Abstract: Engaging Adolescents and Young Adults in Kazakhstan to Develop a Digital HIV Stigma Reduction Intervention through Crowdsourcing: A Method for Partnerships between Youth and Healthcare Systems (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Sunday, January 14, 2024

Independence BR A, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Alissa Davis, PhD, Associate Professor, Columbia University, New York, NY

Yihang Sun, MSW, Ph.D. Student, Columbia University, New York, NY

Denis Gryazev, Research Assistant, Columbia University Global Health Research Center of Central Asia, Kazakhstan

Joseph Tucker, Professor, University of North Carolina at Chapel Hill, Chapel Hill, NC

Laura Nyblade, Senior Research Health Policy Analyst, RTI International, Research Triangle Park, NC

Karsten Lunze, Assistant Professor, Boston University School of Medicine, MA

Assel Terlikbayeva, MD, Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan

Sholpan Primbetova, MS, MPharm, Deputy Regional Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan

Susan Rosenthal, PhD, Professor of Medical Psychology (in Pediatrics and Psychiatry), Columbia University Medical Center, New York, NY

Weiming Tang, Research Associate Professor of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC

Azamat Kuskulov, Research Assistant, Columbia University, New York, NY

Sara Landers, Research Assistant, Columbia University, New York, NY

Valera Gulyayev, Research Assistant, Columbia University Global Health Research Center of Central Asia, Kazakhstan

Pavel Gulyayev, Research Assistant, Columbia University Global Health Research Center of Central Asia, Kazakhstan

Gaukhar Mergenova, MD, MS, Project Director, Columbia University Global Health Research Center of Central Asia (GHRCCA), Almaty, Kazakhstan

Background: Kazakhstan (KZ) has one of the fastest growing HIV epidemics in the world, with one in four new HIV acquisitions occurring among adolescents and young adults (AYA, 13-29 years old). Yet stigma and a lack of youth-tailored interventions contribute to low HIV testing uptake and care engagement among AYA. Crowdsourcing is an innovative community-engaged intervention development approach that can engage AYA in partnership with researchers and healthcare providers to develop stigma-reduction intervention content. We aimed to determine feasibility of crowdsourcing (i.e., receive at least 50 submissions, with at least a third high-quality (≥3.5 score (70%)) to develop HIV stigma-reduction intervention content to promote HIV testing among AYA in KZ.

Methods: With a steering committee comprised of youth and other stakeholders, we developed an open call requesting multimedia submissions designed to reduce HIV stigma and promote HIV testing. We advertised through social media, youth events at universities and schools, and a multi-lingual website. Due to stigmatizing content in a number of early submissions, we provided additional guidance on the submission portal and via livestream sessions about stigma and how to avoid it. We also provided feedback on problematic submissions and gave contestants a chance to resubmit. Eligible submissions were separated by age group (13-19 or 20-29 years) and judged by a panel composed of AYA (n=25), healthcare providers (n=17), and government/NGO representatives (n=17). Submissions were judged on the following criteria: 1) potential to reduce stigma associated with HIV testing, 2) innovation, 3) relevancy to youth, and 4) overall impression.

Results: The contest website was visited by 2,893 individuals. Between January-March 2022, we received 96 submissions from 76 youth across Kazakhstan. Twenty-seven submissions had stigmatizing content or misinformation; 12 revised and resubmitted after feedback. Roughly three-quarters (n=75/96) of submissions met judging eligibility criteria. The average score for all submissions was 3.4 on a 5-point scale; 39 scored 3.5 (70%) or higher. Submission formats were: video (33.3%), text (32.4%), image (30.4%). Nearly two-thirds (65%) of participants were between ages 13-19. Healthcare providers on the judging panel were highly enthusiastic about youth submissions and requested to post youth content on clinic websites.

Conclusions: Crowdsourcing is a community-engaged implementation science tool shown feasible in this study to engage AYA in partnership with researchers and providers to develop youth-friendly HIV interventions. Social workers should consider using crowdsourcing in research with community members to create interventions tailored for vulnerable and/or historically marginalized populations.