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Vazquez Guillamet LJ, Babey MM, Njah M, Blake H, Jasani A, Kyeng R, Hao J, Long D, Tih P, Turan JM, Khan EM, Dionne J. Acceptability, feasibility and potential of an intervention using secret Facebook groups to complement existing HIV prevention strategies among female sex workers in Cameroon, a randomized pilot study. AIDS Care 2024; 36:517-527. [PMID: 37921364 DOI: 10.1080/09540121.2023.2275048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023]
Abstract
This randomized pilot project evaluated an intervention promoting health care literacy around HIV, pre-exposure prophylaxis (PrEP), and stigma reduction using private social media groups that complemented existing HIV prevention services among female sex workers (FSWs) in Cameroon. The intervention was 12 HIV and sexual health videos tailored to FSWs that were released over 8 weeks through a secret Facebook group platform. In-person surveys were administered before, after the intervention, and three months later. No HIV seroconversions were detected; all participants completed follow-up and agreed to recommend the intervention to a coworker. Although the intervention was assessed to be acceptable and feasible to implement, poor internet connectivity was a key barrier. In time-series analysis, the intervention group participants reported improved PrEP interest, PrEP knowledge, and condom use along with reduced PrEP and HIV-related stigma, but no impact on sex-work related stigma or social cohesion. Similar results occurred in the control group. Cross-contamination and small pilot study size might have hindered the ability to detect the differential impact of this intervention. As communications technology increases in Cameroon, it is essential to learn more about FSWs preferences on the use of social media platforms for HIV prevention strategies.
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Affiliation(s)
- Laia J Vazquez Guillamet
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Mah Babey
- Cameroon Baptist Convention Health Services, Yaoundé, Cameroon
| | - Mercy Njah
- Cameroon Baptist Convention Health Services, Yaoundé, Cameroon
| | - Hassanatu Blake
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amy Jasani
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rahel Kyeng
- Cameroon Baptist Convention Health Services, Yaoundé, Cameroon
| | - Jiaying Hao
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dustin Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pius Tih
- Cameroon Baptist Convention Health Services, Yaoundé, Cameroon
| | - Janet M Turan
- Department of Health Policy and Organization, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Public Health, Koç University School of Medicine, Istanbul, Turkey
| | | | - Jodie Dionne
- Division of Infectious Diseases, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Wu N, Wang SJ, Brazeau AS, Chan D, Mussa J, Nakhla M, Elkeraby M, Ell M, Prevost M, Lepine L, Panagiotopoulos C, Mukerji G, Butalia S, Henderson M, Da Costa D, Rahme E, Dasgupta K. Supporting and Incentivizing Peer Leaders for an Internet-Based Private Peer Community for Youths With Type 1 Diabetes: Social Network and Directed Content Analysis. J Med Internet Res 2023; 25:e48267. [PMID: 38085568 PMCID: PMC10751631 DOI: 10.2196/48267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/04/2023] [Accepted: 10/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Youths with type 1 diabetes (T1D) frequently experience stigma. Internet-based peer communities can mitigate this through social support but require leaders to catalyze exchange. Whether nurturing potential leaders translates into a central role has not been well studied. Another issue understudied in such communities is lurking, the viewing of exchanges without commenting or posting. OBJECTIVE We aimed to assess the centrality of the peer leaders we selected, trained, and incentivized within the Canadian Virtual Peer Network (VPN)-T1D. This is a private Facebook (Meta Platforms, Inc) group that we created for persons aged 14 to 24 years with T1D. We specifically sought to (1) compare a quantitative estimate of network centrality between peer leaders and regular members, (2) assess the proportions of network exchanges that were social support oriented, and (3) assess proportions of high engagement (posts, comments, reactions, and votes) and low engagement (lurking) exchanges. METHODS We recruited peer leaders and members with T1D from prior study cohorts and clinics. We trained 10 leaders, provided them with a monthly stipend, and encouraged them to post on the private Facebook group we launched on June 21, 2017. We extracted all communications (posts, messages, reactions, polls, votes, and views) that occurred until March 20, 2020. We calculated each member's centrality (80% of higher engagement communications comprising posts, comments, and reactions plus 20% of members with whom they connected). We divided each member's centrality by the highest centrality to compute the relative centrality, and compared the mean values between leaders and members (linear regression). We calculated the proportions of communications that were posts, comments, reactions, and views without reaction. We performed content analysis with a social support framework (informational, emotional, esteem-related, network, and tangible support), applying a maximum of 3 codes per communication. RESULTS VPN-T1D gained 212 regular members and 10 peer leaders over 33 months; of these 222 members, 26 (11.7%) exited. Peer leaders had 10-fold higher relative centrality than regular members (mean 0.53, SD 0.26 vs mean 0.04, SD 0.05; 0.49 difference; 95% CI 0.44-0.53). Overall, 91.4% (203/222) of the members connected at least once through posts, comments, or reactions. Among the 75,051 communications, there were 5109 (6.81%) posts, comments, and polls, 6233 (8.31%) reactions, and 63,709 (84.9%) views (lurking). Moreover, 54.9% (3430/6253) of codes applied were social support related, 66.4% (2277/3430) of which were informational (eg, insurance and travel preparation), and 20.4% (699/3430) of which were esteem related (eg, relieving blame). CONCLUSIONS Designating, training, and incentivizing peer leaders may stimulate content exchange and creation. Social support was a key VPN-T1D deliverable. Although lurking accounted for a high proportion of the overall activity, even those demonstrating this type of passive participation likely derived benefits, given that the network exit rate was low. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/18714.
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Affiliation(s)
- Nancy Wu
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Susan Joanne Wang
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Anne-Sophie Brazeau
- School of Human Nutrition, Faculty of Agricultural and Environmental Sciences, McGill University, Ste Anne de Bellevue, QC, Canada
| | - Deborah Chan
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Joseph Mussa
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Meranda Nakhla
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Mariam Elkeraby
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Patient partner, Montreal, QC, Canada
| | - Maryna Ell
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Patient partner, Montreal, QC, Canada
| | - Melinda Prevost
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Patient partner, Montreal, QC, Canada
| | - Laurie Lepine
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Patient partner, Montreal, QC, Canada
| | - Constadina Panagiotopoulos
- Endocrinology & Diabetes Unit, British Columbia Children's Hospital and Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Geetha Mukerji
- Institute of Health Policy, Management and Evaluation, Health Sciences Building, University of Toronto, Toronto, ON, Canada
| | - Sonia Butalia
- Department of Medicine, Cumming School of Medicine, Health Sciences Centre, Foothills Campus, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
- Centre de Recherche CHU Sainte-Justine, Montreal, QC, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Deborah Da Costa
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Elham Rahme
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
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Aperman-Itzhak T, Prilleltensky I, Rosen L. Improving Knowledge, Engagement, and Self-Efficacy in the Creation of Healthy Home Environments for Mothers Using a Facebook Intervention (Design for Wellness): Randomized Controlled Trial. J Med Internet Res 2023; 25:e46640. [PMID: 37934566 PMCID: PMC10664014 DOI: 10.2196/46640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 06/13/2023] [Accepted: 07/19/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Designing the home environment can promote well-being. Social networks provide learning opportunities to improve health. OBJECTIVE This study aimed to develop and evaluate a Facebook intervention called Design for Wellness (DWELL). The program was created to improve knowledge, engagement, and self-efficacy in the creation of healthy home environments. METHODS A randomized controlled trial was conducted to assess the effects of the intervention program DWELL. Content was uploaded to the Facebook group and gave the participants practical solutions for how to design their home environment for wellness. The intervention addressed multiple components of health behaviors, such as healthy eating, physical activity, tobacco-free environment, hygiene, family conversations regarding wellness issues, and stress reduction. The main outcome was the participants' overall score on the DWELL index, which we developed to assess the elements of our intervention: knowledge, awareness, engagement, and self-efficacy regarding home design for wellness. The intervention was conducted in Israel and lasted 6 weeks during the third wave of the COVID-19 pandemic. The primary analysis included a multivariable model to assess the DWELL score at the end of the study while controlling for baseline characteristics. The waitlist control group did not receive an intervention between the 2 administrations of the questionnaire. RESULTS In total, 643 participants began the program: 322 (50.1%) in the intervention group and 321 (49.9%) in the control group. Of the 643 participants, 476 (74%) completed the study. At the end of the study, there was a statistically significant benefit of the intervention as assessed using a one-way analysis of covariance: there was a mean difference of 8.631 (SD 1.408) points in the DWELL score in favor of the intervention group (intervention: mean 61.92, SD 14.30; control: mean 53.29, SD 16.374; P<.001). Qualitative feedback from participants in the intervention group strengthened the positive results as most of them found the group beneficial. The Facebook group was very active. Being more engaged in the group correlated with having a higher DWELL score, but this relationship was weak (r=0.37; P<.001). The mean significant difference of 26.281 (SD 19.24) points between the overall DWELL score and the overall engagement score indicated that participants who were not active in the group still followed the posts and benefited. We found no improvements in the secondary outcome regarding participants' well-being. The COVID-19 lockdown may have prevented this. CONCLUSIONS DWELL was found to be a beneficial intervention for improving perceptions of the design of home environments to foster wellness. Facebook was an effective platform to deliver this intervention. DWELL may become a prototype for other health promotion interventions. TRIAL REGISTRATION ClinicalTrials.gov NCT03736525; https://clinicaltrials.gov/study/NCT03736525?term=DWELL&rank=1.
