Challenges of and Solutions for Developing Tailored Video Interventions That Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: Tutorial (Preprint)

Abstract

UNSTRUCTURED Video is a versatile and popular medium for digital health interventions and as the technology behind mobile devices and applications advances, video-based interventions may become increasingly common. Though a complex and busy environment, clinic waiting rooms offer the opportunity for implementing digital interventions to patients waiting to see their providers. However, to increase efficient ways of working in public health, to leverage the scalability and low cost of implementing digital interventions, and to keep up with rapidly advancing technology and user needs, more guidance is needed on the design and development of video-based tailored interventions. Here we provide a tutorial for digital intervention researchers and developers who wish to efficiently design and develop video-based, tailored, digital health interventions by describing our challenges and solutions encountered with Positive Health Check (PHC). PHC, a hybrid app, is a brief, interactive, individually- tailored video-based digital HIV behavioral counseling intervention. Hybrid applications are available from an Internet URL or can be downloaded from Google Play and the Apple Store. PHC uses video clips, and multimedia digital assets to deliver intervention content. These include interactive, tailored messages and graphics, a repurposed animated video and patient and provider handouts generated in real-time by PHC. This tutorial addresses numerous challenges and solutions for (1) using video as a medium to enhance user engagement through “video doctors”, full screen video, storyboards and streamlined scripts; (2) navigating the complexity of linking a database of video clips with other digital assets through script coding and flow diagrams of algorithms for delivering a tailored user experience; and, (3) identifying main steps to building an app that will seamlessly deliver to users individually-tailored messages, graphics and handouts. These steps include using keyframes to design integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven backend solution that will tailor message delivery to individual users. Although PHC focuses on promoting health and well-being among persons with HIV, the challenges and solutions presented here are transferable to video-based digital health interventions focused on other areas of health.