A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study
Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing...
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| Veröffentlicht in: | PloS one 2019-08, Vol.14 (8), p.e0221508 |
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| creator | Cordova, David Mendoza Lua, Frania Muñoz-Velázquez, Jaime Street, Katie Bauermeister, Jose A Fessler, Kathryn Adelman, Nicole Neilands, Torsten B Boyer, Cherrie B |
| description | Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention.
Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis.
Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans.
Findings suggest the feasibilit |
| doi_str_mv | 10.1371/journal.pone.0221508 |
| format | Article |
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Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis.
Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans.
Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0221508</identifier><identifier>PMID: 31437240</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Acceptability ; Acquired immune deficiency syndrome ; Addictive behaviors ; Adolescent ; African Americans ; AIDS ; Ambulatory care facilities ; Biology and Life Sciences ; Child health ; Client satisfaction ; Clinics ; Communication ; Community health services ; Community involvement ; Community participation ; Community research ; Content analysis ; Counseling psychology ; Customer satisfaction ; Demographic aspects ; Disease prevention ; Disease transmission ; Drug abuse ; Drug use ; Drugs ; Effectiveness ; Empowerment ; Feasibility Studies ; Health risks ; HIV ; HIV infections ; HIV Infections - prevention & control ; HIV tests ; Human immunodeficiency virus ; Humans ; Infections ; Internet ; Intervention ; Juvenile drug abuse ; Medical tests ; Medicine and Health Sciences ; Multilevel Analysis ; Participatory research ; Patient Acceptance of Health Care ; People and places ; Population ; Prevention ; Public health ; Qualitative analysis ; Qualitative research ; Research design ; Risk behavior ; Risk communication ; Risk management ; Risk reduction ; Risk Reduction Behavior ; Risk taking ; Self-efficacy ; Sexually transmitted diseases ; Social Sciences ; Social work ; STD ; Storytelling ; Substance abuse treatment ; Substance-Related Disorders - prevention & control ; Technology ; Telemedicine ; United States ; Urban areas ; Urban health ; Viruses ; Youth</subject><ispartof>PloS one, 2019-08, Vol.14 (8), p.e0221508</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Cordova et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention.
Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis.
Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans.
Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.</description><subject>Acceptability</subject><subject>Acquired immune deficiency syndrome</subject><subject>Addictive behaviors</subject><subject>Adolescent</subject><subject>African Americans</subject><subject>AIDS</subject><subject>Ambulatory care facilities</subject><subject>Biology and Life Sciences</subject><subject>Child health</subject><subject>Client satisfaction</subject><subject>Clinics</subject><subject>Communication</subject><subject>Community health services</subject><subject>Community involvement</subject><subject>Community participation</subject><subject>Community research</subject><subject>Content analysis</subject><subject>Counseling psychology</subject><subject>Customer satisfaction</subject><subject>Demographic aspects</subject><subject>Disease prevention</subject><subject>Disease transmission</subject><subject>Drug abuse</subject><subject>Drug 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communication</subject><subject>Risk management</subject><subject>Risk reduction</subject><subject>Risk Reduction Behavior</subject><subject>Risk taking</subject><subject>Self-efficacy</subject><subject>Sexually transmitted diseases</subject><subject>Social Sciences</subject><subject>Social work</subject><subject>STD</subject><subject>Storytelling</subject><subject>Substance abuse treatment</subject><subject>Substance-Related Disorders - prevention & control</subject><subject>Technology</subject><subject>Telemedicine</subject><subject>United States</subject><subject>Urban areas</subject><subject>Urban 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Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cordova, David</au><au>Mendoza Lua, Frania</au><au>Muñoz-Velázquez, Jaime</au><au>Street, Katie</au><au>Bauermeister, Jose A</au><au>Fessler, Kathryn</au><au>Adelman, Nicole</au><au>Neilands, Torsten B</au><au>Boyer, Cherrie B</au><au>Laws, M Barton</au><aucorp>Youth Leadership Council</aucorp><aucorp>Youth Leadership Council</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-08-22</date><risdate>2019</risdate><volume>14</volume><issue>8</issue><spage>e0221508</spage><pages>e0221508-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Drug abuse and sexually transmitted infections (STIs), including the human immunodeficiency virus (HIV), remain significant public health concerns in the United States. Youth are at disproportionate risk of drug use and STIs/HIV, yet interventions aimed at improving STI and HIV testing and reducing STI/HIV risk behaviors through technology-based engagement in clinic settings are limited. The purpose of this study was to examine the feasibility and acceptability of Storytelling 4 Empowerment (S4E), a multilevel mobile-health drug abuse and STI/HIV preventive application (app) for clinic settings. We also explored uptake of STI/HIV testing among youth immediately post-intervention.
