Browsing by Author "Hightow-Weidman, Lisa"
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- ItemDeveloping a Mobile App (LYNX) to Support Linkage to HIV/Sexually Transmitted Infection Testing and Pre-Exposure Prophylaxis for Young Men Who Have Sex With Men: Protocol for a Randomized Controlled T...(0000-00-00) Liu, Albert; Coleman, Kenneth; Bojan, Kelly; Serrano, Pedro Alonso; Oyedele, Temitope; Garcia, Amayvis; Enriquez-Bruce, Elizabeth; Emmanuel, Patricia; Jones, Jeb; Sullivan, Patrick; Hightow-Weidman, Lisa; Buchbinder, Susan; Scott, HymanBACKGROUND Young men who have sex with men YMSM in the United States have among the highest incidence of HIV and sexually transmitted infection STI and the lowest uptake of HIV and STI testing and pre exposure prophylaxis PrEP Nearly universal mobile phone ownership among youth provides an opportunity to leverage mobile health apps to increase HIV STI testing and PrEP uptake among YMSM OBJECTIVE The goals of this project are to develop and refine LYNX a novel mobile app to support linkage to HIV STIs testing and PrEP services among YMSM in the United States and to evaluate the acceptability and feasibility of LYNX in a pilot randomized controlled trial RCT METHODS This research protocol will be conducted in 3 phases an iterative development phase with a series of 3 focus groups among 20 YMSM to refine the LYNX app an open technical pilot among 15 YMSM to optimize usability of the app and then a 6 month pilot RCT among 60 HIV uninfected YMSM at risk for HIV acquisition Developed using the Information Motivation and Behavioral skills theoretical model the LYNX app includes an electronic diary to track sexual behaviors information a personalized risk score to promote accurate risk perception information motivation testing reminders motivation behavioral skills and access to home based HIV STI testing options and geospatial based HIV STI testing care sites behavioral skills Feasibility and acceptability will be assessed through app analytics of usage patterns and acceptability scales administered via computer assisted self interview at 3 and 6 months We will also evaluate preliminary efficacy by comparing the proportion of YMSM who test at least once during the 6 month pilot and the proportion who successfully link to a PrEP provider in the intervention versus control groups RESULTS Formative work is currently underway The LYNX pilot RCT will begin enrollment in October 2018 with study results available in 2019 CONCLUSIONS The LYNX app is one of the first mobile apps designed to increase HIV STI testing and PrEP uptake among YMSM As low perceived risk is a barrier to HIV STI testing and PrEP use among youth the personalized risk assessment and interactive sexual diary in LYNX could assist YMSM in better understanding their HIV risk and providing motivation to test for HIV STIs and initiate PrEP Coupled with community based recruitment this novel mobile app has great potential to reach and engage YMSM not currently involved in care and increase rates of HIV STI testing and PrEP uptake in this vulnerable population TRIAL REGISTRATION ClinicalTrials gov NCT03177512 https clinicaltrials gov ct2 show NCT03177512 Archived by WebCite at http www webcitation org 73c917wAw INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID PRR1 10 2196 10659
- ItemA Gamified Smartphone App to Support Engagement in Care and Medication Adherence for HIV-Positive Young Men Who Have Sex With Men (AllyQuest): Development and Pilot Study.(0000-00-00) Hightow-Weidman, Lisa; Muessig, Kathryn; Knudtson, Kelly; Srivatsa, Mala; Lawrence, Ellena; Legrand, Sara; Hotten, Anna; Hosek, SybilBACKGROUND HIV disproportionately impacts young men who have sex with men YMSM who experience disparities across the HIV care continuum Addressing antiretroviral therapy ART adherence among YMSM is an urgent public health priority Technology based interventions particularly mobile health platforms can provide tailored adherence interventions and allow YMSM to engage and connect with others OBJECTIVE The objective of this study was to describe the development of AllyQuest a novel theoretically based smartphone app designed to improve engagement in care and ART adherence and social support among HIV positive YMSM METHODS AllyQuest was built on an established platform for patient engagement that embeds social networking and fundamental game mechanics such as challenges points and rewards A medication tracker provides reminders to promote ART adherence via personalized adherence strategies that are user and context specific a calendar allows for reflection on adherence over time After iterative development with input from two youth advisory boards usability testing was conducted to assess app functionality comprehension of the educational content use of intervention features and overall impressions of app relevance and appeal A 28 day pilot trial was conducted with 20 HIV YMSM to evaluate intervention feasibility and acceptability RESULTS Mean age of participants was 21 8 years range 19 24 and 95 19 20 of the participants were nonwhite The mean time of app use was 158 4 min SD 114 1 with a range of 13 to 441 min There was a mean of 21 2 days of use out of a total possible 28 days There were 222 posts to the daily discussion social wall Feasibility and acceptability ratings were high Overall participants found the app easy to use and navigate not intrusive and had few reported technical issues Higher levels of app usage were positively correlated with HIV self management outcomes and there was a statistically significant PUnder 05 positive association between the number of days logged into the app and knowledge and confidence in ability to reliably take HIV medications CONCLUSIONS AllyQuest represents a new highly scalable solution that is well suited to meet the specific prevention and care needs of HIV YMSM The development of this intervention is both timely and vital given the urgency of the ongoing HIV epidemic among YMSM
