School of Nursing Department of Health Behavior and Biological Sciences and the Center for Sexuality and Health Disparities University of Michigan Ann Arbor, MI United States.
Department of Medicine Division of Allergy and Infectious Diseases University of Washington Seattle, WA United States.
JMIR Public Health Surveill. 2015 Nov 16;1(2):e18. doi: 10.2196/publichealth.4449. eCollection 2015 Jul-Dec.
Gay, bisexual, and other men who have sex with men (MSM) account for a disproportionate burden of new HIV infections in the United States. Mobile technology presents an opportunity for innovative interventions for HIV prevention. Some HIV prevention apps currently exist; however, it is challenging to encourage users to download these apps and use them regularly. An iterative research process that centers on the community's needs and preferences may increase the uptake, adherence, and ultimate effectiveness of mobile apps for HIV prevention.
The aim of this paper is to provide a case study to illustrate how an iterative community approach to a mobile HIV prevention app can lead to changes in app content to appropriately address the needs and the desires of the target community.
In this three-phase study, we conducted focus group discussions (FGDs) with MSM and HIV testing counselors in Atlanta, Seattle, and US rural regions to learn preferences for building a mobile HIV prevention app. We used data from these groups to build a beta version of the app and theater tested it in additional FGDs. A thematic data analysis examined how this approach addressed preferences and concerns expressed by the participants.
There was an increased willingness to use the app during theater testing than during the first phase of FGDs. Many concerns that were identified in phase one (eg, disagreements about reminders for HIV testing, concerns about app privacy) were considered in building the beta version. Participants perceived these features as strengths during theater testing. However, some disagreements were still present, especially regarding the tone and language of the app.
These findings highlight the benefits of using an interactive and community-driven process to collect data on app preferences when building a mobile HIV prevention app. Through this process, we learned how to be inclusive of the larger MSM population without marginalizing some app users. Though some issues in phase one were able to be addressed, disagreements still occurred in theater testing. If the app is going to address a large and diverse risk group, we cannot include niche functionality that may offend some of the target population.
在美国，男同性恋者、双性恋者和其他与男性发生性关系的男性（MSM）占新感染艾滋病毒人数的不成比例。移动技术为艾滋病毒预防的创新干预措施提供了机会。目前已经存在一些艾滋病毒预防应用程序；然而，鼓励用户下载这些应用程序并定期使用这些应用程序具有挑战性。以社区的需求和偏好为中心的迭代研究过程可能会增加移动艾滋病毒预防应用程序的采用率、坚持率和最终效果。
本文旨在提供一个案例研究，说明如何通过迭代的社区方法来开发移动艾滋病毒预防应用程序，从而改变应用程序的内容，以适当地满足目标社区的需求和愿望。
在这项三阶段研究中，我们在亚特兰大、西雅图和美国农村地区与男同性恋者和艾滋病毒检测顾问进行了焦点小组讨论（FGD），以了解构建移动艾滋病毒预防应用程序的偏好。我们使用这些小组的数据构建了应用程序的测试版，并在其他 FGD 中进行了现场测试。主题数据分析检查了这种方法如何解决参与者表达的偏好和关注点。
在现场测试期间，使用该应用程序的意愿增加了，而不是在第一阶段的 FGD 期间。在第一阶段确定的许多关注点（例如，对艾滋病毒检测提醒的分歧、对应用程序隐私的担忧）都在构建测试版时得到了考虑。参与者在现场测试中认为这些功能是优势。然而，仍然存在一些分歧，尤其是关于应用程序的语气和语言。
这些发现强调了在构建移动艾滋病毒预防应用程序时使用互动和社区驱动的过程来收集应用程序偏好数据的好处。通过这个过程，我们了解了如何包容更广泛的男同性恋者群体，而不会使一些应用程序用户边缘化。虽然在第一阶段能够解决一些问题，但在现场测试中仍存在分歧。如果该应用程序要解决一个庞大而多样化的风险群体，我们不能包含可能冒犯一些目标人群的利基功能。
