NIH Awards $5.7 Million To Evaluate Positive Peers App
A MetroHealth-led research team received a five-year, $5.7 million grant from the National Institute on Minority Health and Health Disparities – part of the National Institutes of Health – to evaluate the effectiveness of an innovative app launched in 2016 as a resource for people ages 13-34 living with HIV.
The grant will evaluate the effectiveness of MetroHealth’s Positive Peers private mobile app as a clinic-based intervention to optimize health outcomes among individuals in the targeted population, especially those belonging to racial, ethnic, and sexual and gender minority groups.
The original Positive Peers app team includes Ann Avery, MD, Physician Investigator in MetroHealth’s Division of Infectious Disease, Department of Medicine; MetroHealth social worker Jennifer McMillen Smith, MSSA, LISW-S; Steven Lewis, MS, MPH, from the MetroHealth Research Institute; and Mary Step, PhD, Associate Professor, Health Sciences, Kent State University College of Public Health. The project was funded by the Health Resource Service Administration (HRSA) Special Projects of National Significance under their social media-related initiative to improve viral suppression among young people with HIV and piloted with 128 MetroHealth patients. In March 2020, the team made the app available nationwide and an additional 220 patients from 32 states have joined the app.
Beginning in March 2024, the study will begin enrolling participants in a randomized control study to at clinic sites in six geographic areas of high HIV prevalence (Houston, Los Angeles, Newark, Seattle, Columbus and Cincinnati).
Each location will enroll 50 people, all of whom will be either newly diagnosed with HIV or not optimally engaged in their HIV care. Eligible people will include those who have not taken antiretroviral therapy daily to achieve viral suppression (undetectable status) in the last two years.
“We’re trying to hyper focus on the population that needs this the most,” Dr. Avery said. “We hope to see that using the Positive Peers mobile app has positive benefit on patient outcomes, particularly viral suppression. We know that patients who are virally suppressed have better health outcomes and can’t pass the infection on to their partner”
Individuals will randomly be assigned to one of two groups. One group will begin using the Positive Peers app immediately. The other group will begin using the app six months after enrolling in the trial. The one-year commitment includes taking five short online surveys and giving researchers access to medical records for an additional six months.
Although ongoing data analysis conducted by the Positive Peers team suggests the mobile app’s benefits and effectiveness for patients using it compared to those who don’t, the results of a randomized trial will be more definitive.
"The NIH grant that will allow Dr. Avery and her team to evaluate the efficacy of Positive Peers is a perfect example of how The MetroHealth System is translating innovations and discoveries to improve the health and quality of life of our most vulnerable populations," said John Chae, MD, MetroHealth’s Senior Vice President, Chief Academic Officer.
“We’ve found that people are likely to sign up for the app if it’s suggested by a trusted health partner,” said McMillen Smith, who has facilitated HIV support groups at MetroHealth for the past 15 years. The group for young people started 13 years ago.
“What sets Positive Peers apart from other mobile health interventions is the community,” said Dr. Avery, Professor of Medicine at Case Western Reserve University. “There is strength that you get from talking to somebody who's been walking that same journey, that same lived experience.”
As project director, McMillen Smith sees the depth of the conversations on the platform. “They’re sharing valuable information,” she said. “People are giving support. We’ve created a space where people feel safe, and that’s an unquantifiable benefit.”
The online community and blog posts that Positive Peers provides increase awareness and knowledge about HIV, said Dr. Avery.
“We hope to lessen the stigma that continues to be a big barrier to people getting the care they need,” she said. “HIV is a chronic manageable disease and not a death sentence.”
Founded in 1837, MetroHealth is leading the way to a healthier you and a healthier community through service, teaching, discovery, and teamwork. Cuyahoga County’s public, safety-net hospital system, MetroHealth meets people where they are, providing care through four hospitals, four emergency departments, and more than 20 health centers and 40 additional sites. Each day, our 8,000 employees focus on providing our community with equitable health care–through patient-focused research, access to care, and support services–that seeks to eradicate health disparities rooted in systematic barriers. For more information, visit metrohealth.org.