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Affiliation(s)
- Tal Aperman-Itzhak
- Department of Health Promotion, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Isaac Prilleltensky
- School of Education and Human Development, University of Miami, Miami, FL, United States
| | - Laura Rosen
- Department of Health Promotion, School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Flickinger TE, Campbell BR, Timm A, Baee S, Datta D, Shenoi SV, Rozanova J, Dillingham R. Use of a Mobile Health Intervention by Older Versus Younger People with HIV: Analysis of Usage, Social Support, and Network Interactions. TELEMEDICINE REPORTS 2022; 3:191-200. [PMID: 36636167 PMCID: PMC9811827 DOI: 10.1089/tmr.2022.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND People with HIV in the United States are aging, with risk for negative health outcomes from social isolation. PositiveLinks is a mobile health (mHealth) intervention that includes an anonymous Community Message Board (CMB) for peer-to-peer conversations. We investigated differences in CMB usage and social support between younger (<50 years) and older (≥50) members. METHODS We assessed the relationship between age groups and app use using chi-square tests. CMB posts were analyzed qualitatively to categorize forms of social support. To have a visual understanding of this relationship, we created a network diagram to display interactions among PL members. RESULTS Among 87 participants, 31 (42.5%) were in the older age group. Older members launched the app more often at 6 months (445.5 vs. 240.5 mean launches per participant, p ≤ 0.001) and 12 months (712.3 vs. 292.6 launches, p ≤ 0.001) compared with younger members. Older members also demonstrated more CMB posts at 6 months (47.4 vs. 7.6 mean posts per participant, p = 0.02) and 12 months (77.5 vs. 10.6 posts, p = 0.04). Of 1861 CMB posts, 7% sought support and 72% provided support. In addition, the network visualization showed that four participants, who were in the older age group, had more post generation than others and most of their posts provided support. CONCLUSIONS Older PL members demonstrated significantly more app use than younger members, including CMB posts for social support. This durable app engagement indicates that mHealth can enable social connection among people living with chronic disease across the lifespan.
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Affiliation(s)
- Tabor E. Flickinger
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Breanna R. Campbell
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Allyson Timm
- School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Sonia Baee
- School of Engineering and Applied Science, University of Virginia, Charlottesville, Virginia, USA
| | - Debajyoti Datta
- School of Engineering and Applied Science, University of Virginia, Charlottesville, Virginia, USA
| | - Sheela V. Shenoi
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Julia Rozanova
- Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia, Charlottesville, Virginia, USA
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Storman D, Jemioło P, Swierz MJ, Sawiec Z, Antonowicz E, Prokop-Dorner A, Gotfryd-Burzyńska M, Bala MM. Meeting the Unmet Needs of Individuals With Mental Disorders: Scoping Review on Peer-to-Peer Web-Based Interactions. JMIR Ment Health 2022; 9:e36056. [PMID: 36469366 PMCID: PMC9788841 DOI: 10.2196/36056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 06/24/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND An increasing number of online support groups are providing advice and information on topics related to mental health. OBJECTIVE This study aimed to investigate the needs that internet users meet through peer-to-peer interactions. METHODS A search of 4 databases was performed until August 15, 2022. Qualitative or mixed methods (ie, qualitative and quantitative) studies investigating interactions among internet users with mental disorders were included. The φ coefficient was used and machine learning techniques were applied to investigate the associations between the type of mental disorders and web-based interactions linked to seeking help or support. RESULTS Of the 13,098 identified records, 44 studies (analyzed in 54 study-disorder pairs) that assessed 82,091 users and 293,103 posts were included. The most frequent interactions were noted for people with eating disorders (14/54, 26%), depression (12/54, 22%), and psychoactive substance use disorders (9/54, 17%). We grouped interactions between users into 42 codes, with the empathy or compassion code being the most common (41/54, 76%). The most frequently coexisting codes were request for information and network (35 times; φ=0.5; P<.001). The algorithms that provided the best accuracy in classifying disorders by interactions were decision trees (44/54, 81%) and logistic regression (40/54, 74%). The included studies were of moderate quality. CONCLUSIONS People with mental disorders mostly use the internet to seek support, find answers to their questions, and chat. The results of this analysis should be interpreted as a proof of concept. More data on web-based interactions among these people might help apply machine learning methods to develop a tool that might facilitate screening or even support mental health assessment.
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Affiliation(s)
- Dawid Storman
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Paweł Jemioło
- AGH University of Science and Technology, Krakow, Poland
| | - Mateusz Jan Swierz
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
| | - Zuzanna Sawiec
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Ewa Antonowicz
- Students' Scientific Research Group of Systematic Reviews, Jagiellonian University Medical College, Krakow, Poland
| | - Anna Prokop-Dorner
- Chair of Epidemiology and Preventive Medicine, Jagiellonian University Medical College, Krakow, Poland
| | | | - Malgorzata M Bala
- Chair of Epidemiology and Preventive Medicine, Department of Hygiene and Dietetics, Jagiellonian University Medical College, Krakow, Poland
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Stehr P. The benefits of supporting others online – How online communication shapes the provision of support and its relationship with wellbeing. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Coulson NS, Buchanan H. The Role of Online Support Groups in Helping Individuals Affected by HIV and AIDS: Scoping Review of the Literature. J Med Internet Res 2022; 24:e27648. [PMID: 35881456 PMCID: PMC9364165 DOI: 10.2196/27648] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/29/2021] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background Online support groups provide opportunities for individuals affected by HIV and AIDS to seek information, advice, and support from peers. However, whether and how engagement with online support groups helps individuals affected by HIV and AIDS remains unclear, as does the nature of the evidence on this topic. Objective This scoping review sought to explore whether engagement with HIV and AIDS–related online support groups benefits members in terms of psychosocial well-being and illness management, whether members experienced any negative aspects of these groups, and what types of social support are exchanged within HIV and AIDS–related online support groups. Methods A scoping review of English-language articles (including both qualitative and quantitative studies) was undertaken using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The databases searched included MEDLINE, PubMed, EMBASE, CINAHL, PsycINFO, CENTRAL (Cochrane Register of Controlled Trials), and Scopus. Key findings were synthesized using a narrative and thematic approach. Results A total of 22 papers met the inclusion criteria from an initial pool of 3332 abstracts. These papers included 23% (5/22) quantitative studies, 9% (2/22) mixed methods studies, and 68% (15/22) qualitative studies published between 2007 and 2019. Cross-sectional evidence suggests that engagement with HIV and AIDS–related online support groups is empowering for members and may lead to a range of psychosocial benefits. Furthermore, qualitative evidence suggests that these groups provide an opportunity to connect with similar people and share experiences. This can help improve self-worth, reduce stigma, facilitate improved illness management, and gain greater confidence when interacting with health professionals. However, online support groups are not without their limitations as qualitative evidence suggests that users may encounter examples of interpersonal conflict between members as well as be exposed to challenging content. Finally, HIV and AIDS–related online support groups are avenues through which individuals can solicit support, most commonly informational or emotional. Conclusions HIV and AIDS–related online support groups may have some benefits for members, particularly in terms of providing social support. There is a need for a systematic review of this literature that includes an assessment of the methodological quality of the available evidence.
