Feasibility, acceptability, and design of a mobile health application for high-risk men who have sex with men in Hanoi, Vietnam

Abstract

Background Approximately three quarters of men who have sex with men (MSM) in Vietnam have used a phone or tablet to search for sexual health information online, and over half of these men have used it to locate nearby service providers. As HIV prevalence continues to rise in Vietnamese MSM, smartphones and other electronic media may provide an ideal platform for HIV research and intervention. Here, we describe a pilot study of an ecological momentary assessment (EMA) application (app) and a wearable device (MC10 BioStamp) to monitor risk-taking behaviours and mental health symptomatology and assess the feasibility and acceptability of the app, and mobile health (mHealth) needs of MSM in Vietnam. MethodsWe recruited 50 participants from outpatient clinics and community-based organisations for MSM in Hanoi, Vietnam. For 1 week, participants completed brief surveys on their smartphone at six to eight random time-points every day. At each time-point, participants answered questions assessing: current mood; stress level; qualities of their current environment (including who they were with); mental health symptoms since last notification; risk behaviours; and GPS location (automatically recorded). They additionally wore two sensors on their chest and thigh, monitoring ambulatory heart rate and physical activity. After the week, participants were interviewed about their experiences using the application and were asked survey questions about what features they wanted in future mHealth-related apps.Findings Participants were identified from an existing dataset of MSM (n=198) and invited to return for the study between January and April 2019. Overall, participants reported few issues with the sensors; however, they had more concerns about the app. The most frequent complaints participants had were that the assessments were too repetitive, too frequent, and did not provide enough opportunity for in-depth qualitative responses. What participants most enjoyed about the app was that it provided an opportunity to share and to reflect on their moods and social interactions. To improve, participants felt the messaging needed to be more MSM-friendly and visually appealing, while providing occasional statistics on their weekly moods or behaviours. The most popular app features desired were the ability to talk directly to a service provider about ongoing health concerns (91%; 40/44), locate nearby PrEP providers (82%; 36/44), and locate a nearby HIV/STD testing centre (82%; 36/44).Interpretation This study found that mobile EMA apps and wearable technology are a feasible and acceptable way of monitoring mental distress and HIV risk among MSM in Vietnam. Given that many were already looking towards the app as a means to self-manage and acquire more health-related information, mobile technologies may be a natural platform for bridging research and intervention among this population.

Demand for Mobile Health in Developing Countries During COVID-19: Vietnamese’s Perspectives from Different Age Groups and Health Conditions

“…Many product orientation papers published from 2016 to date have examined the practicality, usefulness, and feasibility of some mHealth applications in various fields such as HIV, maternal and infant health, sexual and reproductive health and user satisfaction and acceptance. [31][32][33][34][35] Furthermore, several market-orientation investigations have been conducted. Using a quantitative approach, studies have found that there is a low percentage of mHealth application users; however, the younger generations were mostly satisfied with mHealth innovations that they had experienced and were ready, and felt receptive to more useful mHealth applications in the near future.…”

Digital Public Health Surveillance Tools for Alcohol Use and HIV Risk Behaviors

“…Overall, study participants had positive feedback about their experience citing preferences for a more tailored experience (i.e., providing feedback on mood and behavior, MSM-friendly messaging) in the future. Additionally, participants stated the ability for telemedicine and locations of HIV service providers nearby as desirable features for future apps [ 56 ]. However, a limiting factor of using data from EMA’s and other apps is that they would require typically individuals to download the app.…”

Feasibility, Acceptability, and Design of a Mobile Ecological Momentary Assessment for High-Risk Men Who Have Sex With Men in Hanoi, Vietnam: Qualitative Study (Preprint)

“…mHealth interventions have shown promising results in improving medication adherence [24,25], health care engagement [24,26,27], and other health-promoting behaviors such as engagement in physical activity [28][29][30] in diverse populations. Furthermore, mHealth may be an acceptable and feasible approach for delivering care, including mental health care, to MSM both in high-income countries and low-and middle-income countries (LMICs), including Malaysia, China, India, Thailand, and Vietnam [31][32][33][34][35][36][37][38][39][40]. This is because MSM are often early adopters of technology and may already use such platforms to access health information and search for sexual partners [34,41].…”