Developing a Primary Care HIV Preventive Intervention App: Grounded in the Voices of Adolescents

Introduction: Urban adolescents in the United States disproportionately engage in licit and illicit drug use and sexual risk behaviors, which place them at increased risk of STI/HIV. With the passing of the Affordable Care Act, primary care visits are projected to significantly increase. Primary care settings, therefore, offer an innovative context to deliver preventive interventions to adolescents who otherwise may not participate in prevention programs. To date, few e-health interventions have been developed to prevent and reduce drug abuse and sexual risk behaviors among urban adolescents in a primary care setting (e.g., Mason et al., 2011). The purpose of this study was to develop an e-health app HIV/STI preventive intervention to be delivered in a primary care setting.

Methods: The present study consisted of a community-engaged (Minkler & Wallerstein, 2010) approach to developing an e-health app. As such, recruitment activities, data collection and analysis were completed in collaboration with the Youth Leadership Council. The study design consisted of two phases, including formative focus group interviews and app development. Guided by the principles of agile software development (Dyba & Dingsoyer, 2008), the formative focus group data collection (n=30) and intervention development phases were synergistic. Therefore, while the focus group data were collected, the interface was built and the messaging was incorporated into the interface once all data were collected. Qualitative data were analyzed using Nvivo 8 software and were coded across three main domains: format, content and process.

 

Results: Formative focus group data indicate that the intervention app should be brief, focus on specific substances and sex risk behaviors relevant to the community, include clay animation videos, include interactive components, and be delivered in a private area during the primary care visit.

 

Conclusions: Community-engaged approaches to developing e-health preventive interventions may be an effective method to increase participant engagement and ensure program relevance to the targeted population. The principles of agile software development have great utility for continuous design improvement and testing based on rapid feedback and change (Dyba & Dingsoyer, 2008). A next step in this program of research is to examine the acceptability, feasibility, and efficacy of the intervention in preventing and reducing HIV/STI risk behaviors among urban adolescents in a primary care setting.