Research towards implementing technology-based prevention with positives

University Of South Florida, Tampa FL

Investigators

Linked publications & trials

Abstract

? DESCRIPTION (provided by applicant): Despite increased access to antiretroviral (ARV) drugs and behavioral interventions, HIV remains a public health problem worldwide. Access to interventions is oftentimes limited, especially for people living with HIV (PLH) living in the rura and underserved areas. Providing Internet or mobile text-message based interventions can increase reach and there is increasing evidence of cost-effectiveness. However, data are scarce on PLH's access to technology and the acceptability of such interventions. It is also important to get the perspective of the health care providers who provide services to PLH to ensure that technology-based, or ehealth, prevention with [HIV] positives interventions (henceforth, ePWPIs) can fit with existing systems for reaching PLH clients. Aim 1 is to determine the extent to which PLH in Florida have the technical capacity (i.e., device access) to participate in technology-based, or eHealth, prevention with (HIV) positives interventions (henceforth, ePWPIs) via their own devices. This will be done with a statewide survey (approximate N=17656) of English and Spanish-speaking PLH in Florida via Ryan White case managers, as well as a more in-depth assessment with a subset of the statewide survey participants. Aim 2 is to describe PLH's willingness to adopt ePWPIs via their own devices and how adoption may vary based on participant (e.g., demographics, technology readiness), technology (e.g., text, app, video-chat), and intervention characteristics (i.e., perceptions of usefulness, cost, relative advantage). We will do this through an exploratory sequential mixed methods follow-up study with a sub-set of participants from the statewide assessment. Findings from 30 qualitative, in-person PLH interviews (Phase 2a) about willingness to adopt ePWPIs will inform an in-depth primarily quantitative assessment (N=400 PLH) regarding access, use, and willingness to adopt ePWPIs, guided in part by an adapted Technology Readiness and Acceptance Model (TRAM35). Aim 3 is to examine key stakeholder (i.e., medical care providers and ASO staff) perceptions of fit between ePWPIs and their existing systems for reaching clients and delivering programs, and identify potential ePWPI implementation strategies to maximize fit. This will be done via semi-structured interviews. The study is innovative as it is guided by the consolidated framework for implementation research (CFIR) and the TRAM. Findings will be critical in shaping the scientific agenda regarding ePWPIs and will lead to subsequent R01 applications, including a R01 trial that tests effectiveness of an approach that matches ePWPIs to geographical areas and subpopulations, employing implementation strategies that emerged from this R21.