Itake charge: development and evaluation of an m-health transition intervention for youth living with HIV in kenya

The National Institute of Child Health and Human Development awarded the University of Washington $402,147 on July 9, 2026, under the Child Health and Human Development Extramural Research program (CFDA 93.865) to develop and evaluate an mobile health transition intervention for youth living with HIV in Kenya.

The project, titled "I TAKE CHARGE," will use user-centered design to build a digital toolkit for youth transitioning from pediatric to adult HIV care. The intervention will incorporate gaming, videos, animations, and a provider interface using open-source rapid development frameworks and local Kenyan digital health expertise. Development will proceed in two aims: an initial assessment of needs, preferences, facilitators, and barriers in current transition processes to create a digital prototype (Aim 1), followed by an iterative adaptive refinement process (Aim 2) informed by evidence-based content and engagement with youth, healthcare providers, and policymakers. The team will complete milestones prior to moving to an R33 phase.

The University of Washington Office of Sponsored Programs administers the award as the recipient. Performance occurs in Seattle, Washington. The award period extends through June 30, 2028. This is a Project Grant assistance type. The work addresses high disengagement in HIV care among youth during transition to adult services, a vulnerable period associated with elevated morbidity and mortality in this population.

Abstract

Significance: youth living with HIV (YLH) are a global priority population to end the HIV epidemic by 2030 due to historically low engagement in care and poor outcomes. Transition from pediatric/youth care to adult care is a vulnerable period where there is high risk for disengagement in care resulting in high rates of morbidity and mortality among YLH. Structured interventions to support transition to adult HIV care are critical to ensure continuity of HIV care beyond adolescence. In-person transition interventions developed by our team (attach) have shown promise in improving transition readiness and engagement in care but required additional cost and staff time. Mhealth interventions offer great promise to overcome these challenges during transition care to improve engagement in care for YLH yet few exist for YLH in africa. Approach: currently no mhealth interventions exist for YLH transitioning to adult care in kenya. This study will use user-centered design to develop a mhealth intervention for YLH who are transitioning to adult care using local kenyan digital health expertise and direct input from YLH and other key stakeholders. We will use an open-source rapid development framework to build an interactive digital toolkit including gaming, videos, animations, and a provider interface to improve the transition process for YLH. To inform design, we will evaluate needs, preferences, facilitators, and barriers to current transition processes. We will use this information to create an initial digital prototype (aim 1). We will then use an iterative, adaptive process (adapt-ITT) to refine the digital adolescent transition intervention (itake charge) based on evidence-based content and engagement with youth, healthcare providers, and policy- makers (aim 2). Milestones: prior to moving to the R33 phase, we will have a fully developed digital intervention (itake charge) that has been successfully theater tested and has quantifiable acceptability and feasibility measures >70% based on user feedback. We will then determine effectiveness and implementation outcomes associated with itake charge in a hybrid implementation-effectiveness pilot randomized clinical trial in 10 high- volume HIV care clinics in kenya (aim 3). Investigators: multiple principal investigators: kristin beima-sofie is a leader in implementation science and expert in user-centered design and qualitative data analysis. Irene njuguna is an expert in pediatric and adolescent HIV research in kenya including intervention development and evaluation. Brian zanoni is an expert in mhealth intervention development, communication and evaluation, adolescent HIV research, and implementation science. CO-investigators: paul macharia is a computer scientist with expertise in human centered designs for the development, prototyping and testing of digital health interventions in kenya. Cyrus mugo has expertise in mhealth intervention research and delivery in kenya. Dalton wamalwa has expertise in intervention development and evaluation among adolescents with HIV in kenya. Barbra richardson is a biostatistician with expertise in cluster randomized clinical trial design and analysis.