Adapting an m-Health Intervention for Spanish-Speaking Latinx People Living with HIV in the Nonurban Southern United States

Flickinger, Tabor; Sherbuk, Jacqueline E.; Guex, Kristen Petros de; Añazco, Diego; Hilgart, Michelle; McManus, Kathleen A; Ingersoll, Karen S.; Dillingham, Rebecca

doi:10.1089/tmr.2020.0018

Cited by 9 publications

(12 citation statements)

References 32 publications

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“…Although approaches to adaptation vary, most examples included in Table 1 describe a user-centered design approach informed by qualitative data collection, with iterative usability testing [20]. Often through the use of focus groups or in-depth interviews, investigators solicit end-user feedback to inform content modifications (e.g.…”

Section: Acceptability Testingmentioning

confidence: 99%

Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research

Budhwani¹,

Kiszla

Hightow-Weidman

2022

Current Opinion in HIV and AIDS

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Purpose of reviewAlthough many HIV prevention and/or treatment digital health interventions (DHIs) have shown feasibility and acceptability, fewer have indicated efficacy, and only a subset have been adapted for new contexts. Adaptation is a key element of pragmatic implementation science research. Adaptation is cost effective and time efficient compared with new development. Leveraging adaptation can lead to accelerated scale-up and enhanced public health impact. Considering the value of adaptation, the purpose of this piece is to present examples of DHI to DHI adaptation sequences to inform future HIV prevention and/or treatment research. Recent findingsFrom an examination of recent academic articles (01 November 2016 to 31 October 2021), we identified adaptation sequences that included an original DHI with at least two adaptations. Four models are presented herein; examples consist of adapted DHIs for new population, health outcome, geography, or a combination thereof. SummaryAdaptation is a promising scientific approach to expeditiously respond to the evolving HIV landscape. We present examples of DHI adaptations alongside considerations for each type of adaptation; we also present adaptation challenges with responsive strategies. We suggest when conducted with attention to rigor (leveraging adaptation frameworks, community engagement, and tailoring content), adaptation is a powerful tool to pragmatically address the HIV epidemic.

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Section: Acceptability Testingmentioning

confidence: 99%

Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research

Budhwani¹,

Kiszla

Hightow-Weidman

2022

Current Opinion in HIV and AIDS

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“…ConexionesPositivas (CP) is an mHealth intervention adapted from PositiveLinks (PL), an evidence-based intervention for people with HIV (PWH), that includes many features targeting the challenges faced by Spanish speakers in the United States. 3 , 12 , 13 Some of these features include daily tracking of medication adherence, mood, and stress; appointment reminders; educational resources; laboratory results; and secure messaging with clinic staff and providers. 3 CP was developed through translation and adaptation of PL, informed by feedback from the Spanish-speaking PWH who used the application during its pilot phase.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 12 , 13 Some of these features include daily tracking of medication adherence, mood, and stress; appointment reminders; educational resources; laboratory results; and secure messaging with clinic staff and providers. 3 CP was developed through translation and adaptation of PL, informed by feedback from the Spanish-speaking PWH who used the application during its pilot phase.…”

Section: Introductionmentioning

confidence: 99%

Optimizing usability of a mobile health intervention for Spanish-speaking Latinx people with HIV through user-centered design: a post-implementation study

Petros De Guex,

Flickinger,

Mayevsky

et al. 2023

JAMIA Open

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Objective Latinx people comprise 30% of all new human immunodeficiency virus (HIV) infections in the United States and face many challenges to accessing and engaging with HIV care. To bridge these gaps in care, a Spanish-language mobile health (mHealth) intervention known as ConexionesPositivas (CP) was adapted from an established English-language platform called PositiveLinks (PL) to help improve engagement in care and reduce viral nonsuppression among its users. We aimed to determine how CP can address the challenges that Latinx people with HIV (PWH) in the United States face. Materials and methods We conducted a post-implementation study of the CP mHealth platform, guided by principles of user-centered design. We enrolled 20 Spanish-speaking CP users in the study, who completed the previously validated System Usability Scale (SUS) and semistructured interviews. Interviews were transcribed and translated for analysis. We performed thematic coding of interview transcripts in Dedoose. Results The SUS composite score was 75, which is within the range of good usability. Four categories of themes were identified in the interviews: client context, strengths of CP, barriers to use and dislikes, and suggestions to improve CP. Positive impacts included encouraging self-monitoring of medication adherence, mood and stress, connection to professional care, and development of a support system for PWH. Discussion While CP is an effective and easy-to-use application, participants expressed a desire for improved personalization and interactivity, which will guide further iteration. Conclusion This study highlights the importance of tailoring mHealth interventions to improve equity of access, especially for populations with limited English proficiency.

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“…Traditional formative methods [20][21][22][23], often guided by the principles of user-and human-centered design (HCD [24][25][26][27][28][29]), aim to incorporate the insights of prospective mHealth user bases. Focus groups, user-experience interviews, and related in-person or virtual interactions are often undertaken to gain these insights.…”

Section: Introductionmentioning

confidence: 99%

Integrating Natural Language Processing and Interpretive Thematic Analyses to Gain Human-Centered Design Insights on HIV Mobile Health: Proof-of-Concept Analysis

Skeen¹,

Jones²,

Cruse³

et al. 2022

JMIR Hum Factors

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Background HIV mobile health (mHealth) interventions often incorporate interactive peer-to-peer features. The user-generated content (UGC) created by these features can offer valuable design insights by revealing what topics and life events are most salient for participants, which can serve as targets for subsequent interventions. However, unstructured, textual UGC can be difficult to analyze. Interpretive thematic analyses can preserve rich narratives and latent themes but are labor-intensive and therefore scale poorly. Natural language processing (NLP) methods scale more readily but often produce only coarse descriptive results. Recent calls to advance the field have emphasized the untapped potential of combined NLP and qualitative analyses toward advancing user attunement in next-generation mHealth. Objective In this proof-of-concept analysis, we gain human-centered design insights by applying hybrid consecutive NLP-qualitative methods to UGC from an HIV mHealth forum. Methods UGC was extracted from Thrive With Me, a web app intervention for men living with HIV that includes an unstructured peer-to-peer support forum. In Python, topics were modeled by latent Dirichlet allocation. Rule-based sentiment analysis scored interactions by emotional valence. Using a novel ranking standard, the experientially richest and most emotionally polarized segments of UGC were condensed and then analyzed thematically in Dedoose. Design insights were then distilled from these themes. Results The refined topic model detected K=3 topics: A: disease coping; B: social adversities; C: salutations and check-ins. Strong intratopic themes included HIV medication adherence, survivorship, and relationship challenges. Negative UGC often involved strong negative reactions to external media events. Positive UGC often focused on gratitude for survival, well-being, and fellow users’ support. Conclusions With routinization, hybrid NLP-qualitative methods may be viable to rapidly characterize UGC in mHealth environments. Design principles point toward opportunities to align mHealth intervention features with the organically occurring uses captured in these analyses, for example, by foregrounding inspiring personal narratives and expressions of gratitude, or de-emphasizing anger-inducing media.

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Adapting an m-Health Intervention for Spanish-Speaking Latinx People Living with HIV in the Nonurban Southern United States

Cited by 9 publications

References 32 publications

Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research

Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research

Optimizing usability of a mobile health intervention for Spanish-speaking Latinx people with HIV through user-centered design: a post-implementation study

Integrating Natural Language Processing and Interpretive Thematic Analyses to Gain Human-Centered Design Insights on HIV Mobile Health: Proof-of-Concept Analysis

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