ABSTRACT
BACKGROUND: Adolescents living with HIV are disproportionally affected by depression, which worsens antiretroviral therapy adherence, increases viral load, and doubles the risk of mortality. Because most adolescents living with HIV live in low- and middle-income countries, few receive depression treatment due to a lack of mental health services and specialists in low-resource settings. Chatbot technology, used increasingly in health service delivery, is a promising approach for delivering low-intensity depression care to adolescents living with HIV in resource-constrained settings. OBJECTIVE: The goal of this study is to develop and pilot-test for the feasibility and acceptability of a prototype, optimized conversational agent (chatbot) to provide mental health education, self-help skills, and care linkage for adolescents living with HIV. METHODS: Chatbot development comprises 3 phases conducted over 2 years. In the first phase (year 1), formative research will be conducted to understand the views, opinions, and preferences of up to 48 youths aged 10-19 years (6 focus groups of up to 8 adolescents living with HIV per group), their caregivers (5 in-depth interviews), and HIV program personnel (5 in-depth interviews) regarding depression among adolescents living with HIV. We will also investigate the perceived acceptability of a mental health chatbot, including barriers and facilitators to accessing and using a chatbot for depression care by adolescents living with HIV. In the second phase (year 1), we will iteratively program a chatbot using the SmartBot360 software with successive versions (0.1, 0.2, and 0.3), meeting regularly with a Youth Advisory Board comprised of adolescents living with HIV who will guide and inform the chatbot development and content to arrive at a prototype version (version 1.0) for pilot-testing. In the third phase (year 2), we will pilot-test the prototype chatbot among 50 adolescents living with HIV naïve to its development. Participants will interact with the chatbot for up to 2 weeks, and data will be collected on the acceptability of the chatbot-delivered depression education and self-help strategies, depression knowledge changes, and intention to seek care linkage. RESULTS: The study was awarded in April 2022, received institutional review board approval in November 2022, received funding in December 2022, and commenced recruitment in March 2023. By the completion of study phases 1 and 2, we expect our chatbot to incorporate key needs and preferences gathered from focus groups and interviews to develop the chatbot. By the completion of study phase 3, we will have assessed the feasibility and acceptability of the prototype chatbot. Study phase 3 began in April 2024. Final results are expected by January 2025 and published thereafter. CONCLUSIONS: The study will produce a prototype mental health chatbot developed with and for adolescents living with HIV that will be ready for efficacy testing in a subsequent, larger study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55559.
Subject(s)
HIV Infections , Humans , Adolescent , HIV Infections/psychology , HIV Infections/diagnosis , Pilot Projects , Male , Female , Peru/epidemiology , Young Adult , Child , Mass Screening/methods , Depression/therapy , Self Care , Mental Health , Focus GroupsABSTRACT
Objetivo: El objetivo de este trabajo es comparar 2 marcadores del trastorno específico del lenguaje en niños españoles de 5 a 7 años. Estos marcadores son la repetición de oraciones y la repetición de pseudopalabras, que son los utilizados para esta función en la investigación sobre este trastorno. Los 2 remiten a déficits de memoria como origen de este trastorno. Se revisan las formas en que estas tareas han sido utilizadas en el marcaje del trastorno específico del lenguaje. Participantes: Se han aplicado estas tareas a 3 grupos de niños de 5 a 7 años; uno constituido por niños con trastorno específico del lenguaje, otro por niños con trastorno de habla y articulación y otro con niños con desarrollo típico. Resultados: Los análisis discriminantes y la curva ROC ponen de manifiesto que es la repetición de oraciones la que tiene una mayor sensibilidad y especificidad para distinguir a los niños con trastorno específico del lenguaje de los niños con desarrollo típico, pero muestra una sensibilidad discreta en la diferenciación de los niños con desarrollo típico de los que tienen trastorno de habla y articulación. Ninguna de las tareas logra diferenciar con una precisión aceptable a los niños con trastorno específico del lenguaje de los que tienen trastorno de habla y articulación. Discusión y conclusiones: Se explican las razones de la distinta potencia marcadora de ambas tareas para identificar a los niños con trastorno específico del lenguaje, trastorno de habla y articulación y desarrollo típico
Objective: This study compares two markers of Specific Language Impairment in Spanish children aged 5 to 7. The markers examined are sentence repetition and pseudoword repetition, which are the two main tasks outlined in the research to identify this disorder. Both contemplate memory deficits as the source of this disorder. We review the ways in which these tasks have been used in marking Specific Language Impairment. Participants: These tasks have been applied to three groups of children, aged 5 to 7 years; one consisting of children with Specific Language Impairment, another of children with Speech Sound Disorder and another of children who are typically developing. Results: The results of the discriminant analysis and ROC curve show that sentence repetition exhibits higher sensitivity and specificity in distinguishing children with Specific Language Impairment from children who are typically developing, but only show modest sensibility in differentiating children who are typically developing from children with Speech Sound Disorder. Neither of the two tasks can distinguish with acceptable accuracy children with Specific Language Impairment from children with Speech Sound Disorder. Discussion and conclusions: We explain the reasons of different marking power to identify children with Specific Language Impairment, Speech Sound Disorder and typical development