- ItemA Mobile-Based App (MyChoices) to Increase Uptake of HIV Testing and Pre-Exposure Prophylaxis by Young Men Who Have Sex With Men: Protocol for a Pilot Randomized Controlled Trial.(0000-00-00) Biello, Katie B; Marrow, Elliot; Mimiaga, Matthew J; Sullivan, Patrick; Hightow-Weidman, Lisa; Mayer, Kenneth HBACKGROUND HIV incidence is growing most rapidly in the United States among young men who have sex with men YMSM Overwhelming evidence demonstrates that routine testing and expanded use of pre exposure prophylaxis PrEP would dramatically reduce the population burden of HIV however uptake of both interventions is suboptimal among young adults The use of mobile phone apps by YMSM is ubiquitous and may offer unique opportunities for public health interventions MyChoices is a theory driven app to increase HIV testing and PrEP uptake It was developed by an interdisciplinary team based on feedback from a diverse sample of YMSM OBJECTIVE The aim of this paper is to describe the protocol for the refinement beta testing and pilot randomized controlled trial RCT to examine the acceptability and feasibility of the MyChoices app METHODS This 3 phase study includes 4 theater testing groups for app refinement with a total of approximately 30 YMSM for beta testing including quantitative assessments and exit interviews with approximately 15 YMSM over a 2 month period and for a pilot RCT with 60 YMSM The pilot will assess feasibility acceptability and preliminary efficacy of the MyChoices app compared with referrals only in increasing HIV testing and PrEP uptake All participants will be recruited at iTech clinical research sites in Boston MA and Bronx NY RESULTS App refinement is underway Enrollment for the pilot RCT began in October 2018 CONCLUSIONS MyChoices is one of the first comprehensive theory driven HIV prevention apps designed specifically for YMSM If MyChoices demonstrates acceptability and feasibility in this pilot RCT a multicity 3 arm randomized controlled efficacy trial of this app and another youth optimized app LYNX versus standard of care is planned within iTech If shown to be efficacious the app will be scalable with the ability to reach YMSM across the United States as well as be geographically individualized with app content integrated with local prevention and testing activities INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID PRR1 10 2196 10694
- Item"No one's at home and they won't pick up the phone": using the Internet and text messaging to enhance partner services in North Carolina.(2014-01-13) Hightow-Weidman, Lisa; Beagle, Steve; Pike, Emily; Kuruc, Joann; Leone, Peter; Mobley, Victoria; Foust, Evelyn; Gay, CynthiaBACKGROUND The Internet and mobile devices are increasingly used by men who have sex with men to find potential partners Lack of partner information besides e mail addresses or user profiles limits the ability to adequately perform partner notification by traditional means and test those at high risk To streamline North Carolina Internet Partner Notification IPN services University of North Carolina at Chapel Hill collaborated with the North Carolina Division of Public Health beginning in July 2011 to formalize state IPN and text messaging for partner notification txtPN policies and centralize notification practices by designating a single IPN txtPN field coordinator within the University of North Carolina at Chapel Hill METHODS We compared the number of IPN and txtPN contacts initiated and their outcomes in July 1 2011 to June 30 2012 and compared with outcomes in January 1 2010 to December 31 2010 the year before the collaboration RESULTS Overall 362 IPN contacts were initiated compared with 133 initiated in 2010 More than half 59 1 were black mean age was 28 8 years Almost all were men who have sex with men 83 7 Approximately two thirds n 230 63 5 of contacts were successfully notified using centralized IPN Seven new cases of HIV infection 11 new cases of syphilis and 19 known previous HIV positive persons were identified Text messaging for partner notification was used for 29 contacts who did not initially respond to traditional notification or IPN 14 48 responded to txtPN in a median time of 57 5 minutes interquartile range 9 2708 CONCLUSIONS Centralization of IPN services augmented partner detection of new HIV and syphilis diagnoses Text messaging for partner notification represents a potentially effective method for augmenting traditional partner services In addition IPN and txtPN allow identification of HIV infected persons in need of linkage to care
