Congratulations to Marta Mulawa, assistant professor, on the award of her proposal to the Duke Global Health Institute Small Research Grant Program for a project entitled: Supporting the Customization of a Smartphone App to Improve Treatment Adherence among South African Adolescents Living with HIV. This project has been awarded for a one-year period with a start date January 15, 2021.

Interventions that engage adolescents living with HIV to improve adherence to antiretroviral therapy (ART) are urgently needed. Adolescents repeatedly demonstrate suboptimal levels of ART adherence, which is associated with increased morbidity and mortality. Developing adherence-promoting interventions for adolescents requires an understanding of factors that shape adherence from multiple levels of influence. Developmental theories suggest that adolescents are particularly sensitive to their social networks. Mobile health (mHealth) interventions, those that use mobile technology (e.g., smartphones apps) to transmit health information, hold promise as an effective way to improve ART adherence. Notably, these smartphone apps can be used to engage social networks and provide social support. Access to mobile phone technology is rapidly increasing among youth in South Africa, making mHealth interventions feasible and potentially scalable in this setting. Funded through a K01 Mentored Research Scientist Development Award from the National Institute of Mental Health (NIMH), Dr. Marta Mulawa is currently customizing HealthMpowerment, a theory-based smartphone app-delivered intervention, to improve ART adherence among adolescents living with HIV in Cape Town, South Africa, a DGHI Priority Location. HealthMpowerment was developed based on the Institute of Medicine's Integrated Behavior Model with extensive input from youth. The app is designed to foster social support, offer tools for self-monitoring and habit formation, provide resources for goal setting and action planning, and present users with engaging informational resources. Dr. Mulawa’s research is conducted in collaboration with Drs. Lisa Hightow-Weidman and Kathryn Muessig at the University of North Carolina at Chapel Hill and with Dr. Jackie Hoare at the University of Cape Town. The team is currently working to iteratively customize the HealthMpowerment intervention content for the South African context. The team will soon begin collecting formative data (in-depth interviews and focus group discussions) from adolescents living with HIV in Cape Town to further refine the content and to customize the HealthMpowerment app for this population. In the subsequent phase of the study, the team will pilot test the customized intervention with 50 adolescents living with HIV to assess its feasibility and acceptability and explore preliminary effects on ART adherence and social support. The proposed DGHI Global Health Research Resources award will enhance this K01-funded research study by supporting the effort of a part-time Research Assistant (RA). The RA will support this study by adapting existing intervention content (e.g., articles and activities developed within the US context) for delivery in the South African context; tracking progress of qualitative data collection, translation, transcription, and analysis; contributing to qualitative data analysis; and developing new content (e.g., articles and activities) based on findings from qualitative data.