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Affiliation(s)
- Neil S Coulson
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Heather Buchanan
- School of Medicine, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, United Kingdom
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Brooks ABJ, Herrmann PL, Andreas S. The use of banter in psychotherapy: A systematic literature review. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Adrian B. J. Brooks
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis University of Klagenfurt Klagenfurt Austria
| | - Pauline L. Herrmann
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis University of Klagenfurt Klagenfurt Austria
| | - Sylke Andreas
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis University of Klagenfurt Klagenfurt Austria
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Chenneville T, Drake H, Gabbidon K, Rodriguez C, Hightow-Weidman L. Bijou: Engaging Young MSM in HIV Care Using a Mobile Health Strategy. J Int Assoc Provid AIDS Care 2021; 20:23259582211030805. [PMID: 34242100 PMCID: PMC8274121 DOI: 10.1177/23259582211030805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Young men who have sex with men (YMSM) living with HIV experience challenges with retention in care, which negatively affects viral suppression. To address this, researchers piloted Bijou, a program designed to provide health education through electronically delivered behavior and risk reduction modules. Participants were 29 YMSM aged 19-24 living with HIV from the southeastern US. Participants completed pre, post, and 3-month follow-up (3MFU) surveys assessing knowledge, intervention acceptability, satisfaction, self-efficacy, ehealth literacy, and usability. Findings revealed significant improvement in knowledge and e-health literacy from pre-test to post-test but lost significance at 3MFU. Self-efficacy scores did not show significant differences from pre-test to post-test or 3MFU. Participants who completed all modules considered Bijou usable and acceptable; however, many did not complete the program. Findings suggest a need for adaptations to promote knowledge retention, e-health literacy, engagement over time, and research with a larger, more representative sample.
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Peer Group Focused eHealth Strategies to Promote HIV Prevention, Testing, and Care Engagement. Curr HIV/AIDS Rep 2021; 17:557-576. [PMID: 32794071 DOI: 10.1007/s11904-020-00527-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Electronic communication platforms are increasingly used to support all steps of the HIV care cascade (an approach defined as eHealth). Most studies have employed individual-level approaches in which participants are connected with information, reminders, or a healthcare worker. Recent growth in use of social media platforms, which create digital communities, has created an opportunity to leverage virtual peer-to-peer connection to improve HIV prevention and care. In this article, we describe the current landscape of peer group eHealth interventions in the HIV field, based on a review of published literature, an online survey of unpublished ongoing work, and discussions with practitioners in the field in an in-person workshop. RECENT FINDINGS We identified 45 published articles and 12 ongoing projects meeting our inclusion criteria. Most reports were formative or observational; only three randomized evaluations of two interventions were reported. Studies indicated that use of peer group eHealth interventions is acceptable and has unique potential to influence health behaviors, but participants reported privacy concerns. Evaluations of health outcomes of peer group eHealth interventions show promising data, but more rigorous evaluations are needed. Development of group eHealth interventions presents unique technological, practical, and ethical challenges. Intervention design must consider privacy and data sovereignty concerns, and respond to rapid changes in platform use. Innovative development of open-source tools with high privacy standards is needed.
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Chory A, Nyandiko W, Martin R, Aluoch J, Scanlon M, Ashimosi C, Njoroge T, McAteer C, Apondi E, Vreeman R. HIV-Related Knowledge, Attitudes, Behaviors and Experiences of Kenyan Adolescents Living with HIV Revealed in WhatsApp Group Chats. J Int Assoc Provid AIDS Care 2021; 20:2325958221999579. [PMID: 33657911 PMCID: PMC7940722 DOI: 10.1177/2325958221999579] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mobile technologies represent a scalable platform for delivering knowledge and interventions targeting adolescents living with HIV (ALWH) in low and middle income countries. Data from mobile interventions can be used to assess the contextual understanding and experiences of ALWH. METHODS We examined HIV-related knowledge, attitudes, beliefs, behaviors, and experiences of Kenyan ALWH revealed in the contextual data from enrollment in a WhatsApp® group chat intervention. RESULTS Thirty ALWH (17 female, mean age 15.4) on ART, engaged in HIV care and aware of their status, were enrolled. Qualitative analysis of WhatsApp® chat discussions identified a gap in HIV knowledge, high medication-taking literacy, need for mental health support and significant barriers to adherence. Participants discussed challenges with HIV stigma and medication-taking in the school setting. CONCLUSION These discussions demonstrate a need for education on HIV topics, mental health support for ALWH, and interventions for stigma mitigation in the school setting.
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Affiliation(s)
- Ashley Chory
- Department of Global Health and Health System Design, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Winstone Nyandiko
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Child Health and Paediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Roxanne Martin
- Department of Global Health and Health System Design, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Josephine Aluoch
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | - Michael Scanlon
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Indiana University School of Medicine, Indiana, USA
| | | | - Tabitha Njoroge
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
| | | | - Edith Apondi
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Moi Teaching and Referral Hospital, Eldoret, Kenya
- Department of Child Health and Paediatrics, School of Medicine, College of Health Sciences, Moi University, Eldoret, Kenya
| | - Rachel Vreeman
- Department of Global Health and Health System Design, Arnhold Institute for Global Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya
- Indiana University School of Medicine, Indiana, USA
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Colson PW, Franks J, Wu Y, Winterhalter FS, Knox J, Ortega H, El-Sadr WM, Hirsch-Moverman Y. Adherence to Pre-exposure Prophylaxis in Black Men Who Have Sex with Men and Transgender Women in a Community Setting in Harlem, NY. AIDS Behav 2020; 24:3436-3455. [PMID: 32385678 DOI: 10.1007/s10461-020-02901-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
While oral pre-exposure prophylaxis (PrEP) has proven efficacious for HIV prevention, consistent use is necessary to achieve its intended impact. We compared effectiveness of enhanced PrEP (enPrEP) adherence support to standard of care (sPrEP) among Black MSM and TGW attending a community clinic in Harlem, NY. EnPrEP included peer navigation, in-person/online support groups, and SMS messages. Self-reported adherence over previous 30 days, collected in quarterly interviews, was defined as ≥ 57%. Crude and adjusted analyses examined factors associated with adherence. A total of 204 participants were enrolled and randomized; 35% were lost to follow-up. PrEP adherence was 30% at 12-months; no intervention effect was observed (p = 0.69). Multivariable regression analysis found that lower adherence was associated with low education and depressive symptoms. We found that an enhanced adherence intervention did not improve PrEP adherence. Findings point to the need for innovative methods to improve PrEP adherence among Black MSM and TGW.Clinical Trial Registration NCT02167386, June 19, 2014.
