Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth: Protocol for a randomized controlled trial

Dallas Swendeman, Elizabeth Mayfield Arnold, Danielle Harris, Jasmine Fournier, W. Scott Comulada, Cathy Reback, Maryann Koussa, Manuel Ocasio, Sung Jae Lee, Leslie Kozina, Maria Isabel Fernández, Mary Jane Rotheram

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: America's increasing HIV epidemic among youth suggests the need to identify novel strategies to leverage services and settings where youth at high risk (YAHR) for HIV can be engaged in prevention. Scalable, efficacious, and cost-effective strategies are needed, which support youth during developmental transitions when risks arise. Evidence-based behavioral interventions (EBIs) have typically relied on time-limited, scripted, and manualized protocols that were often delivered with low fidelity and lacked evidence for effectiveness. Objective: This study aims to examine efficacy, implementation, and cost-effectiveness of easily mountable and adaptable, technology-based behavioral interventions in the context of an enhanced standard of care and study assessments that implement the guidelines of Centers for Disease Control and Prevention (CDC) for routine, repeat HIV, and sexually transmitted infection (STI) testing for high-risk youth. Methods: Youth aged between 12 and 24 years (n=1500) are being recruited from community-based organizations and clinics serving gay, bisexual, and transgender youth, homeless youth, and postincarcerated youth, with eligibility algorithms weighting African American and Latino youth to reflect disparities in HIV incidence. At baseline and 4-month intervals over 24 months (12 months for lower-risk youth), interviewers monitor uptake of HIV prevention continuum steps (linkage to health care, use of pre- or postexposure prophylaxis, condoms, and prevention services) and secondary outcomes of substance use, mental health, and housing security. Assessments include rapid diagnostic tests for HIV, STIs, drugs, and alcohol. The study is powered to detect modest intervention effects among gay or bisexual male and transgender youth with 70% retention. Youth are randomized to 4 conditions: (1) enhanced standard of care of automated text-messaging and monitoring (AMM) and repeat HIV/STI testing assessment procedures (n=690); (2) online group peer support via private social media plus AMM (n=270); (3) coaching that is strengths-based, youth-centered, unscripted, based on common practice elements of EBI, available over 24 months, and delivered by near-peer paraprofessionals via text, phone, and in-person, plus AMM (n=270); and (4) online group peer support plus coaching and AMM (n=270). Results: The project was funded in September 2016 and enrollment began in May 2017. Enrollment will be completed between June and August 2019. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions: This hybrid implementation-effectiveness study examines alternative models for implementing the CDC guidelines for routine HIV/STI testing for YAHR of acquiring HIV and for delivering evidence-based behavioral intervention content in modular elements instead of scripted manuals and available over 24 months of follow-up, while also monitoring implementation, costs, and effectiveness. The greatest impacts are expected for coaching, whereas online group peer support is expected to have lower impact but may be more cost-effective.

Original languageEnglish (US)
Article numbere11165
JournalJournal of medical Internet research
Volume21
Issue number8
DOIs
StatePublished - Jan 1 2019

Fingerprint

Text Messaging
Peer Group
Self-Help Groups
Randomized Controlled Trials
HIV
Sexually Transmitted Diseases
Transgender Persons
Standard of Care
Centers for Disease Control and Prevention (U.S.)
Mentoring
Cost-Benefit Analysis
Guidelines
Social Media
Homeless Youth
Costs and Cost Analysis
Evidence-Based Practice
Condoms
Secondary Prevention
Hispanic Americans
Routine Diagnostic Tests

Keywords

  • adolescents
  • HIV/AIDS
  • homelessness
  • mHealth
  • MSM
  • prevention
  • transgender

ASJC Scopus subject areas

  • Health Informatics

Cite this

Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth : Protocol for a randomized controlled trial. / Swendeman, Dallas; Arnold, Elizabeth Mayfield; Harris, Danielle; Fournier, Jasmine; Comulada, W. Scott; Reback, Cathy; Koussa, Maryann; Ocasio, Manuel; Lee, Sung Jae; Kozina, Leslie; Fernández, Maria Isabel; Rotheram, Mary Jane.

In: Journal of medical Internet research, Vol. 21, No. 8, e11165, 01.01.2019.

