Use of cognitive interviews to develop PrEP education for men in New York and Alabama

We conducted cognitive interviews on a two-module PrEP training series developed by our study team to assess how clear, appropriate, and useful the videos are for gay, bisexual, and other men who have sex with men (collectively referred to as MSM) who are taking or interested in starting PrEP.

MSM aged 18-39 were recruited through convenience sampling to participate in cognitive interviews during which study staff screen-shared the PrEP training series and asked open-ended questions on the modules' script content, visuals and graphics, and audio. Audio recordings were transcribed and analyzed for common themes using a codebook guided by Fogg's Functional Triad, a theoretical framework which describes the persuasive functions of technology as a tool, media, and a social actor.

Thirty participants completed cognitive interviews between November 2023 and January 2024. Common feedback included that the PrEP training videos were a useful tool for those who were either looking to start or continue PrEP use. Further, participants appreciated that the videos were inclusive of diverse populations who may benefit from PrEP, and noted that they should include important topics such as access to PrEP and plain language to improve comprehension of material.

Our study applied Fogg's Functional Triad to identify ways in which our PrEP training series can facilitate PrEP uptake and adherence and allowed us to understand how this video series may be perceived prior to sharing it with the general public during our mChoice implementation study.

The training series has the potential to promote shared decision making in a healthcare setting. Feedback collected during cognitive interviews demonstrates the need for clear and comprehensive PrEP educational tools made specifically for patients as well as the need for involvement of the priority intervention audience in the creation of the training materials prior to their release to the public.