Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case...

Area of Science:

• Public Health
• Digital Health
• HIV Prevention

Background:

• Assisted partner services (APSs), or index testing, are crucial for HIV testing but often face low partner elicitation rates.
• A mobile health (mHealth) tool, Computer-Assisted Self-Interview (CASI)-Plus, was developed to address this challenge among individuals newly diagnosed with HIV.
• The tool aims to increase the identification of sexual and needle-sharing partners for HIV testing.

Purpose of the Study:

• To gather client and healthcare worker (HCW) input during the formative research phase of the CASI-Plus study.
• To ensure the acceptability, feasibility, and usability of the mHealth tool in its design.
• To adapt human-centered design (HCD) principles for tool development in a challenging context.

Main Methods:

• Employed formative human-centered design (HCD) methods, including in-depth interviews with clients and design workshops with HCWs in Ukraine.
• Conducted software platform assessment and heuristic evaluation of potential mHealth platforms.
• Utilized usability walk-throughs with simulated cases involving HCWs and clients to test the REDCap prototype.

Main Results:

• Simplified HCD methods successfully gathered rich input for tool design, prioritizing culturally sensitive and context-appropriate features.
• Key prioritized features included information on HIV index testing benefits, a nonjudgmental self-guided questionnaire, client stories, and visual aids.
• Two-way SMS text messaging was deemed impractical due to privacy concerns, regulations, and HCW workload.

Conclusions:

• Human-centered design research was feasible in Ukraine despite the wartime setting.
• The CASI-Plus mHealth tool demonstrated acceptability among both HCWs and clients.
• A randomized clinical trial is planned to evaluate the REDCap-based CASI-Plus tool's impact on partner naming and testing rates.