her research team includes Mike Elliot, Ph.D., assistant professor of biostatistics, and Mario Schootman, Ph.D., professor of epidemiology, who are both in the College for Public Health and Social Justice; Timothy Trull, Ph.D., curators' professor of psychological sciences, and Yi Shang, Ph.D., professor and the director of graduate studies in the department of computer science, both of the University of Missouri-Columbia; and Rachel Presti, M.D., Ph.D., assistant professor in the division of infectious diseases and the AIDS Clinical Trial Unit of Washington University School of Medicine. These experts in behavioral science, addiction, EMA science, geospatial epidemiology and HIV treatment will work with local HIV care providers throughout the project to ensure that the research process is effective and appropriate and to disseminate results in meaningful ways to clinic partners, patients, and community members.
The Saint Louis University College for Public Health and Social Justice is the only academic unit of its kind among the nearly 250 Catholic institutions of higher education in the United States.
With a focus on finding innovative and collaborative solutions for complex global health problems, the college offers nationally recognized programs in global public health, social work, health management and health policy, epidemiology, biostatistics, environmental and occupational health, behavioral science and health education, emergency management, biosecurity and disaster preparedness, and criminology and criminal justice.