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Moore DA, Nunns M, Shaw L, Rogers M, Walker E, Ford T, Garside R, Ukoumunne O, Titman P, Shafran R, Heyman I, Anderson R, Dickens C, Viner R, Bennett S, Logan S, Lockhart F, Thompson Coon J. Interventions to improve the mental health of children and young people with long-term physical conditions: linked evidence syntheses. Health Technol Assess 2020; 23:1-164. [PMID: 31122334 DOI: 10.3310/hta23220] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Although mental health difficulties can severely complicate the lives of children and young people (CYP) with long-term physical conditions (LTCs), there is a lack of evidence about the effectiveness of interventions to treat them. OBJECTIVES To evaluate the clinical effectiveness and cost-effectiveness of interventions aiming to improve the mental health of CYP with LTCs (review 1) and explore the factors that may enhance or limit their delivery (review 2). DATA SOURCES For review 1, 13 electronic databases were searched, including MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Science Citation Index. For review 2, MEDLINE, PsycINFO and CINAHL were searched. Supplementary searches, author contact and grey literature searches were also conducted. REVIEW METHODS The first systematic review sought randomised controlled trials (RCTs) and economic evaluations of interventions to improve elevated symptoms of mental ill health in CYP with LTCs. Effect sizes for each outcome were calculated post intervention (Cohen's d). When appropriate, random-effects meta-analyses produced pooled effect sizes (d). Review 2 located primary qualitative studies exploring experiences of CYP with LTCs, their families and/or practitioners, regarding interventions aiming to improve the mental health and well-being of CYP with LTCs. Synthesis followed the principles of metaethnography. An overarching synthesis integrated the findings from review 1 and review 2 using a deductive approach. End-user involvement, including topic experts and CYP with LTCs and their parents, was a feature throughout the project. RESULTS Review 1 synthesised 25 RCTs evaluating 11 types of intervention, sampling 12 different LTCs. Tentative evidence from seven studies suggests that cognitive-behavioural therapy interventions could improve the mental health of CYP with certain LTCs. Intervention-LTC dyads were diverse, with few opportunities to meta-analyse. No economic evaluations were located. Review 2 synthesised 57 studies evaluating 21 types of intervention. Most studies were of individuals with cancer, a human immunodeficiency virus (HIV) infection or mixed LTCs. Interventions often aimed to improve broader mental health and well-being, rather than symptoms of mental health disorder. The metaethnography identified five main constructs, described in an explanatory line of argument model of the experience of interventions. Nine overarching synthesis categories emerged from the integrated evidence, raising implications for future research. LIMITATIONS Review 1 conclusions were limited by the lack of evidence about intervention effectiveness. No relevant economic evaluations were located. There were no UK studies included in review 1, limiting the applicability of findings. The mental health status of participants in review 2 was usually unknown, limiting comparability with review 1. The different evidence identified by the two systematic reviews challenged the overarching synthesis. CONCLUSIONS There is a relatively small amount of comparable evidence for the effectiveness of interventions for the mental health of CYP with LTCs. Qualitative evidence provided insight into the experiences that intervention deliverers and recipients valued. Future research should evaluate potentially effective intervention components in high-quality RCTs integrating process evaluations. End-user involvement enriched the project. STUDY REGISTRATION This study is registered as PROSPERO CRD42011001716. FUNDING The National Institute for Health Research (NIHR) Health Technology Assessment programme and the NIHR Collaboration for Leadership in Applied Health Research and Care South West Peninsula.
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Affiliation(s)
- Darren A Moore
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Morwenna Rogers
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Erin Walker
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Tamsin Ford
- Child Mental Health Group, University of Exeter Medical School, Exeter, UK
| | - Ruth Garside
- The European Centre for Environment and Human Health, University of Exeter Medical School, Exeter, UK
| | - Obi Ukoumunne
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Penny Titman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Roz Shafran
- University College London Institute of Child Health, London, UK
| | - Isobel Heyman
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Rob Anderson
- Evidence Synthesis & Modelling for Health Improvement, University of Exeter Medical School, Exeter, UK
| | - Chris Dickens
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Russell Viner
- University College London Institute of Child Health, London, UK
| | - Sophie Bennett
- University College London Institute of Child Health, London, UK
| | - Stuart Logan
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
| | - Fiona Lockhart
- Biomedical Research Centre Patient & Public Involvement Group, University College London Hospitals, London, UK
| | - Jo Thompson Coon
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula, University of Exeter Medical School, Exeter, UK
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Wu N, Brazeau AS, Nakhla M, Chan D, Da Costa D, Mukerji G, Butalia S, Pacaud D, Henderson M, Panagiotopoulos C, Rahme E, Dasgupta K. Type 1 Diabetes Mellitus Virtual Patient Network as a Peer Support Community: Protocol for Social Network Analysis and Content Analysis. JMIR Res Protoc 2020; 9:e18714. [PMID: 32865502 PMCID: PMC7490683 DOI: 10.2196/18714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/05/2020] [Accepted: 07/21/2020] [Indexed: 01/26/2023] Open
Abstract
Background Type 1 Diabetes Mellitus Virtual Patient Network (T1DM-VPN) is a private Facebook group for youths with type 1 diabetes mellitus (T1DM) in Canada intended to facilitate peer-to-peer support. It was built on the finding that stigma is prevalent among youth with T1DM and impedes self-management. Objective We aim to determine if T1DM-VPN provides support as intended and to ascertain what type of members provide support. Specifically, we will (1) identify text consistent with any one of 5 social support categories, (2) describe the network by visualizing its structure and reporting basic engagement statistics, and (3) determine whether being a designated peer leader is related to a member’s centrality (ie, importance in the network) and how frequently they offer social support. Methods We will manually extract interaction data from the Facebook group (posts, comments, likes/reactions, seen) generated from June 21, 2017 (addition of first member), to March 1, 2020. Two researchers will independently code posts and comments according to an existing framework of 5 social support categories—informational, emotional, esteem, network, and tangible—with an additional framework for nonsocial support categories. We will calculate how frequently each code is used. We will also report basic engagement statistics (eg, number of posts made per person-month) and generate a visualization of the network.
We will identify stable time intervals in the history of T1DM-VPN by modeling monthly membership growth as a Poisson process. Within each interval, each member’s centrality will be calculated and standardized to that of the most central member. We will use a centrality formula that considers both breadth and depth of connections (centrality = 0.8 × total No. of connections + 0.2 × total No. of interactions). Finally, we will construct multivariate linear regression models to assess whether peer leader status predicts member centrality and the frequency of offering social support. Other variables considered for inclusion in the models are gender and age at diagnosis. Results T1DM-VPN was launched in June 2017. As of March 1, 2020, it has 196 patient-members. This research protocol received ethics approval from the McGill University Health Centre Research Ethics Board on May 20, 2020. Baseline information about each group member was collected upon addition into the group, and collection of interaction data is ongoing as of May 2020. Conclusions This content analysis and social network analysis study of a virtual patient network applies epidemiological methods to account for dynamic growth and activity. The results will allow for an understanding of the topics of importance to youth with T1DM and how a virtual patient network evolves over time. This work is intended to serve as a foundation for future action to help youth improve their experience of living with diabetes. International Registered Report Identifier (IRRID) PRR1-10.2196/18714
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Affiliation(s)
- Nancy Wu
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | | | - Meranda Nakhla
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Deborah Chan
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Deborah Da Costa
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Geetha Mukerji
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Sonia Butalia
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniele Pacaud
- Department of Pediatrics, Alberta Children's Hospital, University of Calgary, Calgary, AB, Canada
| | - Mélanie Henderson
- Division of Endocrinology and Diabetes, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
| | | | - Elham Rahme
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Kaberi Dasgupta
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
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15
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Young LE, Soliz S, Xu JJ, Young SD. A review of social media analytic tools and their applications to evaluate activity and engagement in online sexual health interventions. Prev Med Rep 2020; 19:101158. [PMID: 32685364 PMCID: PMC7358714 DOI: 10.1016/j.pmedr.2020.101158] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 06/25/2020] [Accepted: 06/28/2020] [Indexed: 11/05/2022] Open
Abstract
Social media analytic tools offer ways to evaluate online sex health interventions. Most tools measure reach, aggregate activity, and page- and post-level engagement. User-level activity and engagement metrics are rarely provided. Various metrics comprising composite engagement scores are difficult to discern. Most tools have limited or no capabilities in text and social network analytics.
Unprecedented public engagement with social media has provided viable and culturally relevant platforms for application in sexual health interventions, yet there are concerns that methods for evaluating engagement in these interventions have not kept pace with their implementation. More recently, the rise of social media analytics (SMA) and online marketing has spawned the development of analytic tools that boast promise for such a task. In this paper, we review a sample of the most popular of these tools, paying particular attention to: (1) the social media platforms that can be analyzed; (2) analytic capabilities; and (3) measures of engagement. We follow this with a review of sexual health intervention studies that apply these tools in evaluation efforts. Our findings suggest that these tools have numerous analytic capabilities that would be useful for evaluating interventions more efficiently. However, in nearly all cases, the tools we reviewed alone would not be sufficient to fully grasp engagement dynamics, as they need to be complemented with additional tools for textual analysis and social network analysis. Therefore, we consider this fertile ground for future collaborations between software developers and behavioral health scientists to develop more comprehensive analytic platforms with applications for public health research.
