Technology-driven methodologies to collect qualitative data among youth to inform HIV prevention and care interventions

Walk a mile in my shoes: perspectives towards sharing of health and experience data among individuals living with sickle cell disorder

Background

Advancements in digital health technologies (DHTs) mean people are increasingly recording and managing personal health data. As observed during the COVID-19 pandemic, sharing of such data may provide unrivalled opportunities in advancing our understanding of conditions otherwise poorly understood, including rare conditions.

Methods

A semi-structured focus group (n=25) explored perspectives and experiences of sharing health data among those with a group of rare haematological conditions, sickle cell disorder (SCD). The focus group explored (I) what 'feeling well' looks like; (II) how this could be monitored using DHTs; (III) which data healthcare professionals (HCPs) should pay greater attention to and; (IV) types of data willing to be shared, with whom, and under which conditions. Key themes were further assessed via an online survey (n=50).

Results

Patient-relevant measures of condition-management focused on "everything else that comes with" SCD, suggesting HCPs did not pay sufficient attention to day-to-day symptom variability. This was juxtaposed against the "fixed and one-off" electronic health record (EHR), collecting pre-specified data at pre-determined snapshots of time, not considered reflective of outcomes associated with "feeling well" day-to-day. Forty-four-point-seven percent of respondents had previously shared health data. Most were willing to share data concerning symptoms and health service utilisation, but were less willing to share genomic and EHR data. Sixty-one-point-seven percent believed HCPs did not pay enough attention to daily fluctuations in mental and physical health. Financial benefits (74.5%), trust in organisations seeking data (72.3%), and knowing how data will be used (61.7%) were key facilitators of data sharing. Seventy-one percent, 70% and 65.2% had not previously shared health data with the pharmaceutical industry, charitable organisations and digital health interventions respectively, but were open to doing so in the future.

Conclusions

Those living with the rare condition SCD were supportive of collecting and sharing data to foster research and improve understanding and outcomes. However, specific requirements were identified to respect privacy and informational needs regarding future use of data. DHTs can be a valuable tool in improving understanding of the day-to-day impact of health conditions, but understanding patient needs is critical in ensuring involvement in the process, as not all data types are considered of equal value, benefit, or risk.

Nothing About Us Without Us: Involving Youth Living With HIV in a Virtual Advisory Board

PURPOSE

We adapted a traditional community advisory board to the needs of youth living with HIV (YLWH), resulting in a virtual, asynchronous, and anonymous youth advisory board (YAB). The YAB's evolution fostered participation during the adaptation of an HIV care mobile health application.

METHODS

YAB members, comprised of YLWH in South Texas, engaged in the mobile application's formative evaluation, adaptation, and pilot implementation. We collected feedback via surveys and interviews, analyzed and integrated responses, tracked participation and YAB adaptations, and performed content analysis.

RESULTS

Driven by feedback, the YAB evolved from in-person group meetings to the current iteration. We administered five surveys, and YAB members provided feedback on communication preferences; mobile app elements; privacy and confidentiality; and virtual support groups.

DISCUSSION

Our adaptive process highlights three primary drivers of innovation: COVID-19 risk reduction, asynchrony, anonymity. Our success in maintaining YAB engagement suggests the adapted model could be employed to support youth input in other contexts.

Perceptions of Contexts of Intimate Partner Violence Among Young, Partnered Gay, Bisexual and Other Men Who Have Sex With Men in the United States

There has been a growth in research illustrating that gay, bisexual, and other men who have sex with men (GBMSM) experience intimate partner violence (IPV) at rates that are comparable to those among heterosexual women. However, the majority of research on IPV among same-sex male couples has focused on adults, and research on the experience of IPV among younger men (those aged under 18), remains at a nascent stage, despite knowledge that IPV is often common among younger men. This article adds to the growing body of literature on IPV among young GBMSM (YGBMSM) through of an analysis of qualitative data from in-depth interviews (IDI) with GBMSM aged 15-19 (n = 30) in romantic relationships partnerships. The study sought to explore issues of relationship development, relationship contexts, and understandings of IPV. More than one-half of the sample reported experiencing some form of IPV in their current or past relationships. Participants described a range of experiences of IPV, including physical IPV, emotional IPV, sexual IPV, and controlling behaviors. Emotional IPV in the form of negative comments and controlling behaviors such as jealousy were the most commonly reported forms of violence behaviors. Although few participants reported experiencing physical or sexual IPV, several discussed concerns about giving, and partners' acknowledging, sexual consent. Antecedents to IPV included wanting or feeling pressured to participate in normative development milestones, short-lived relationships, and societal stigma. Interventions that develop content on IPV and that reflect the lived realities of YGBMSM who are experiencing their first relationships are urgently needed. Study findings also support the need for training teachers, health care providers, and parents to identify signs of IPV and provide them with the knowledge and skills to talk to YGBMSM about relationships and violence to reduce IPV.

'We are essential:' Pediatric health care social workers' perspectives on being designated essential workers during the COVID-19 pandemic

Continued provision of essential services is critical to maintaining society's functioning during a crisis. During COVID-19, lockdowns and restrictions designed to preserve the public's health forced an examination of what it means to be an essential worker. Drawing from thematic analyses of focus group data from 55 social workers employed in a large, urban, pediatric, quaternary hospital, this study examines the perspectives of hospital social workers on the meaning of the essential status designation of social work. Findings revealed themes pertaining the substance of social work, the ways in which essential status is carried out, and implications of the designation not only for the future of the profession but also for the populations who receive social work services. The discussion raised important questions about the essential role of social workers in broader health care settings. Our findings suggest that health care systems need to engage in ongoing discussions of how to maximize the efficacy of the social work workforce, both in terms of integration with medical teams and recognition of the important roles social workers play across the hospital system, and facilitate the performance of their essential functions.

Perspectives from Young Partnered Gay, Bisexual, and Other Men Who Have Sex with Men on the Adaptation of Couples HIV Testing and Counseling (CHTC)

Young gay, bisexual, and other men who have sex with men (YGBMSM) are a priority population for HIV prevention efforts. Although there has been a growing focus on dyadic HIV prevention interventions for same-gender male couples, the unique needs of partnered YGBMSM have been largely overlooked. In this qualitative study, we explored partnered YGBMSM's perceptions of existing HIV prevention interventions to inform the design of a relationship-focused HIV prevention intervention. Between July and November 2018, we conducted in-depth interviews with 30 young partnered YGBMSM (mean age = 17.8, SD = 1.1). Participants described that interventions were needed to address skills regarding: (1) implicit versus explicit communication about sexual agreements; (2) boundary setting and identifying signs of abusive relationships; and (3) relationship dynamics (e.g., trust). Participants noted the absence of inclusive sexual education for them; thus, findings suggest that the provision of relationship skills training are requisites for HIV prevention interventions with YGBMSM in the US.