The Usability and Acceptability of an Adolescent mHealth HIV/STI and Drug Abuse Preventive Intervention in Primary Care

Abstract

Human Immunodeficiency Virus (HIV)/sexually transmitted infection (STI) risk behaviors among adolescents remain significant public health concerns. Shifts in policy and advances in technology provide opportunities for researchers and clinicians to deliver and evaluate mobile-health (mHealth) prevention programs in primary care, however, research is limited. This study assessed the usability and acceptability of Storytelling 4 Empowerment-a mHealth HIV/STI and drug abuse preventive intervention app-among adolescents in primary care. Informed by principles of community-based participatory research, we recruited a purposive sample of 30 adolescents from a youth-centered community health care clinic in Southeast Michigan. The study sample is primarily African American and female. Adolescents who participated in the Storytelling 4 Empowerment intervention assessed its usability and acceptability, and self-reported their HIV/STI risk behaviors. We used a multiple-methods approach. Adolescents reported high acceptability of the content, process, and format of Storytelling 4 Empowerment, as evidenced by qualitative data and mean scores from the Session Evaluation Form for the HIV/STI and Alcohol/Drug content, overall Storytelling 4 Empowerment intervention, and Client Satisfaction Questionnaire-8. Findings indicate that Storytelling 4 Empowerment is acceptable among adolescents in primary care. A next step is to examine the effect of Storytelling 4 Empowerment on adolescent sexual risk and drug use behaviors and HIV/STI testing.

Using technology to assess and intervene with illicit drug-using persons at risk for HIV

“…Characteristics of eight recent, in-progress or completed technology-based interventions are shown in Table 2 [19, 20, 23, 33–37]. Seven of the intervention studies are being conducted in the US [19, 20, 23, 33–35, 37], and one in Canada [36].…”

“…Seven of the intervention studies are being conducted in the US [19, 20, 23, 33–35, 37], and one in Canada [36]. Three of the studies reported trial outcomes [20, 23, 35], two of which are pilot trials with small sample sizes [20, 23], and one is a larger-scale efficacy trial [35].…”

“…Among the five mobile app interventions [19, 20, 23, 33, 37], features include: self-management skills development; drug use self-monitoring; alerts to high-risk locations; skills development for resisting drug use; ways to contact support network members, counselors, and peer navigators; and ART adherence and appointment reminders for participants with HIV. Of the two completed studies, one reported higher mean weeks of opioid abstinence for men receiving the mobile app plus standard methadone maintenance therapy (MMT) compared to a historical control of patients on standard MMT [20].…”

Adolescent Experiences of Clinician–Patient HIV/STI Communication in Primary Care

“…Data are from a larger study focused on the development and examination of a mobile-health HIV/STI and drug abuse preventive intervention (Córdova et al, 2015; Córdova et al, 2016). Data collection occurred between December 2013 and October 2014, and was approved by the University of Michigan’s Institutional Review Board.…”

“…Ecodevelopmental theory has been applied to develop a fuller understanding of how parent–adolescent communication shapes HIV/STI risk behaviors (Córdova, Huang, Pantin, & Prado, 2012). The theory may also have great utility for developing a fuller understanding of clinician–adolescent HIV/STI communication, yet research remains limited (Córdova et al, 2015; Córdova et al, 2016). Furthermore, social interaction theory affirms that clinician–adolescent communication does not happen in isolation, but rather occurs in a dynamic and reciprocal manner; therefore, incorporating aspects of interpersonal communication processes into an ecodevelopmental framework may be helpful.…”