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Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study.

作者信息

Puttkammer Nancy, Dunbar Elizabeth, Germanovych Myroslava, Rosol Mariia, Golden Matthew, Hubashova Anna, Fedorchenko Vladyslav, Hetman Larisa, Legkostup Liudmyla, Flowers Jan, Nesterova Olena

机构信息

Digital Initiatives Group at I-TECH, Department of Global Health, University of Washington, Seattle, WA, United States.

Department of Human Centered Design and Engineering, College of Engineering, University of Washington, Seattle, WA, United States.

出版信息

JMIR Form Res. 2025 Jan 30;9:e66132. doi: 10.2196/66132.


DOI:10.2196/66132
PMID:39883930
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11826939/
Abstract

BACKGROUND: Assisted partner services (APSs; sometimes called index testing) are now being brought to scale as a high-yield HIV testing strategy in many nations. However, the success of APSs is often hampered by low levels of partner elicitation. The Computer-Assisted Self-Interview (CASI)-Plus study sought to develop and test a mobile health (mHealth) tool to increase the elicitation of sexual and needle-sharing partners among persons with newly diagnosed HIV. CASI-Plus provides client-facing information on APS methods and uses a standardized, self-guided questionnaire with nonjudgmental language for clients to list partners who would benefit from HIV testing. The tool also enables health care workers (HCWs) to see summarized data to facilitate partner tracking. OBJECTIVE: The formative research phase of the CASI-Plus study aimed to gather client and HCW input on the design of the CASI-Plus tool to ensure its acceptability, feasibility, and usability. METHODS: This study gathered input to prioritize features and tested the usability of CASI-Plus with HCWs and clients receiving HIV services in public health clinics in wartime Ukraine. The CASI-Plus study's formative phase, carried out from May 2023 to July 2024, adapted human-centered design (HCD) methods grounded in principles of empathy, iteration, and creative ideation. The study involved 3 steps: formative HCD, including in-depth individual interviews with clients, such as men who have sex with men and people who inject drugs, and internet-based design workshops with HCWs from rural and urban HIV clinics in Chernihiv and Dnipro; software platform assessment and heuristic evaluation, including assessment of open-source mHealth platforms against CASI-Plus requirements, prototype development, and testing of the REDCap (Research Electronic Data Capture) prototype based on usability heuristics; and usability walk-throughs, including simulated cases with HCWs and clients. RESULTS: The formative phase of the CASI-Plus study included in-depth individual interviews with 10 clients and 3 workshops with 22 HCWs. This study demonstrated how simplified HCD methods, adapted to the wartime context, gathered rich input on prioritized features and tool design. The CASI-Plus design reflected features that are both culturally sensitive and in alignment with the constraints of Ukraine's wartime setting. Prioritized features included information about the benefits of HIV index testing; a nonjudgmental, self-guided questionnaire to report partners; client stories; and bright images to accompany the text. Two-way SMS text messaging between clients and HCWs was deemed impractical based on risks of privacy breaches, national patient privacy regulations, and HCW workload. CONCLUSIONS: It was feasible to conduct HCD research in Ukraine in a wartime setting. The CASI-Plus mHealth tool was acceptable to both HCWs and clients. The next step for this research is a randomized clinical trial of the effect of the REDCap-based CASI-Plus tool on the number of partners named and the rate of partners completing HIV testing.

摘要

相似文献

[1]
Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study.

JMIR Form Res. 2025-1-30

[2]
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BMC Infect Dis. 2023-5-5

[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[10]
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本文引用的文献

[1]
AI-assisted HIV case finding in Ukraine.

Lancet Microbe. 2024-7

[2]
Distinctive model for HIV index testing (IT) in Eastern Europe: results of Ukraine's physician-led, integrated IT programme.

BMJ Open. 2023-9-20

[3]
Will the Russian war in Ukraine unleash larger epidemics of HIV, TB and associated conditions and diseases in Ukraine?

Harm Reduct J. 2023-9-1

[4]
Using human-centered design to co-design dedicated menstrual health spaces with people who menstruate in Bidi Bidi refugee settlement, Uganda: Learnings for further adaptation and scale in humanitarian settings.

BMC Womens Health. 2023-6-20

[5]
Profile of partners who completed HIV testing and received a new HIV diagnosis in Ukraine's HIV index testing program: a retrospective cohort study to inform program improvement.

BMC Infect Dis. 2023-5-5

[6]
Applying Human-Centered Design in Global Mental Health to Improve Reach Among Underserved Populations in the United States and India.

Glob Health Sci Pract. 2023-2-28

[7]
International Collaboration to Develop a Remote Monitoring Web App for COVID-19 Patients in Armenia: Design and Development With Agile Methodology.

JMIR Hum Factors. 2022-11-25

[8]
Russia's War in Ukraine - The Devastation of Health and Human Rights.

N Engl J Med. 2022-7-14

[9]
Exploring the Equity Impact of Current Digital Health Design Practices: Protocol for a Scoping Review.

JMIR Res Protoc. 2022-5-17

[10]
A Theory of Change for Guiding the Integration of Human-Centered Design Into Global Health Programming.

Glob Health Sci Pract. 2021-11-29

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