Employing community-based participatory research principles and a multi-method research design, we developed a clinician-facing app, and examined the feasibility and acceptability of S4E among clinicians (n = 6) and youth (n = 20) in an urban youth-centered community health clinic. S4E aimed to improve clinician-youth risk communication and youths' drug use and STI/HIV knowledge, self-efficacy, and refusal skills. We also explored youths' uptake of STI and HIV testing. Quantitative data were analyzed by computing mean scores and proportions, and qualitative analyses followed the tenets of content analysis.
Among eligible participants, 86.9% of youth and 85.7% of clinicians enrolled in the study, suggesting the feasibility of recruiting participants from the targeted clinic. Most clinicians identified as non-Hispanic white (83%) and female (66.7%). Among the youth, 70% identified as non-Hispanic white, followed by 30% African American, and 50% identified as female with a mean age of 19.6 (SD = 1.5, Range = 16-21). The quantitative findings suggest that the acceptability of S4E is high, as indicated by the Client Satisfaction Questionnaire (mean score = 25.2, SD: 4.8). Immediately post-intervention, all youth who reported past 90-day condomless sex or having never been tested for STIs or HIV in their lifetime, were tested for both STIs and HIV. Qualitative themes revealed four overarching themes, including S4E: (1) faciliated timely, targeted, and tailored prevention and risk reduction strategies; (2) shaped clinician and youth communication and interaction during the clinic visit; (3) may have improved uptake of STI/HIV testing and increased STI/HIV knowledge and self-efficacy; and (4) had high feasibiliy and acceptability among youth and clninicans.
Findings suggest the feasibility and acceptability of S4E in an urban community-based health clinic setting. A next important step is to examine the efficacy of S4E in a randomized controlled trial design.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31437240</pmid><doi>10.1371/journal.pone.0221508</doi><tpages>e0221508</tpages><orcidid>https://orcid.org/0000-0001-9998-1934</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-08, Vol.14 (8), p.e0221508 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2278023449 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Sociological Abstracts; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Acceptability Acquired immune deficiency syndrome Addictive behaviors Adolescent African Americans AIDS Ambulatory care facilities Biology and Life Sciences Child health Client satisfaction Clinics Communication Community health services Community involvement Community participation Community research Content analysis Counseling psychology Customer satisfaction Demographic aspects Disease prevention Disease transmission Drug abuse Drug use Drugs Effectiveness Empowerment Feasibility Studies Health risks HIV HIV infections HIV Infections - prevention & control HIV tests Human immunodeficiency virus Humans Infections Internet Intervention Juvenile drug abuse Medical tests Medicine and Health Sciences Multilevel Analysis Participatory research Patient Acceptance of Health Care People and places Population Prevention Public health Qualitative analysis Qualitative research Research design Risk behavior Risk communication Risk management Risk reduction Risk Reduction Behavior Risk taking Self-efficacy Sexually transmitted diseases Social Sciences Social work STD Storytelling Substance abuse treatment Substance-Related Disorders - prevention & control Technology Telemedicine United States Urban areas Urban health Viruses Youth |
| title | A multilevel mHealth drug abuse and STI/HIV preventive intervention for clinic settings in the United States: A feasibility and acceptability study |
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