Project dates: August 2015 - May 2019
This K23 award detailed a 3-year scope of mentored career development. Dr. Navarra’s goal is to become an independent, and leading nurse scientist in designing, implementing, and evaluating technology supported behavioral interventions, targeted for improved disease self-management among human immunodeficiency virus (HIV)-infected ethnic, minority adolescents and young adults. Training focused on three important areas: 1) health informatics for implementation of technology supported behavioral interventions, 2) health disparities, and 3) advanced qualitative and mixed methods design and analysis.
The specific research project aligned with her research and training goals, Adherence Connection for Counseling, Education, and Support (ACCESS), and addressed the challenge of adherence to antiretroviral treatment among HIV-infected adolescents and young adults. A mixed method design was proposed and the specific aims were to: 1) Characterize the feasibility and acceptability of a peer led, mHealth cognitive behavioral intervention delivered via remote videoconferencing using smartphones; 2) Obtain initial estimates of the biobehavioral impact of ACCESS on HIV virologic outcomes and self-reported ART adherence, beliefs and knowledge about antiretroviral treatment, adherence self-efficacy, and healthcare utilization (retention in HIV care).
Abstract on NIH RePORTERFeasibility and acceptability of the Adherence Connection Counseling, Education, and Support (ACCESS) Proof of Concept: A peer-led, mobile health (mHealth) cognitive behavioral antiretroviral therapy (ART) adherence intervention for HIV-infected (HIV+) adolescents and young adults (AYA)
AIDS and Behavior, 27 (6), 1807-1823. doi: 10.1007/s10461-022-03913-0. PMCID: PMC9792943 .
Dunn Navarra AM, Whittemore R, Bakken S, Rosenberg MJ, Gormley M, Bethea J, Gwadz M, Cleland C, Liang E, Melkus GD (2020).
Adherence self-management and the influence of contextual factors among emerging adults with human immunodeficiency virus
Nursing Research, 69 (3), 197-209. doi: 10.1097/NNR.0000000000000422. PMCID: PMC7286659.
Dunn Navarra AM, Gwadz MV, Bakken S, Whittemore R, Cleland CM, Melkus GD (2019).
Adherence connection for counseling, education, and support: Research protocol for a proof of concept study
JMIR Research Protocols, 8 (3), e12543. doi: 10.2196/12543. PMCID: PMC6458537.
Dunn Navarra AM, Ford H, Cleland CM, Liang E, Rodriguez K (2019).
Engaging and Supporting Youth to Promote Adherence Success (EASYPAS): A cognitive behavioral intervention for youth living with HIV
Journal of the Association of Nurses in AIDS Care, 30 (3), 372-378. doi: 10.1097/JNC.0000000000000034. PMCID: PMC6984638.
Dunn Navarra AM, Gwadz MV, Whittemore R, Bakken SR, Cleland CM, Burleson W, Jacobs SK, Melkus GD (2017).
Health technology-enabled interventions for adherence support and retention in care among US HIV-infected adolescents and young adults: An integrative review
AIDS and Behavior, 21 (11), 3154-3171. doi: 10.1007/s10461-017-1867-6. PMCID: PMC5731637.