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Affiliation(s)
- Lindsay E Young
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Stephanie Soliz
- School of Social Work, University of Washington, Seattle, United States
| | - Jackie Jingyi Xu
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, United States
| | - Sean D Young
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, CA, United States
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16
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Dulli L, Ridgeway K, Packer C, Murray KR, Mumuni T, Plourde KF, Chen M, Olumide A, Ojengbede O, McCarraher DR. A Social Media-Based Support Group for Youth Living With HIV in Nigeria (SMART Connections): Randomized Controlled Trial. J Med Internet Res 2020; 22:e18343. [PMID: 32484444 PMCID: PMC7298637 DOI: 10.2196/18343] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 03/25/2020] [Accepted: 04/10/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Youth living with HIV (YLHIV) enrolled in HIV treatment experience higher loss to follow-up, suboptimal treatment adherence, and greater HIV-related mortality compared with younger children or adults. Despite poorer health outcomes, few interventions target youth specifically. Expanding access to mobile phone technology, in low- and middle-income countries (LMICs) in particular, has increased interest in using this technology to improve health outcomes. mHealth interventions may present innovative opportunities to improve adherence and retention among YLHIV in LMICs. OBJECTIVE This study aimed to test the effectiveness of a structured support group intervention, Social Media to promote Adherence and Retention in Treatment (SMART) Connections, delivered through a social media platform, on HIV treatment retention among YLHIV aged 15 to 24 years and on secondary outcomes of antiretroviral therapy (ART) adherence, HIV knowledge, and social support. METHODS We conducted a parallel, unblinded randomized controlled trial. YLHIV enrolled in HIV treatment for less than 12 months were randomized in a 1:1 ratio to receive SMART Connections (intervention) or standard of care alone (control). We collected data at baseline and endline through structured interviews and medical record extraction. We also conducted in-depth interviews with subsets of intervention group participants. The primary outcome was retention in HIV treatment. We conducted a time-to-event analysis examining time retained in treatment from study enrollment to the date the participant was no longer classified as active-on-treatment. RESULTS A total of 349 YLHIV enrolled in the study and were randomly allocated to the intervention group (n=177) or control group (n=172). Our primary analysis included data from 324 participants at endline. The probability of being retained in treatment did not differ significantly between the 2 study arms during the study. Retention was high at endline, with 75.7% (112/163) of intervention group participants and 83.4% (126/161) of control group participants active on treatment. HIV-related knowledge was significantly better in the intervention group at endline, but no statistically significant differences were found for ART adherence or social support. Intervention group participants overwhelmingly reported that the intervention was useful, that they enjoyed taking part, and that they would recommend it to other YLHIV. CONCLUSIONS Our findings of improved HIV knowledge and high acceptability are encouraging, despite a lack of measurable effect on retention. Retention was greater than anticipated in both groups, likely a result of external efforts that began partway through the study. Qualitative data indicate that the SMART Connections intervention may have contributed to retention, adherence, and social support in ways that were not captured quantitatively. Web-based delivery of support group interventions can permit people to access information and other group members privately, when convenient, and without travel. Such digital health interventions may help fill critical gaps in services available for YLHIV. TRIAL REGISTRATION ClinicalTrials.gov NCT03516318; https://clinicaltrials.gov/ct2/show/NCT03516318.
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Affiliation(s)
| | | | | | | | - Tolulope Mumuni
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | | | - Adesola Olumide
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladosu Ojengbede
- Center for Population and Reproductive Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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17
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E-health. Patterns of use and perceived benefits and barriers among people living with HIV and their physicians. Part 1: Information retrieval on the Internet and social networks. Med Mal Infect 2020; 50:575-581. [PMID: 32289382 DOI: 10.1016/j.medmal.2020.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 01/14/2020] [Accepted: 04/06/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To identify patterns of use, perceived benefits, and barriers among people living with HIV (PLHIV) of online searches for health information and via social media. METHODS Online multicentre observational survey (October 15th-19th, 2018). RESULTS Study participation was accepted by 838/1377 PLHIV followed in 46 centres, of which 325 (39%) responded online: 181 (56%) had already used the Internet to search for health information; 88/181 (49%) on HIV infection and 78 (43%) on nutrition. These 56% were characterised by a higher educational level (OR=1.82±0.50; P=0.028) and more often consulted other specialists (OR=3.14±1.26; P=0.004). A subset of 87/180 (48%) PLHIV had changed the way they looked after their health based on their online research, and were more often in material/social deprivation (P=0.02) and diabetic (P=0.02). A small subset of 19/180 (11%) had already asked or answered a question on a forum; these people tended to be women (P=0.03) in material/social deprivation (P=0.009). 296/322 (92%) PLHIV trusted their physician whereas only 206 (64%) trusted information sourced on medical websites. 238/323 (74%) PLHIV expected their physicians to recommend websites if asked, whereas only 23/323 (7%) had actually been given this guidance. CONCLUSION More than half of PLHIV surveyed had already searched for health information on the Internet, and one in two had changed their behaviour based on the online search. PLHIV did not see the Internet as an alternative to physicians but they wanted their physicians to guide them on how to find quality health information to better self-manage their condition.
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18
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Shaw L, Moore D, Nunns M, Thompson Coon J, Ford T, Berry V, Walker E, Heyman I, Dickens C, Bennett S, Shafran R, Garside R. Experiences of interventions aiming to improve the mental health and well-being of children and young people with a long-term physical condition: A systematic review and meta-ethnography. Child Care Health Dev 2019; 45:832-849. [PMID: 31339591 PMCID: PMC6851835 DOI: 10.1111/cch.12708] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 05/09/2019] [Accepted: 07/13/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND Children and young people with long-term physical health conditions are at increased risk of experiencing mental health and well-being difficulties. However, there is a lack of research that explores the experiences of and attitudes towards interventions aiming to improve their mental health and well-being. This systematic review seeks to address this gap in the literature by exploring what children and young people with long-term conditions, their caregivers, and health practitioners perceive to be important aspects of interventions aiming to improve their mental health and well-being. METHODS An information specialist searched five academic databases using predefined criteria for qualitative evaluations of interventions aiming to improve the mental health or well-being of children with long-term physical conditions. Reviewers also performed supplementary citation and grey literature searches. Two reviewers independently screened titles, abstracts, and full texts that met the inclusion criteria and conducted data extraction and quality assessment. Meta-ethnography was used to synthesize the findings. RESULTS Screening identified 60 relevant articles. We identified five overarching constructs through the synthesis: (a) Getting In and Staying In, (b) Therapeutic Foundation, (c) Social Support, (d) A Hopeful Alternative, and (e) Empowerment. The line of argument that links these constructs together indicates that when interventions can provide an environment that allows young people to share their experiences and build empathetic relationships, it can enable participants to access social support and increase feelings of hope and empowerment. CONCLUSION These findings may provide a framework to inform the development of mental health interventions for this population and evaluate existing interventions that already include some of the components or processes identified by this research. Further research is needed to establish which of the constructs identified by the line of argument are most effective in improving the mental well-being of young people living with long-term conditions.