Research output: Contribution to journalArticle

Swendeman, D, Arnold, EM, Harris, D, Fournier, J, Comulada, WS, Reback, C, Koussa, M, Ocasio, M, Lee, SJ, Kozina, L, Fernández, MI & Rotheram, MJ 2019, 'Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth: Protocol for a randomized controlled trial', Journal of medical Internet research, vol. 21, no. 8, e11165. https://doi.org/10.2196/11165
Swendeman, Dallas ; Arnold, Elizabeth Mayfield ; Harris, Danielle ; Fournier, Jasmine ; Comulada, W. Scott ; Reback, Cathy ; Koussa, Maryann ; Ocasio, Manuel ; Lee, Sung Jae ; Kozina, Leslie ; Fernández, Maria Isabel ; Rotheram, Mary Jane. / Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth : Protocol for a randomized controlled trial. In: Journal of medical Internet research. 2019 ; Vol. 21, No. 8.
@article{923c865e8c984c0ba960455636031dc6,
title = "Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth: Protocol for a randomized controlled trial",
abstract = "Background: America's increasing HIV epidemic among youth suggests the need to identify novel strategies to leverage services and settings where youth at high risk (YAHR) for HIV can be engaged in prevention. Scalable, efficacious, and cost-effective strategies are needed, which support youth during developmental transitions when risks arise. Evidence-based behavioral interventions (EBIs) have typically relied on time-limited, scripted, and manualized protocols that were often delivered with low fidelity and lacked evidence for effectiveness. Objective: This study aims to examine efficacy, implementation, and cost-effectiveness of easily mountable and adaptable, technology-based behavioral interventions in the context of an enhanced standard of care and study assessments that implement the guidelines of Centers for Disease Control and Prevention (CDC) for routine, repeat HIV, and sexually transmitted infection (STI) testing for high-risk youth. Methods: Youth aged between 12 and 24 years (n=1500) are being recruited from community-based organizations and clinics serving gay, bisexual, and transgender youth, homeless youth, and postincarcerated youth, with eligibility algorithms weighting African American and Latino youth to reflect disparities in HIV incidence. At baseline and 4-month intervals over 24 months (12 months for lower-risk youth), interviewers monitor uptake of HIV prevention continuum steps (linkage to health care, use of pre- or postexposure prophylaxis, condoms, and prevention services) and secondary outcomes of substance use, mental health, and housing security. Assessments include rapid diagnostic tests for HIV, STIs, drugs, and alcohol. The study is powered to detect modest intervention effects among gay or bisexual male and transgender youth with 70{\%} retention. Youth are randomized to 4 conditions: (1) enhanced standard of care of automated text-messaging and monitoring (AMM) and repeat HIV/STI testing assessment procedures (n=690); (2) online group peer support via private social media plus AMM (n=270); (3) coaching that is strengths-based, youth-centered, unscripted, based on common practice elements of EBI, available over 24 months, and delivered by near-peer paraprofessionals via text, phone, and in-person, plus AMM (n=270); and (4) online group peer support plus coaching and AMM (n=270). Results: The project was funded in September 2016 and enrollment began in May 2017. Enrollment will be completed between June and August 2019. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions: This hybrid implementation-effectiveness study examines alternative models for implementing the CDC guidelines for routine HIV/STI testing for YAHR of acquiring HIV and for delivering evidence-based behavioral intervention content in modular elements instead of scripted manuals and available over 24 months of follow-up, while also monitoring implementation, costs, and effectiveness. The greatest impacts are expected for coaching, whereas online group peer support is expected to have lower impact but may be more cost-effective.",
keywords = "adolescents, HIV/AIDS, homelessness, mHealth, MSM, prevention, transgender",
author = "Dallas Swendeman and Arnold, {Elizabeth Mayfield} and Danielle Harris and Jasmine Fournier and Comulada, {W. Scott} and Cathy Reback and Maryann Koussa and Manuel Ocasio and Lee, {Sung Jae} and Leslie Kozina and Fern{\'a}ndez, {Maria Isabel} and Rotheram, {Mary Jane}",
year = "2019",
month = "1",
day = "1",
doi = "10.2196/11165",
language = "English (US)",
volume = "21",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
publisher = "Journal of medical Internet Research",
number = "8",

}

TY - JOUR

T1 - Text-messaging, online peer support group, and coaching strategies to optimize the HIV prevention continuum for youth