- ItemA Realistic Talking Human Embodied Agent Mobile Phone Intervention to Promote HIV Medication Adherence and Retention in Care in Young HIV-Positive African American Men Who Have Sex With Men: Qualitative...(0000-00-00) Dworkin, Mark; Chakraborty, Apurba; Lee, Sangyoon; Monahan, Colleen; Hightow-Weidman, Lisa; Garofalo, Robert; Qato, Dima; Jimenez, AntonioBACKGROUND Avatars and embodied agents are a promising innovation for human health intervention because they may serve as a relational agent that might augment user engagement in a behavioral change intervention and motivate behavioral change such as antiretroviral adherence and retention in care OBJECTIVE This study aimed to develop a theory driven talking avatar like embodied agent mobile phone intervention guided by the information motivation behavioral skills model to promote HIV medication adherence and retention in care in young African American men who have sex with men MSM METHODS We performed 5 iterative focus groups in Chicago with HIV positive African American MSM aged 18 34 years to inform the ongoing development of a mobile phone app Participants for the focus groups were recruited from 4 University of Illinois at Chicago Community Outreach Intervention Project sites located in different high HIV incidence areas of the city and the University of Illinois at Chicago HIV clinic using fliers and word of mouth The focus group data analysis included developing an ongoing list of priorities for app changes and discussion between two of the investigators based on the project timeline resources and to what extent they served the app s objectives RESULTS In this study 16 men participated including 3 who participated in two groups The acceptability for an embodied agent app was universal in all 5 focus groups The app included the embodied agent response to questions and antiretroviral regimen information adherence tracking CD4 count and viral load tracking motivational spoken messages and customizability Concerns that were identified and responded to in the development process included privacy stigma avoiding the harsh or commanding tone of voice avoiding negative motivational statements and making reminder functions for a variety of health care interactions CONCLUSIONS An avatar like embodied agent mHealth approach was acceptable to young HIV positive African American MSM Its relational nature may make it an effective method of informing motivating and promoting health behavioral skills Furthermore the app s ease of access stigma free environment and audiovisual format may help overcome some adherence barriers reported in this population
- ItemReducing HIV Vulnerability Through a Multilevel Life Skills Intervention for Adolescent Men (The iREACH Project): Protocol for a Randomized Controlled Trial.(0000-00-00) Bauermeister, Jose; Sullivan, Patrick S; Gravens, Laura; Wolfe, James; Countryman, Kristina; Smith-Bankhead, Neena; Drab, Ryan A; Sallabank, Gregory; Helms, Jordan D; Khatibi, Kristie; Filipowicz, Rebecca; Horvath, Keith Joseph; Bonar, Erin; Castel, Amanda; Hightow-Weidman, Lisa; Guest, Jodie; Stephenson, RobBACKGROUND Few HIV interventions have demonstrated efficacy in reducing HIV risk among adolescent men who have sex with men AMSM and fewer still have recognized the unique needs of AMSM based on race ethnicity or geographical setting Recognizing that youths HIV vulnerability is intricately tied to their development and social context delivering life skills training during adolescence might delay the onset or reduce the consequences of risk factors for HIV acquisition and equip AMSM with the skills to navigate HIV prevention This protocol describes the development and testing of iREACH an online multilevel life skills intervention for AMSM OBJECTIVE This randomized controlled trial RCT aims to test the efficacy of an online delivered life skills intervention iREACH on cognitive and behavioral HIV related outcomes for AMSM METHODS iREACH is a prospective RCT of approximately 600 cisgender adolescent males aged 13 to 18 years who report same sex attractions The intervention will be tested with a racial ethnically diverse sample 50 racial ethnic minority of AMSM living in four regions in the United States 1 Chicago to Detroit 2 Washington DC to Atlanta 3 San Francisco to San Diego and 4 Memphis to New Orleans RESULTS This project is currently recruiting participants Recruitment began in March 2018 CONCLUSIONS iREACH represents a significant innovation in the development and testing of a tailored life skills focused intervention for AMSM and has the potential to fill a significant gap in HIV prevention intervention programming and research for AMSM REGISTERED REPORT IDENTIFIER RR1 10 2196 10174
