Mobile Phone and Social Media Use and Preferences for a Secondary Prevention mHealth Intervention Among Youth Living With HIV

Dowshen, Nadia; Meisarah, Mark; Lee, Susan S.

doi:10.1016/j.jadohealth.2015.10.174

Cited by 3 publications

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“…Advances in mobile phone and social media technologies have created opportunities to engage and intervene with large numbers of youth at relatively low costs, using technologies that permeate their daily routines [25,28]. This study will use 2 primary technology platforms, that is, text messaging and social media, in addition to telephone and in-person visits based on youths’ preferences.…”

Section: Introductionmentioning

confidence: 99%

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial

Swendeman¹,

Arnold²,

Harris³

et al. 2019

JMIR Res Protoc

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Background America’s increasing HIV epidemic among youth suggests the need to identify novel strategies to leverage services and settings where youth at high risk (YAHR) for HIV can be engaged in prevention. Scalable, efficacious, and cost-effective strategies are needed, which support youth during developmental transitions when risks arise. Evidence-based behavioral interventions (EBIs) have typically relied on time-limited, scripted, and manualized protocols that were often delivered with low fidelity and lacked evidence for effectiveness. Objective This study aims to examine efficacy, implementation, and cost-effectiveness of easily mountable and adaptable, technology-based behavioral interventions in the context of an enhanced standard of care and study assessments that implement the guidelines of Centers for Disease Control and Prevention (CDC) for routine, repeat HIV, and sexually transmitted infection (STI) testing for high-risk youth. Methods Youth aged between 12 and 24 years (n=1500) are being recruited from community-based organizations and clinics serving gay, bisexual, and transgender youth, homeless youth, and postincarcerated youth, with eligibility algorithms weighting African American and Latino youth to reflect disparities in HIV incidence. At baseline and 4-month intervals over 24 months (12 months for lower-risk youth), interviewers monitor uptake of HIV prevention continuum steps (linkage to health care, use of pre- or postexposure prophylaxis, condoms, and prevention services) and secondary outcomes of substance use, mental health, and housing security. Assessments include rapid diagnostic tests for HIV, STIs, drugs, and alcohol. The study is powered to detect modest intervention effects among gay or bisexual male and transgender youth with 70% retention. Results The project was funded in September 2016 and enrollment began in May 2017. Enrollment will be completed between June and August 2019. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions This hybrid implementation-effectiveness study examines alternative models for implementing the CDC guidelines for routine HIV/STI testing for YAHR of acquiring HIV and for delivering evidence-based behavioral intervention content in modular elements instead of scripted manuals and available over 24 months of follow-up, while also monitoring implementation, costs, and effectiveness. The greatest impacts are expected for coaching, whereas online group peer support is expected to have lower impact but may be more cost-effective. Trial Registration ClinicalTrials.gov NCT03134833; https://clinicaltrials.gov/ct2/show/NCT03134833 (Archived by WebCite at http://www.webcitation.org/76el0Viw9) International Registered Report Identifier (IRRID) DERR1-10.2196/11165

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Section: Introductionmentioning

confidence: 99%

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial

Swendeman¹,

Arnold²,

Harris³

et al. 2019

JMIR Res Protoc

View full text Add to dashboard Cite

show abstract

“…Advances in mobile and social media technologies have created opportunities to engage and intervene with large numbers of youth at relatively low-costs, using technologies that permeate their daily routines [20,23]. This study will use two primary technology platforms: text messaging and social media, as well as a more traditional in-person and tele-health coaching strategy.…”

Section: Introduction Backgroundmentioning

confidence: 99%

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial (Preprint)

Swendeman¹,

Arnold²,

Harris³

et al. 2018

Preprint

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Background: The rate of HIV has doubled in the last 15 years among young people to 22% of HIV cases. Scientific advances in biomedical HIV prevention strategies have not been utilized by youth. Methods/Design: Young people aged 12 -24 years old (n= 1500) are being recruited from community-based organizations (CBO) and clinics serving gay, bisexual, and transgender youth, homeless youth, youth on probation or released from incarceration, and youth in other high-risk venues (e.g., bars and clubs). Youth are randomized in a factorial design to: 1) an automated messaging and monitoring intervention (AMMI) using text messages (n = 900); 2) AMMI plus peer support via private social media (n = 200); 3) AMMI plus strengths-based coaching (n = 200); and 4) AMMI, peer support, and coaching (n = 200). At four-month intervals over 24 months, interviewers monitor: uptake of the steps in the HIV Prevention Continuum (linkage to health care and adherence to pre-or post-exposure prophylaxis or 100% condom use), and conduct repeat rapid diagnostic tests for HIV, sexually transmitted infections (STI), drugs and alcohol use. Weekly automated monitoring via text (or email) in AMMI includes questions on acute HIV and STI symptoms for immediate follow-up by interviewers to provide HIV and STI testing, STI treatment, and partner therapy. Discussion: The greatest impacts are expected among youth receiving the most intensive intervention (i.e., AMMI, peer support, and coach). However, the youth's concurrent mental health, substance abuse, and housing and food security are expected to be significant covariates that influence the uptake of the HIV Prevention Continuum. This study operationalizes the guidelines of the Centers of Disease Control and Prevention (CDC) regarding the prevention of HIV among the highest risk youth, using community-based point of care diagnostics supported by scalable technology-mediated interventions. Similarly, over 90% of adolescents under age 18 go online daily, more than half several times a day which is facilitated by access to smartphones among 75% of youth of each ethnicity, crossing the digital divide [28]. Much of this online activity is driven by social media use, particularly via smartphones -for example, over 70% of adolescents under 18 years use Facebook, while about half also use Instagram and Snapchat [28]. The interventions in this study use text messaging and social media to engage "youth where they are" in the digital environment. This approach has resulted in four intervention arms which vary in intensity and costs. In order of increasing intensity and costs, the interventions are: 1) automated text-messaging and weekly monitoring probes; 2) peer support via social media; 3) paraprofessional coaching; and 4) all three combined. This study's automated and interpersonally-mediated technology-based interventions will be based on the shared features of existing EBI -we will not create a new app nor an EBI with a manual to be replicated with 6 fidelity [14,33,34]. In the last 25 years, over...

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A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study

et al. 2019

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Background Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention. Method Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician–youth risk communication and youths’ drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths’ uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis. Results Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16–21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans. Conclusions Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.

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Mobile Phone and Social Media Use and Preferences for a Secondary Prevention mHealth Intervention Among Youth Living With HIV

Cited by 3 publications

References 0 publications

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial

Text-Messaging, Online Peer Support Group, and Coaching Strategies to Optimize the HIV Prevention Continuum for Youth: Protocol for a Randomized Controlled Trial (Preprint)

A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study

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