T2 - Protocol for a randomized controlled trial

AU - Swendeman, Dallas

AU - Arnold, Elizabeth Mayfield

AU - Harris, Danielle

AU - Fournier, Jasmine

AU - Comulada, W. Scott

AU - Reback, Cathy

AU - Koussa, Maryann

AU - Ocasio, Manuel

AU - Lee, Sung Jae

AU - Kozina, Leslie

AU - Fernández, Maria Isabel

AU - Rotheram, Mary Jane

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: America's increasing HIV epidemic among youth suggests the need to identify novel strategies to leverage services and settings where youth at high risk (YAHR) for HIV can be engaged in prevention. Scalable, efficacious, and cost-effective strategies are needed, which support youth during developmental transitions when risks arise. Evidence-based behavioral interventions (EBIs) have typically relied on time-limited, scripted, and manualized protocols that were often delivered with low fidelity and lacked evidence for effectiveness. Objective: This study aims to examine efficacy, implementation, and cost-effectiveness of easily mountable and adaptable, technology-based behavioral interventions in the context of an enhanced standard of care and study assessments that implement the guidelines of Centers for Disease Control and Prevention (CDC) for routine, repeat HIV, and sexually transmitted infection (STI) testing for high-risk youth. Methods: Youth aged between 12 and 24 years (n=1500) are being recruited from community-based organizations and clinics serving gay, bisexual, and transgender youth, homeless youth, and postincarcerated youth, with eligibility algorithms weighting African American and Latino youth to reflect disparities in HIV incidence. At baseline and 4-month intervals over 24 months (12 months for lower-risk youth), interviewers monitor uptake of HIV prevention continuum steps (linkage to health care, use of pre- or postexposure prophylaxis, condoms, and prevention services) and secondary outcomes of substance use, mental health, and housing security. Assessments include rapid diagnostic tests for HIV, STIs, drugs, and alcohol. The study is powered to detect modest intervention effects among gay or bisexual male and transgender youth with 70% retention. Youth are randomized to 4 conditions: (1) enhanced standard of care of automated text-messaging and monitoring (AMM) and repeat HIV/STI testing assessment procedures (n=690); (2) online group peer support via private social media plus AMM (n=270); (3) coaching that is strengths-based, youth-centered, unscripted, based on common practice elements of EBI, available over 24 months, and delivered by near-peer paraprofessionals via text, phone, and in-person, plus AMM (n=270); and (4) online group peer support plus coaching and AMM (n=270). Results: The project was funded in September 2016 and enrollment began in May 2017. Enrollment will be completed between June and August 2019. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions: This hybrid implementation-effectiveness study examines alternative models for implementing the CDC guidelines for routine HIV/STI testing for YAHR of acquiring HIV and for delivering evidence-based behavioral intervention content in modular elements instead of scripted manuals and available over 24 months of follow-up, while also monitoring implementation, costs, and effectiveness. The greatest impacts are expected for coaching, whereas online group peer support is expected to have lower impact but may be more cost-effective.

AB - Background: America's increasing HIV epidemic among youth suggests the need to identify novel strategies to leverage services and settings where youth at high risk (YAHR) for HIV can be engaged in prevention. Scalable, efficacious, and cost-effective strategies are needed, which support youth during developmental transitions when risks arise. Evidence-based behavioral interventions (EBIs) have typically relied on time-limited, scripted, and manualized protocols that were often delivered with low fidelity and lacked evidence for effectiveness. Objective: This study aims to examine efficacy, implementation, and cost-effectiveness of easily mountable and adaptable, technology-based behavioral interventions in the context of an enhanced standard of care and study assessments that implement the guidelines of Centers for Disease Control and Prevention (CDC) for routine, repeat HIV, and sexually transmitted infection (STI) testing for high-risk youth. Methods: Youth aged between 12 and 24 years (n=1500) are being recruited from community-based organizations and clinics serving gay, bisexual, and transgender youth, homeless youth, and postincarcerated youth, with eligibility algorithms weighting African American and Latino youth to reflect disparities in HIV incidence. At baseline and 4-month intervals over 24 months (12 months for lower-risk youth), interviewers monitor uptake of HIV prevention continuum steps (linkage to health care, use of pre- or postexposure prophylaxis, condoms, and prevention services) and secondary outcomes of substance use, mental health, and housing security. Assessments include rapid diagnostic tests for HIV, STIs, drugs, and alcohol. The study is powered to detect modest intervention effects among gay or bisexual male and transgender youth with 70% retention. Youth are randomized to 4 conditions: (1) enhanced standard of care of automated text-messaging and monitoring (AMM) and repeat HIV/STI testing assessment procedures (n=690); (2) online group peer support via private social media plus AMM (n=270); (3) coaching that is strengths-based, youth-centered, unscripted, based on common practice elements of EBI, available over 24 months, and delivered by near-peer paraprofessionals via text, phone, and in-person, plus AMM (n=270); and (4) online group peer support plus coaching and AMM (n=270). Results: The project was funded in September 2016 and enrollment began in May 2017. Enrollment will be completed between June and August 2019. Data analysis is currently underway, and the first results are expected to be submitted for publication in 2019. Conclusions: This hybrid implementation-effectiveness study examines alternative models for implementing the CDC guidelines for routine HIV/STI testing for YAHR of acquiring HIV and for delivering evidence-based behavioral intervention content in modular elements instead of scripted manuals and available over 24 months of follow-up, while also monitoring implementation, costs, and effectiveness. The greatest impacts are expected for coaching, whereas online group peer support is expected to have lower impact but may be more cost-effective.

KW - adolescents

KW - HIV/AIDS

KW - homelessness

KW - mHealth

KW - MSM

KW - prevention

KW - transgender

UR - http://www.scopus.com/inward/record.url?scp=85071448081&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071448081&partnerID=8YFLogxK

U2 - 10.2196/11165

DO - 10.2196/11165

M3 - Article

C2 - 31400109

AN - SCOPUS:85071448081

VL - 21

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 8

M1 - e11165

ER -