Using Intervention Mapping to Develop an mHealth Intervention to Support Men Who Have Sex With Men Engaging in Chemsex (Budd): Development and Usability Study

Abstract

Background Chemsex refers to the intentional use of drugs before or during sex among men who have sex with men (MSM). Engaging in chemsex has been linked to significant negative impacts on physical, psychological, and social well-being. However, no evidence-based support tools have addressed either these harms or the care needs of MSM who engage in chemsex. Objective The purpose of this paper was to describe the development of a mobile health intervention (named Budd) using the intervention mapping protocol (IMP). Budd aims to support and inform MSM who participate in chemsex, reduce the negative impacts associated with chemsex, and encourage more reasoned participation. Methods The IMP consists of 6 steps to develop, implement, and evaluate evidence-based health interventions. A needs assessment was carried out between September 2, 2019, and March 31, 2020, by conducting a literature study and in-depth interviews. Change objectives were selected based on these findings, after which theory-based intervention methods were selected. The first version of the intervention was developed in December 2020 and pilot-tested between February 1, 2021, and April 30, 2021. Adjustments were made based on the findings from this study. A separate article will be dedicated to the effectiveness study, conducted between October 15, 2021, and February 24, 2022, and implementation of the intervention. The Budd app went live in April 2022. Results Budd aims to address individual factors and support chemsex participants in applying harm reduction measures when taking drugs (drug information, drug combination tool, and notebook), preparing for participation in a chemsex session (articles on chemsex, preparation tool, and event-specific checklist), planning sufficient time after a chemsex session to recover (planning tool), seeking support for their chemsex participation (overview of existing local health care and peer support services, reflection, personal statistics, and user testimonials), taking HIV medication or pre-exposure prophylaxis in a timely manner during a chemsex session (preparation tool), and contacting emergency services in case of an emergency and giving first aid to others (emergency information and personal buddy). Conclusions The IMP proved to be a valuable tool in the planning and development of the Budd app. This study provides researchers and practitioners with valuable information that may help them to set up their own health interventions. International Registered Report Identifier (IRRID) RR1-10.2196/39678

Drug behaviors, sexually transmitted infection prevention, and sexual consent during chemsex: insights generated in the Budd app after each chemsex session

“…First, to help in closing the scientific knowledge gap on the actual behavior during chemsex. The development of the Budd-mobile health intervention ( 10 ) was scientifically supported via the Intervention Mapping Protocol ( 25 ). Secondly, and potentially more relevant than the scientific knowledge, we hope that our findings support the improvement and optimization of care and support for people who engage in chemsex.…”

“…The app, called ‘Budd’, was developed using the Intervention Mapping Protocol (IMP), in co-design with stakeholders and chemsex participants and was launched in April 2022. A dedicated article describing the three-year process of development was published elsewhere ( 10 ).…”

“…Adhered risk reduction practices were integrated as app components in order to improve the use and acceptability of the app. A second consultation round was organized among eight chemsex participants to pilot-test the proof of concept version of the app on usability and acceptability ( 10 ). In a third consultation, prior to launching the app, 11 chemsex users tested the final version of the app on its effectiveness.…”

Application of the Delphi Method for Content Validity Analysis of a Questionnaire to Determine the Risk Factors of the Chemsex

“…The literature indicates the importance of self-monitoring for the reduction of harm from chemsex use [19] as well as the development of different programs that allow computer applications [18] and other applications (app) [20,21] to support and inform participants, reduce the negative impacts associated with chemsex and encourage more reasoned participation. On the other hand, the lack of knowledge of professionals in our country [22] regarding a growing problem should be considered.…”