Sam‐Agudu 2017.
| Study name | Adolescent Coordinated Transition (ACT) to improve health outcomes among young people living with HIV in Nigeria |
| Methods |
Study design: cluster‐RCT Country: Nigeria |
| Participants | Adolescents living with HIV (ALHIV), 13‐ to 17‐year‐olds Inclusion criteria: For study sites: a. amongst secondary‐ and tertiary level PEPFAR supported healthcare facilities with at least 21 months’ experience in providing comprehensive HIV care and treatment services; b. at least 20 ALHIV enrolled in care as of 31 July 1206; c. separate paediatric and adult HIV care teams and clinics; d. at least one dedicated physician and one dedicated nurse for each paediatric and adult HIV clinic. For participants: a. documented HIV infection; b. aware of HIV diagnosis; c. currently on ART. Exclusion criteria: a. medically unstable patients Stated purpose: to measure the comparative effectiveness of the ACT intervention versus usual care on post‐transfer retention in care amongst ALHIV at 21 and 24 months post‐transfer |
| Interventions |
Intervention: Adolescent Coordinated Transition (ACT) The ACT intervention is adapted and modified from the model described by Maturo 2011. ACT has three main components: 1) Paediatric Adult Pediatric Adult (PAPA) model: alternating paediatric adult visits during the 21‐month transition period that allows both adult and paediatric clinicians and the transitioning adolescents to address difficulties related to transition and adapt to the termination of the paediatric provider‐patient relationship. 2) A monthly peer‐led organized support group (OS) facilitated by trained young adults living with HIV and guided by a standardized six‐module curriculum covering HIV basics, treatment and adherence, support networks, adolescent rights, living positively, and member choice. The OSG curriculum will address topics that will enhance the adolescent's knowledge of HIV disease and how to self‐manage their medical care. 3) A case management team consisting of a physician, a nurse, and a trained patient advocate Control: Usual care (The usual “transition” of care for ALHIV in Nigeria is abrupt transfer to adult care, defined as immediate handover of the ALHIV from paediatric to adult care, without a transition period, and no formal or documented communication between paediatric and adult providers prior to, or after transfer. There is also no structured pre‐transfer education and/or counselling provided to ALHIV and their caregivers with respect to procedures and expectations in adult care. In CG clinics, ALHIV will stop accessing paediatric care and start accessing the adult HIV clinic at the routine age of transfer at the facility. Adolescents will have access to all available services at the adult clinic including any adult support groups that may be available). |
| Outcomes |
Participants'outcomes of interest for this review
Economic outcomes Nil Time points: baseline, post‐intervention (12‐months, 24‐months and 36‐months post‐baseline) |
| Starting date | 28 June 2017 |
| Contact information | Echezona E. Ezeanolue, eezeanolue@gmail.com or echezona.ezeanolue@gmail.com |
| Notes |
Source of funding: Eunice Kennedy Shriver National Institute of Child Health and Human Development of the National Institutes of Health under award number R01HD089871 to EEE and NASA Prospective trial registration number: NCT03152006 |