Positive health check: developing a web-based video counseling tool for HIV primary care clinics

ABSTRACT

HIV prevention efforts are increasingly aimed at engaging people living with HIV (PLWH) in healthcare to enhance treatment adherence and retention in care. Clinics need evidence-based interventions to support these goals and guidance on how to successfully implement these interventions in clinical settings. We describe the development of Positive Health Check (PHC) digital health intervention to support adherence and retention in care as well as a pilot implementation to determine feasibility. We developed PHC using input from seven HIV primary care providers. Over 15 months, providers gave feedback on the development of PHC by participating in nine inquiries, via online methods or webinars, addressing topics related to intervention development and implementation. After a 1-month pilot test, four providers shared their impressions of PHC implementation via a structured, open-ended interview. Providers’ comments resulted in script revisions, feedback on the filming of four virtual doctors (actors) balanced by race and gender, a user-friendly visual design, and more engaging messaging. Implementation feedback informed protocols to increase privacy and strategies to gain buy-in from clinics. Providers responded positively after using the final version of PHC, and again after the 1-month pilot implementation. Using a collaborative development approach with healthcare providers is a viable method for developing clinic-based interventions to support clinical encounters for PLWH. Intervention development should include strategies to support integrating mobile interventions into clinic workflows.

KEYWORDS:

• HIV
• prevention and control
• intervention development
• patient-centered care
• digital intervention
• implementation

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics approval

The ethics committee of RTI International determined that this study did not constitute human subjects research.

Notes on contributors

Camilla Harshbarger, Ph.D., specializes in the development, dissemination, and implementation of web-based HIV prevention interventions for diverse, at-risk U.S. populations. She has consulted overseas, conducting needs assessments and program evaluation in the field of international development, using ethnographic, qualitative, quantitative and participatory research methods.

Olivia Taylor, MPH, has specialized expertise in incorporating digital and social technologies into theory-driven behavior change initiatives. She has extensive experience in qualitative, quantitative, and participatory research methods, including formative research, survey development and analysis, experimental message testing, and evaluation planning and implementation.

Jennifer D. Uhrig, Ph.D., has expertise that spans the health communication process, from initial exploratory research to product development and pretesting to designing and conducting comprehensive process and outcome evaluations of public health communication and social marketing campaigns. She is skilled at quantitative and qualitative research methods, including the design, conduct, and analysis of experiments, surveys, focus groups, and in-depth interviews.

Megan Lewis, Ph.D., specializes in social science and health behavior research, and program evaluation, including formative, outcome, and impact evaluation. She has expertise in health-related, interpersonal communication focusing on health promotion and chronic illness management and the use of health and social science behavior theory in guiding research and intervention development.

Additional information

Funding

This work was supported by a contract to RTI International from the Centers for Disease Control and Prevention (Contract 200-2007-20016, Task Order 0025).