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Affiliation(s)
- Liz Shaw
- University of Exeter Medical SchoolExeterUK
| | - Darren Moore
- Graduate School of EducationUniversity of ExeterExeterUK
| | - Michael Nunns
- Evidence Synthesis & Modelling for Health ImprovementUniversity of Exeter Medical SchoolExeterUK
| | - Jo Thompson Coon
- Evidence Synthesis & Modelling for Health ImprovementUniversity of Exeter Medical SchoolExeterUK
| | - Tamsin Ford
- Child Mental Health Research GroupUniversity of Exeter Medical SchoolExeterUK
| | - Vashti Berry
- Child Mental Health Research GroupUniversity of Exeter Medical SchoolExeterUK
| | - Erin Walker
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street HospitalLondonUK
| | - Isobel Heyman
- Centre for Outcomes and Experience Research in Children's Health, Illness and Disability, Great Ormond Street HospitalLondonUK,Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | | | - Sophie Bennett
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Roz Shafran
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
| | - Ruth Garside
- European Centre for Environment and Human HealthUniversity of Exeter Medical SchoolTruroUK
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Horvath KJ, MacLehose RF, Martinka A, DeWitt J, Hightow-Weidman L, Sullivan P, Amico KR. Connecting Youth and Young Adults to Optimize Antiretroviral Therapy Adherence (YouTHrive): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e11502. [PMID: 31364601 PMCID: PMC6691670 DOI: 10.2196/11502] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite intensive efforts to engage people living with HIV in the United States, less than half of the youth aged 13 to 24 years achieve viral suppression. There is a clear and continued need for innovative behavioral programs that support optimizing adherence among young persons with HIV. OBJECTIVE There are 3 phases of this project. Phase 1 involves conducting focus groups to obtain feedback from youth about an existing technology-based antiretroviral therapy (ART) adherence intervention. Phase 2 will be used to conduct beta testing with youth to refine and finalize the YouTHrive (YT) intervention. Phase 3 is a randomized controlled trial (RCT) to test the efficacy of the YT intervention among youth living with HIV (YLWH). METHODS In phase 1, we will conduct 6 focus groups with approximately 8 youths (aged 15-19 years) and young adults (aged 20-24 years), each in 3 US cities to obtain (1) feedback from YLWH about the look and feel and content of an existing adult-focused Web-based ART adherence intervention and (2) suggestions for adapting the intervention for YLWH similar to themselves. Phase 2 will involve updating the existing intervention to include features and functionality recommended by YLWH in phase 1; it will conclude with beta testing with 12 participants to gain feedback on the overall design and ensure proper functionality and ease of navigation. For phase 3, we will enroll 300 YLWH in 6 US cities (Atlanta, Chicago, Houston, New York City, Philadelphia, and Tampa) into a 2-arm prospective RCT. Participants will be randomized 1:1 to YT intervention or control group. The randomization sequence will be stratified by city and use random permuted blocks of sizes 2 and 4. Participants randomized to the control condition will view a weekly email newsletter on topics related to HIV, with the exception of ART adherence, for 5 months. Participants randomized to the YT intervention condition will be given access to the YT site for 5 months. Study assessments will occur at enrollment and 5, 8, and 11 months post enrollment. The primary outcome that will be assessed is sustained viral load (VL), defined as the proportion of participants in each study arm who have suppressed VL at both the 5- and 11-month assessment; the secondary outcome that will be assessed is suppressed VL at both the 5- and 11-month assessment between drug-using and nondrug-using participants assigned to the YT intervention arm. RESULTS Participant recruitment began in May 2017 for phase 1 of the study. The data collection for aim 3 is anticipated to end in April 2020. CONCLUSIONS The efficacy trial of the YT intervention will help to fill gaps in understanding the efficacy of mobile interventions to improve ART adherence among at-risk populations. TRIAL REGISTRATION ClinicalTrials.gov NCT03149757; https://clinicaltrials.gov/ct2/show/NCT03149757 (Archived by WebCite at http://www.webcitation.org/73pw57Cf1). INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/11502.
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Affiliation(s)
- K J Horvath
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - R F MacLehose
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - A Martinka
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - J DeWitt
- School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - L Hightow-Weidman
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - P Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - K R Amico
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
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Abstract
PURPOSE OF REVIEW Multiple reviews have examined eHealth/mHealth interventions to address treatment adherence, including those focusing on youth living with HIV (YLWH). This review synthesizes results of prior reviews and recent studies (last 5 years) to provide a path forward for future research, acknowledging both lessons learned and gaps to be addressed. RECENT FINDINGS Recent studies provide further evidence for the feasibility and acceptability of technology-based HIV interventions. Formative research of more comprehensive smartphone applications and pilot studies of computer-delivered interventions provide additional guidance on YLWH's preferences for intervention components and show promising preliminary efficacy for impacting treatment adherence. Expanding access to technology among YLWH, in the United States (US) and globally, supports the continued focus on eHealth/mHealth interventions as a means to reduce disparities in clinical outcomes. Future research should lend greater focus to implementation and scale-up of interventions through the use of adaptive treatment strategies that include costing analyses, measuring and maximizing engagement, fostering information sharing between researchers, and building upon sustainable platforms.
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21
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Berard AA, Smith AP. Post Your Journey: Instagram as a Support Community for People With Fibromyalgia. QUALITATIVE HEALTH RESEARCH 2019; 29:237-247. [PMID: 30066603 DOI: 10.1177/1049732318789102] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Fibromyalgia is a chronic illness with primary symptoms of widespread pain and fatigue. Social media applications have become a recent resource allowing individuals with fibromyalgia to interact in a virtual community devoted to the illness. This study explores how such a community develops and maintains itself on Instagram and the ways it creates social capital for its users. Data are derived from Instagram posts and open-ended questionnaires completed by users living with fibromyalgia who use the application. Using content analysis and semiotic methodology, the study analyzes the diverse ways in which users shared their experiences with fibromyalgia, the management of its symptoms, and issues encountered in accessing health care systems. Instagram aids in the development of a community by facilitating intimate and supportive interactions about the illness and the creation of personalized day-to-day narratives accessible to all. Norms of trust, acceptance, and reciprocity characterize the diversity of interactions in this community.
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Affiliation(s)
- Ashley A Berard
- 1 University of Victoria, Victoria, British Columbia, Canada
| | - André P Smith
- 1 University of Victoria, Victoria, British Columbia, Canada
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22
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Card KG, Lachowsky NJ, Gislason MG, Hogg RS, Roth EA. A Narrative Review of Internet Use, Interpersonal Connectedness, and Sexual Behaviour Among Gay, Bisexual and Other Men Who Have Sex With Men. JOURNAL OF HOMOSEXUALITY 2018; 67:265-283. [PMID: 30582736 DOI: 10.1080/00918369.2018.1536418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Researchers have often considered the impact that online dating has had on gay communities; with some arguing that changes in social behavior may impact the spread of HIV. However, these conclusions are based on the premise that the Internet has fundamentally changed the way gay and bisexual men connect with their communities. Addressing this issue, we searched the PubMed and Web of Science databases for studies examining Internet use and interpersonal connectedness among gay and bisexual men to determine whether those who used the Internet to find sexual partners exhibited different patterns of community connectedness. Though sporadic, findings suggest that Internet use may be associated with lower gay identity, community attachment, and social embeddedness. However, recent reports have suggested that online sex seeking might be associated with greater, not less, interpersonal connectedness. We conclude that additional longitudinal analyses and consistent measurement of gay men's social behavior are needed to draw more definite conclusions.
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Affiliation(s)
- Kiffer G Card
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Nathan J Lachowsky
- School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada
| | - Maya G Gislason
- Faculty of Health Science, Simon Fraser University, Burnaby, Canada
| | - Robert S Hogg
- Faculty of Health Science, Simon Fraser University, Burnaby, Canada
| | - Eric A Roth
- Department of Anthropology, University of Victoria, Victoria, British Columbia, Canada
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Dulli L, Ridgeway K, Packer C, Plourde KF, Mumuni T, Idaboh T, Olumide A, Ojengbede O, McCarraher DR. An Online Support Group Intervention for Adolescents Living with HIV in Nigeria: A Pre-Post Test Study. JMIR Public Health Surveill 2018; 4:e12397. [PMID: 30487116 PMCID: PMC6291681 DOI: 10.2196/12397] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/23/2022] Open
Abstract
Background Adolescents living with HIV (ALHIVs) enrolled in HIV treatment services experience greater loss to follow-up and suboptimal adherence than other age groups. HIV-related stigma, disclosure-related issues, lack of social support, and limited HIV knowledge impede adherence to antiretroviral therapy (ART) and retention in HIV services. The 90-90-90 goals for ALHIVs will only be met through strategies targeted to meet their specific needs. Objectives We aimed to evaluate the feasibility of implementing a social media-based intervention to improve HIV knowledge, social support, ART adherence, and retention among ALHIV aged 15-19 years on ART in Nigeria. Methods We conducted a single-group pre-post test study from June 2017 to January 2018. We adapted an existing support group curriculum and delivered it through trained facilitators in 5 support groups by using Facebook groups. This pilot intervention included five 1-week sessions. We conducted structured interviews with participants before and after the intervention, extracted clinical data, and documented intervention implementation and participation. In-depth interviews were conducted with a subset of participants at study completion. Quantitative data from structured interviews and group participation data were summarized descriptively, and qualitative data were coded and summarized. Results A total of 41 ALHIV enrolled in the study. At baseline, 93% of participants reported existing phone access; 65% used the internet, and 64% were Facebook users. In addition, 37 participants completed the 5-session intervention, 32 actively posted comments in at least one session online, and at least half commented in each of the 5 sessions. Facilitators delivered most sessions as intended and on-time. Participants were enthusiastic about the intervention. Aspects of the intervention liked most by participants included interacting with other ALHIVs; learning about HIV; and sharing questions, experiences, and fears. The key recommendations were to include larger support groups and encourage more group interaction. Specific recommendations on various intervention components were made to improve the intervention. Conclusions This novel intervention was feasible to implement in a predominantly suburban and rural Nigerian setting. Social media may be leveraged to provide much-needed information and social support on platforms accessible and familiar to many people, even in resource-constrained communities. Our findings have been incorporated into the intervention, and an outcome study is underway. Trial Registration ClinicalTrials.gov NCT03076996; https://clinicaltrials.gov/ct2/show/NCT03076996 (Archived by WebCite at http://www.webcitation.org/73oCCEBBC).
