Centre for Health Behaviours Research, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
School of Medicine, University of Nottingham, Nottingham, United Kingdom.
J Med Internet Res. 2021 Sep 16;23(9):e22312. doi: 10.2196/22312.
In the era of potent antiretroviral therapy, a high level of condomless anal intercourse continues to drive increases in HIV incidence in recent years among men who have sex with men. Effective behavior change strategies for promoting HIV-preventive behaviors are warranted. Narrative persuasion is a novel health communication approach that has demonstrated its persuasive advantages in overcoming resistance to counterattitudinal messages. The efficacy of narrative persuasion in promoting health behavior changes has been well documented, but critical research gaps exist for its application to HIV prevention.
In this study, we aimed to (1) capitalize on narrative persuasion to design a web-based multisession intervention for reducing condomless anal intercourse among men who have sex with men in Hong Kong (the HeHe Talks Project) by following a systematic development process; and (2) describe the main components of the narrative intervention that potentially determine its persuasiveness.
Persuasive themes and subtopics related to reducing condomless anal intercourse were initially proposed based on epidemiological evidence. The biographic narrative interview method was used to elicit firsthand experiential stories from a maximum variation sample of local men who have sex with men with diverse backgrounds and experiences related to HIV prevention; different types of role models were established accordingly. Framework analysis was used to aggregate the original quotations from narrators into collective narratives under 6 intervention themes. A dedicated website was finally developed for intervention delivery.
A series of video-based intervention messages in biographic narrative format (firsthand experiential stories shared by men who have sex with men) combined with topic-equivalent argumentative messages were produced and programmed into 6 intervention sessions. The 6-week intervention program can be automatically delivered and monitored online.
We systematically created a web-based HIV prevention intervention derived from peer-generated stories. Strategies used to enhance the efficacy of the narrative intervention have been discussed within basic communication components. This paper describes the methods and experiences of the rigorous development of a narrative communication intervention for HIV prevention, which enables replication of the intervention in the future.
在强效抗逆转录病毒疗法时代，近年来男男性行为者无保护肛交行为的高发仍导致艾滋病毒感染率不断上升。有必要采取有效的行为改变策略来促进艾滋病毒预防行为。叙事说服是一种新的健康传播方法，已证明其在克服反态度信息的阻力方面具有说服力优势。叙事说服在促进健康行为改变方面的功效已得到充分证明，但在将其应用于艾滋病毒预防方面仍存在关键的研究空白。
在这项研究中，我们旨在（1）利用叙事说服来设计一个基于网络的多阶段干预措施，以减少香港男男性行为者中的无保护肛交行为（即 HeHe Talks 项目），并遵循系统的开发过程；（2）描述叙事干预的主要组成部分，这些组成部分可能决定其说服力。
根据流行病学证据，最初提出了与减少无保护肛交行为相关的说服主题和子主题。采用传记叙事访谈方法，从具有不同背景和与艾滋病毒预防相关经验的本地男男性行为者的最大变异样本中获取第一手经验故事；相应地建立了不同类型的榜样。采用框架分析将叙述者的原始引语汇总到 6 个干预主题下的集体叙事中。最后为干预交付开发了一个专用网站。
制作并编程了一系列基于视频的传记叙事格式的干预信息（男男性行为者分享的第一手经验故事），并结合主题等效的辩论信息，将其纳入 6 个干预课程中。该 6 周的干预计划可以在线自动交付和监测。
我们系统地创建了一个基于网络的艾滋病毒预防干预措施，该措施源自同伴生成的故事。讨论了增强叙事干预功效的策略，这些策略包含在基本沟通组件中。本文描述了严格开发艾滋病毒预防叙事传播干预措施的方法和经验，这为未来的干预措施复制提供了依据。