- ItemTesting the Efficacy of a Social Networking Gamification App to Improve Pre-Exposure Prophylaxis Adherence (P3: Prepared, Protected, emPowered): Protocol for a Randomized Controlled Trial.(0000-00-00) Legrand, Sara; Knudtson, Kelly; Benkeser, David; Muessig, Kathryn; Mcgee, Andrew; Sullivan, Patrick S; Hightow-Weidman, LisaBACKGROUND HIV prevalence is high among young men who have sex with men YMSM and young transgender women who have sex with men YTWSM particularly among minorities Despite its proven efficacy and safety the uptake of and adherence to pre exposure prophylaxis PrEP among YMSM and YTWSM is currently limited To date evidence based interventions to promote and sustain PrEP adherence have been limited and not shown to be highly efficacious Given the widespread adoption of smartphones mobile apps can be utilized to increase PrEP adherence for many YMSM and YTWSM OBJECTIVE The study consists of a formative research phase to develop an app based intervention P3 Prepared Protected emPowered to increase PrEP adherence and a randomized controlled trial RCT to test its efficacy P3 is a mobile app built on an established health platform which includes social networking and game based components to encourage PrEP adherence among YMSM and YTWSM P3 includes all P3 features plus adherence counseling delivered via two way text messaging short message service SMS through the app METHODS The formative research phase includes usability testing to assess users comprehension of P3 s educational content understanding and use of intervention features and overall impressions of app functionality followed by app refinements A subsequent field trial will identify and resolve any remaining technical challenges A three arm RCT P3 P3 and standard of care will then be conducted at 6 iTech subject recruitment venues to assess intervention efficacy and to conduct a comparison of costs to deliver the 2 intervention arms RESULTS This is an ongoing research project with initial results from the formative work expected in 2020 and those from the RCT in 2021 CONCLUSIONS P3 aims to provide an engaging interactive experience that is highly appealing for the target population leveraging technology already heavily integrated into the lives of young people and thus meeting users needs in a familiar stimulating way If efficacious P3 could be a sustainable easily disseminated lower cost PrEP intervention for YMSM and YTWSM Further the research aims to determine the processes that are essential to developing and implementing future health related gamification interventions TRIAL REGISTRATION ClinicalTrials gov NCT03320512 https clinicaltrials gov ct2 show NCT03320512 Archived by WebCite at http www webcitation org 74OVZkICl INTERNATIONAL REGISTERED REPORT IDENTIFIER IRRID DERR1 10 2196 10448
- ItemUncovering a Role for Electronic Personal Health Records in Reducing Disparities in Sexually Transmitted Infection Rates Among Students at a Predominantly African American University: Mixed-Methods St...(0000-00-00) Jackman, Kevon-Mark; Baral, Stefan David; Hightow-Weidman, Lisa; Poteat, ToniaBACKGROUND Black youth continue to bear an overwhelming proportion of the United States sexually transmitted infection STI burden including HIV Several studies on web based and mobile health mHealth STI interventions have focused on characterizing strategies to improve HIV related prevention and treatment interventions risk communication and stigma among men who have sex with men MSM people who use substances and adolescent populations The Electronic Sexual Health Information Notification and Education eSHINE Study was an exploratory mixed methods study among students at a historically black university exploring perceptions on facilitating STI testing conversations with partners using electronic personal health records PHRs OBJECTIVE The purpose of this paper is to use eSHINE Study results to describe perceived impacts of electronic PHRs on facilitating STI testing discussions between sexual partners METHODS Semistructured focus groups and individual in depth interviews were conducted on a heterogeneous sample of students n 35 between May and July 2014 Qualitative phase findings guided development of an online survey instrument for quantitative phase data collection Online surveys were conducted using a convenience sample of students n 354 between January and May 2015 Online survey items collected demographic information sexual behaviors beliefs and practices surrounding STI testing communication between partners and beliefs about the impact of electronic PHR access on facilitating these discussions with partners Chi square analysis was performed to assess gender differences across quantitative measures A Wilcoxon signed rank sum test was used to test the null hypothesis that electronic PHRs are believed to have no effect on the timing of dyadic STI health communication RESULTS Participants described multiple individual and dyadic level factors that inhibit initiating discussions about STI testing and test results with partners Electronic PHRs were believed to improve ability to initiate conversations and confidence in STI screening information shared by partners Among online survey participants men were more likely to believe electronic PHRs make it easier to facilitate STI talks with potential partners 59 9 vs 51 9 2 3 93 P 05 The Wilcoxon signed rank test results indicate significant increases in perceived discussion timing before sex with electronic PHR access 61 0 vs 40 4 PUnder 001 CONCLUSIONS Findings suggest that electronic PHR access in STI screening settings among similar populations of Black youth may improve both motivation and personal agency for initiating dyadic STI health communication Results from this study will likely inform novel interventions that use access to electronic PHRs to stimulate important health related discussions between sexual partners Moving forward requires studying strategies for implementing interventions that leverage electronic PHRs to create new sexual health communication channels with providers peers and family among black youth