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Affiliation(s)
- Lisa Dulli
- Department of Program Sciences and Technical Support, Health Services Research, Family Health International (FHI 360), Durham, NC, United States
| | - Kathleen Ridgeway
- Department of Program Sciences and Technical Support, Health Services Research, Family Health International (FHI 360), Durham, NC, United States
| | - Catherine Packer
- Department of Reproductive, Maternal, Newborn and Child Health, Family Health International (FHI 360), Durham, NC, United States
| | - Kate F Plourde
- Department of Program Sciences and Technical Support, Research Utilization, Family Health International (FHI 360), Durham, NC, United States
| | - Tolulope Mumuni
- Center for Population and Reproductive Health (CPRH), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tosin Idaboh
- Nigeria Country Office, Family Health International (FHI 360), Abuja, Nigeria
| | - Adesola Olumide
- Center for Population and Reproductive Health (CPRH), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oladosu Ojengbede
- Center for Population and Reproductive Health (CPRH), College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Donna R McCarraher
- Department of Reproductive, Maternal, Newborn and Child Health, Family Health International (FHI 360), Durham, NC, United States
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Nick EA, Cole DA, Cho SJ, Smith DK, Carter TG, Zelkowitz RL. The Online Social Support Scale: Measure development and validation. Psychol Assess 2018; 30:1127-1143. [PMID: 29781664 DOI: 10.1037/pas0000558] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A new measure, the Online Social Support Scale, was developed based on previous theory, research, and measurement of in-person social support. It includes four subscales: Esteem/Emotional Support, Social Companionship, Informational Support, and Instrumental Support. In college and community samples, factor analytic and item response theory results suggest that subtypes of in-person social support also pertain in the online world. Evidence of reliability, convergent validity, and discriminant validity provide excellent psychometric support for the measure. Construct validity accrues to the measure vis-à-vis support for three hypotheses: (a) Various broad types of Internet platforms for social interactions are differentially associated with online social support and online victimization; (b) similar to in-person social support, online social support offsets the adverse effect of negative life events on self-esteem and depression-related outcome; and (c) online social support counteracts the effects of online victimization in much the same way that in-person friends in one social niche counterbalance rejection in other social niches. (PsycINFO Database Record
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Affiliation(s)
| | - David A Cole
- Psychology and Human Development, Vanderbilt University
| | - Sun-Joo Cho
- Psychology and Human Development, Vanderbilt University
| | - Darcy K Smith
- Psychology and Human Development, Vanderbilt University
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Eghdam A, Hamidi U, Bartfai A, Koch S. Facebook as communication support for persons with potential mild acquired cognitive impairment: A content and social network analysis study. PLoS One 2018; 13:e0191878. [PMID: 29377930 PMCID: PMC5788370 DOI: 10.1371/journal.pone.0191878] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 01/05/2018] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Social media has the potential to increase social participation and support for the well-being of individuals with chronic medical conditions. To date, Facebook is the most popular social medium for different types of communication. However, there is a lack of knowledge about the potential use of Facebook as a means of communication for persons with potential Mild Acquired Cognitive Impairment (MACI), a non-progressive mild cognitive impairment after an acquired brain injury. The aim of this study was to explore how persons with potential MACI, specifically persons with perceived brain fatigue after brain injury, communicate through Facebook, to classify the content of the communication and to visualize the frequency and types of interactions. METHODS AND MATERIALS A social network analysis of the interactions between members' and a qualitative content analysis of a whole year's communication of a public Facebook group for Swedish speaking persons (1310 members) with perceived brain fatigue after an illness or injury to the brain were performed. RESULTS The results showed how members use social media technology and Facebook as a means for communication and support for their condition. Individual group members showed very different patterns of communication and interactions. However, for the group as a whole, the most frequent topics in their communication were related to informational support and banter in posts, and socialization in comments. The findings also showed that the majority of members only communicated with few other members and had few direct communications. The most used communication feature of Facebook was likes in form of "thumbs-up". CONCLUSIONS This study indicated that social media and in this case Facebook is used for communication and social support by persons with potential MACI, and revealed that their communication behavior is similar to the healthy population. Further studies relating specific cognitive problems of the participants to the use of social media would provide more reliable results for this specific group.
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Affiliation(s)
- Aboozar Eghdam
- Health Informatics Centre (HIC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Ulrika Hamidi
- Health Informatics Centre (HIC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Aniko Bartfai
- Division of Rehabilitation Medicine, Department of Clinical Sciences Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Sabine Koch
- Health Informatics Centre (HIC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
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Flickinger TE, DeBolt C, Waldman AL, Reynolds G, Cohn WF, Beach MC, Ingersoll K, Dillingham R. Social Support in a Virtual Community: Analysis of a Clinic-Affiliated Online Support Group for Persons Living with HIV/AIDS. AIDS Behav 2017; 21:3087-3099. [PMID: 27766448 DOI: 10.1007/s10461-016-1587-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Social support can improve outcomes for people living with HIV (PLWH) and could be provided through online support groups. The Positive Links smartphone app is a multicomponent intervention that allows users to interact in a clinic-affiliated anonymous online support group. We investigated how social support was exchanged in a group of 55 participants over 8 months, using an adaptation of the Social Support Behavior Code. Participant interviews assessed their experiences and perceptions of the app. Of 840 posts analyzed, 115 (14 %) were coded as eliciting social support and 433 (52 %) as providing social support. Messages providing support were predominantly emotional (41 %), followed by network (27 %), esteem (24 %), informational (18 %), and instrumental (2 %) support. Participants perceived connection and support as key benefits of the app. Technical issues and interpersonal barriers limited some participants in fully using the app. Mobile technology offers a useful tool to reach populations with barriers to in-person support and may improve care for PLWH.
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Affiliation(s)
- Tabor E Flickinger
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Claire DeBolt
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Ava Lena Waldman
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | | | - Wendy F Cohn
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Mary Catherine Beach
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen Ingersoll
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Rebecca Dillingham
- Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA.
- UVA Center for Global Health, P.O. Box 801379, Charlottesville, VA, 22908, USA.
