ABSTRACT
ABSTRACT: As access to human immunodeficiency virus treatment expands in Low to Middle Income Countries, it becomes critical to develop and test strategies to improve adherence and ensure efficacy. Text messaging improves adherence to antiretroviral treatment antiretroviral treatment in some patient populations, but data surrounding the use of these tools is sparse in pediatric and adolescent patients in low to middle income countries. We evaluated if a text message intervention can improve antiretroviral treatment adherence while accounting for cell phone access, patterns of use, and willingness to receive text messages.We carried out a cross sectional study to understand willingness of receiving text message reminders, followed by a randomized controlled trial to assess effectiveness of text message intervention.Enrolled participants were randomized to receive standard care with regular clinic visits, or standard care plus short message service reminders. Adherence was measured 3 times during the study period using a 4-day Recall Questionnaire. Outcome was measured based on differences in the average adherence between the intervention and control group at each time point (baseline, 3âmonths, 6âmonths).Most respondents were willing to receive text message adherence reminders (81.1%, nâ=â53). Respondent literacy, travel time to clinic, cell phone access, and patterns of use were significantly associated with willingness. In the randomized trial the intervention group (nâ=â50) experienced a small but significant mean improvement in adherence over the six-month period (4%, Pâ<â.01) whereas the control group (nâ=â50) did not (mean improvement: 0.8%, Pâ=â.64).Text message interventions effectively support antiretroviral adherence in pediatric patients living with human immunodeficiency virus. Studies designed to assess the impact of text messaging interventions must examine local context for cellular phone infrastructure and use and must account for potential loss to follow up when patients miss appointments and study assessments.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Seropositivity/drug therapy , Medication Adherence , Text Messaging , Adolescent , Child , Costs and Cost Analysis , Cross-Sectional Studies , Developing Countries , Guatemala , Humans , Text Messaging/economics , Young AdultABSTRACT
En este trabajo se determinan valores que guían a los agricultores frente a decisiones de producción, vida colectiva y ambiente en confrontación con las percepciones de los estudiantes de Agronomía y agrónomos egresados de la Universidad de Caldas. Mediante una metodología descriptiva, se trabajó con tres comunidades de pequeños agricultores para designar sus valores mediante una entrevista semiestructurada, y con sus resultados se cursó una encuesta a estudiantes y agrónomos, se identificaron puntos de encuentro y desencuentro y se sugirieron propuestas formativas en ética agronómica. Los pequeños agricultores reconocen como sus valores de expresión colectiva: responsabilidad, familia, tradición, trabajo, honorabilidad, cooperación, solidaridad, la educación como valor deseado y como valores de expresión individual: orgullo, pertenencia, bienestar, autosuficiencia. Todos los estudiantes de la Facultad coinciden en reconocer algunos de los valores sociales centrales enunciados por los productores agrarios como son: responsabilidad, solidaridad, trabajo, cooperación; en la medida en que avanzan en su formación profesional añaden otros valores y cuando egresan se centran solo en los dos primeros. Hipotéticamente, los estudiantes del programa de Agronomía se ubican de manera ideal en niveles postconvencionales en la escala de valores de Kohlberg, no obstante cuando egresan parecen retroceder en sus concepciones en la medida en que en niveles superiores y entre los egresados aparecen niveles convencionales y preconvencionales.
In this work, values that guide small farmers when facing production decisions, collective life and environment, in confrontation with the perceptions of the Agronomy alumni from Universidad de Caldas are determined. Using a descriptive methodology, three small farmer communities were worked with to designate their values using a semi-structured interview which results were used to apply a survey to students and agronomists. Agreement and disagreement points were identified and formative proposals in agronomic ethics rose. Small farmers identify their collective expression values: responsibility, family, tradition, work, honesty, cooperation, solidarity, education as a desired value; and as individual expression values: pride, membership, welfare, self-sufficiency. All the students from the Faculty coincide in recognizing some of the central social values stated by the agricultural producers such as: responsibility, solidarity, work, cooperation; as they progress in their professional education, they add other values but when they graduate they focus on the two first ones. Hypothetically, the Agronomy Program students are placed in post-conventional levels in Kohlberg's value scale. However, when they graduate it seems to be they back down in their conceptions while in superior levels and among the alumni conventional and pre-conventional levels appear.
