An Evidence-Based HIV Risk-Reduction Intervention for Young African American Women in the US South Using mHealth:...

Area of Science:

• Public Health
• Health Informatics
• Behavioral Science

Background:

• Young African American women face disproportionately high rates of sexually transmitted infections, including HIV.
• Targeted, gender-, culture-, and age-specific interventions are crucial for ending the HIV epidemic.
• The Women's CoOp (WC) is a proven, effective HIV risk-reduction intervention delivered in face-to-face formats.

Purpose of the Study:

• To adapt the evidence-based Women's CoOp (WC) intervention from an in-person format to a self-guided mobile health (mHealth) application.
• To ensure the core elements of the WC intervention are maintained for comparability and fidelity during the adaptation process.
• To leverage mobile technology for broader accessibility and engagement in HIV risk reduction.

Main Methods:

• The adaptation utilized the Personal Health Informatics and Intervention Toolkit (PHIT) framework over five phases.
• Formative research, usability testing, and pretesting were conducted with stakeholders and interventionists.
• The intervention's core elements were converted into a mobile app format, with comparable analogs developed for non-straightforward adaptations.
• The mHealth WC app was deployed on tablets for participants in a randomized trial.

Main Results:

• The seven core elements of the WC intervention were accurately converted to a mobile app format, maintaining comparability to the in-person delivery.
• Cue card materials were adapted with voice-over narration for a self-guided experience.
• Subject matter experts and app developers collaborated to create comparable app-based alternatives for activities like condom practice and goal-setting.
• The finalized mHealth WC app was successfully deployed in local health departments for a randomized trial.

Conclusions:

• A systematic adaptation process successfully created an mHealth equivalent of the in-person WC behavioral health intervention.
• Maintaining fidelity to the original in-person delivery limited the app's potential for enhanced features like gamification and integrated messaging.
• Further research is needed to evaluate the mHealth WC app's impact and efficacy in reducing HIV and substance use risks.