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Menefee HK, Thompson MJ, Guterbock TM, Williams IC, Valdez RS. Mechanisms of Communicating Health Information Through Facebook: Implications for Consumer Health Information Technology Design. J Med Internet Res 2016; 18:e218. [PMID: 27515151 PMCID: PMC4999533 DOI: 10.2196/jmir.5949] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/07/2016] [Accepted: 07/20/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Consumer health information technology (IT) solutions are designed to support patient health management and have the ability to facilitate patients' health information communication with their social networks. However, there is a need for consumer health IT solutions to align with patients' health management preferences for increased adoption of the technology. It may be possible to gain an understanding of patients' needs for consumer health IT supporting their health information communication with social networks by explicating how they have adopted and adapted social networking sites, such as Facebook, for this purpose. OBJECTIVE Our aim was to characterize patients' use of all communication mechanisms within Facebook for health information communication to provide insight into how consumer health IT solutions may be better designed to meet patients' communication needs and preferences. METHODS This study analyzed data about Facebook communication mechanisms use from a larger, three-phase, sequential, mixed-methods study. We report here on the results of the study's first phase: qualitative interviews (N=25). Participants were over 18, used Facebook, were residents or citizens of the United States, spoke English, and had a diagnosis consistent with type 2 diabetes. Participants were recruited through Facebook groups and pages. Participant interviews were conducted via Skype or telephone between July and September 2014. Data analysis was grounded in qualitative content analysis and the initial coding framework was informed by the findings of a previous study. RESULTS Participants' rationales for the use or disuse of a particular Facebook mechanism to communicate health information reflected six broad themes: (1) characteristics and circumstances of the person, (2) characteristics and circumstances of the relationship, (3) structure and composition of the social network, (4) content of the information, (5) communication purpose, and (6) attributes of the technology. CONCLUSIONS The results of this study showed that participants consider multiple factors when choosing a Facebook mechanism for health information communication. Factors included what information they intended to share, what they were trying to accomplish, attributes of technology, and attributes and communication practices of their social networks. There is a need for consumer health IT that allows for a range of choices to suit the intersectionality of participants' rationales. Technology that better meets patients' needs may lead to better self-management of health conditions, and therefore, improve overall health outcomes.
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Affiliation(s)
- Hannah K Menefee
- Department of Population Health Sciences, Virginia Tech, Blacksburg, VA, United States
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Dudina VI, Judina DI, King EJ. Fears about antiretroviral therapy among users of the internet forum for people living with HIV/AIDS in Russia. AIDS Care 2016; 29:268-270. [PMID: 27449384 DOI: 10.1080/09540121.2016.1211607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The purpose of this research was to identify different types of fear related to starting and adhering to antiretroviral therapy (ART) among people living with HIV (PLHIV) in Russia. Data were collected from the Russian-language internet forum for PLHIV (hivlife.info). Qualitative data analysis focused on the sections of the forum where users discussed health-related issues in order to identify fears related to HIV treatment. The following types of fear were revealed: fear of the illness, fear to learn negative information about one's health, fear of side effects, fear of therapy to be ineffective, fear that the appropriate medications will become unavailable, fear of lifestyle changes, and fear for the well-being of significant others. Efforts to increase the uptake of and adherence to ART should take into account the fears of PLHIV.
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Affiliation(s)
- Victoria I Dudina
- a Faculty of Sociology , St. Petersburg State University , St. Petersburg , Russia
| | - Darja I Judina
- a Faculty of Sociology , St. Petersburg State University , St. Petersburg , Russia
| | - Elizabeth J King
- b Department of Health Behavior and Health Education , University of Michigan , Ann Arbor , MI , USA
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Henwood R, Patten G, Barnett W, Hwang B, Metcalf C, Hacking D, Wilkinson L. Acceptability and use of a virtual support group for HIV-positive youth in Khayelitsha, Cape Town using the MXit social networking platform. AIDS Care 2016; 28:898-903. [PMID: 27098208 DOI: 10.1080/09540121.2016.1173638] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Médecins Sans Frontières supports human immunodeficiency virus (HIV)-infected youth, aged 12-25 years, at a clinic in Khayelitsha, South Africa. Patients are enrolled in youth clubs, and provided with a virtual chat room, using the cell-phone-based social networking platform, MXit, to support members between monthly/bimonthly club meetings. The acceptability and uptake of MXit was assessed. METHODS MXit was facilitated by lay counsellors, was password protected, and participants could enter and leave at will. Club members were asked to complete self-administered questionnaires and participate in two focus-group discussions. RESULTS AND DISCUSSION In total, 60 club members completed the questionnaire, and 12 participated in the focus groups. Fifty-eight percentage were aged 23-25 years, 63% were female and 83% had a cell phone. Sixty percentage had used MXit before, with 38% having used it in the past month. Sixty-five percentage were aware of the chat-room and 39% knew how to access it. Thirty-four percentage used the chat-room at least once, 20% had visited the chat-room in the past month, and 29% had used MXit to have private conversations with other club members. Fifty-seven percentage used the chat-room to get advice, and 84% of all respondents felt that offering a service outside the youth club meetings was important and would like to see one to continue. The cost of using social media platforms was an issue with some, as well as the need for anonymity. Preference for other platforms, logistical obstacles, or loss of interest contributed to non-use. CONCLUSIONS Reported usage of the MXit chat-room was low, but participants indicated acceptance of the programme and their desire to interact with their peers through social media. Suggestions to improve the platform included accessible chat histories, using more popular platforms such as Facebook or WhatsApp, and to have topical discussions where pertinent information for youth is provided.
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Affiliation(s)
- Ruth Henwood
- a Médecins Sans Frontières , Cape Town , South Africa
| | | | - Whitney Barnett
- b School of Public Health and Family Medicine , University of Cape Town , Cape Town , South Africa
| | - Bella Hwang
- a Médecins Sans Frontières , Cape Town , South Africa
| | - Carol Metcalf
- a Médecins Sans Frontières , Cape Town , South Africa
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A systematic review of recent smartphone, Internet and Web 2.0 interventions to address the HIV continuum of care. Curr HIV/AIDS Rep 2016; 12:173-90. [PMID: 25626718 DOI: 10.1007/s11904-014-0239-3] [Citation(s) in RCA: 231] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
eHealth, mHealth and "Web 2.0" social media strategies can effectively reach and engage key populations in HIV prevention across the testing, treatment, and care continuum. To assess how these tools are currently being used within the field of HIV prevention and care, we systematically reviewed recent (2013-2014) published literature, conference abstracts, and funded research. Our searches identified 23 published intervention studies and 32 funded projects underway. In this synthesis we describe the technology modes applied and the stages of the HIV care cascade addressed, including both primary and secondary prevention activities. Overall trends include use of new tools including social networking sites, provision of real-time assessment and feedback, gamification and virtual reality. While there has been increasing attention to use of technology to address the care continuum, gaps remain around linkage to care, retention in care, and initiation of antiretroviral therapy.
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Jongbloed K, Parmar S, van der Kop M, Spittal PM, Lester RT. Recent Evidence for Emerging Digital Technologies to Support Global HIV Engagement in Care. Curr HIV/AIDS Rep 2015; 12:451-61. [PMID: 26454756 PMCID: PMC5585015 DOI: 10.1007/s11904-015-0291-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Antiretroviral therapy is a powerful tool to reduce morbidity and mortality for the 35 million people living with HIV globally. However, availability of treatment alone is insufficient to meet new UNAIDS 90-90-90 targets calling for rapid scale-up of engagement in HIV care to end the epidemic in 2030. Digital technology interventions (mHealth, eHealth, and telehealth) are emerging as one approach to support lifelong engagement in HIV care. This review synthesizes recent reviews and primary studies published since January 2014 on digital technology interventions for engagement in HIV care after diagnosis. Technologies for health provide emerging and proven solutions to support achievement of the United Nations targets for the generalized HIV-affected population. Much of the existing evidence addresses antiretroviral therapy (ART) adherence; however, studies have begun to investigate programs to support linkage and retention in care as well as interventions to engage key populations facing extensive barriers to care.
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Affiliation(s)
- Kate Jongbloed
- School of Population & Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z9, Canada.
| | - Sunjit Parmar
- Faculty of Medicine, University of British Columbia, 2350 Health Sciences Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Mia van der Kop
- Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, 566-828 West 10th Avenue, Vancouver, BC, V5Z 1L8, Canada.
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen 18a, Campus Solna, Stockholm, Sweden.
| | - Patricia M Spittal
- School of Population & Public Health, University of British Columbia, 2206 E Mall, Vancouver, BC, V6T 1Z9, Canada.
| | - Richard T Lester
- Division of Infectious Diseases, Faculty of Medicine, University of British Columbia, 566-828 West 10th Avenue, Vancouver, BC, V5Z 1L8, Canada.
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