An Innovative HIV Prevention Intervention Using Social Networking Technology

利用社交网络技术的创新艾滋病毒预防干预措施

• 批准号: 8140725
• 负责人: Corina Lelutiu-Weinberger
• 金额: $ 14.66万
• 依托单位: HUNTER COLLEGE
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8140725
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Acquired Immunodeficiency Syndrome; Address; Affect; Age; Anal Sex; Attitude; Award; Behavior; Behavior Therapy; Behavioral; Budgets; Consent; Data; Data Collection; Drug usage; Education; Enrollment; Feedback; Focus Groups; Generations; HIV; HIV Infections; Individual; Infection; Intervention; Intervention Trial; Interview; Life Style; Methodology; Methods; Modality; Modeling; Modification; Motivation; New York City; Office Visits; Participant; Pattern; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Preparation; Prevention; Preventive Intervention; Procedures; Process; Professional counselor; Protocols documentation; Qualitative Evaluations; Randomized Controlled Trials; Readiness; Recommendation; Reporting; Research; Research Personnel; Risk; Risk Assessment; Risk Reduction; Risk-Taking; Rural Population; Science; Shapes; Site; Social Network; Staging; Structure; Technology; Testing; Therapeutic Intervention; Time; Training; Transcript; United States Public Health Service; Unsafe Sex; base; behavior change; design; efficacy trial; follow-up; high risk; high risk sexual behavior; informant; innovation; male health; men who have sex with men; motivational enhancement therapy; post intervention; preference; response; sex risk; social; social networking website; therapy design

DESCRIPTION (provided by applicant): This project proposes to reconfigure traditional HIV prevention intervention mechanisms to better serve young men who have sex with men (YMSM), whose social and sexual patterns are increasingly shaped by social networking. Drawing on the Information Motivation Behavior model and the principles of Motivational Interviewing (MI), this project will engage HIV-negative YMSM (ages 18-29) in an intervention intended to impact their readiness to change behaviors that put them at risk for HIV infection, namely drug use and sexual risk. The proposed project is a modification of an existing intervention (the Young Men's Health Project or YMHP), in which 24% of those who consented to participate in longitudinal assessments declined participation in the intervention component. This group reported significantly more sexual risk behaviors than intervention participants, however, did not find our current mode of intervention delivery - four weekly office visits with a trained counselor - to fit their lifestyle or preferences. In response to pilot data collected from these participants, the proposed project adapts the existing intervention to support changes in (1) the intervention tailoring process (incorporating key informant feedback instead of delivering solely researcher-designed sessions) and (2) the space in which the intervention takes place (online rather than face-to-face). The study will iteratively adapt and pilot-test the existing face-to-face intervention for delivery through social networking sites, such as Facebook, to increase engagement of high-risk YMSM, who have been difficult to enroll in traditional intervention efforts. This pilot study entails a two-phase process. During Phase I, 15 former YMHP participants (intervention decliners and those who only completed one session) will participate in focus groups to advise us on the feasibility and pragmatic specifications of an HIV prevention intervention received via the instant messaging (IM) function of Facebook. Transcripts of these focus groups will be examined to isolate key recommendations for modifying the delivery modality, structure, and procedures. Once the intervention is modified, the focus groups will be reconvened for additional feedback, from which we will further adjust the intervention. During Phase II, 30 high-risk YMSM (ages 18-29) who are Facebook users will be enrolled in a pilot of the modified intervention. The intervention will span 4 weeks and contain 8 bi-weekly 30 minute MI chat-window sessions consisting of a sequential progression of intervention approaches tailored to each participant's readiness to change their drug use and high risk sexual behavior. Data from Phase II will include pre-post intervention behavioral risk assessments, as well as individual interviews with all 30 intervention participants for a qualitative evaluation regarding the feasibility and acceptability of the intervention's process, structure, and content. The proposed design provides an ideal forum to develop, implement, and iteratively fine-tune a pioneering, interactive intervention delivered via social networking, which will in turn set the stage for a larger efficacy trial. PUBLIC HEALTH RELEVANCE: Findings from the proposed study will inform existing HIV prevention interventions for high-risk drug-using young men who have sex with men (YMSM), in order to make them more acceptable, culturally appropriate, and accessible to this population. This iterative modification of a face-to-face intervention to be delivered via social networking will facilitate more successful recruitment of hard-to-engage HIV-negative behaviorally risky YMSM. This model has tangible benefits to sexual risk and drug use reduction efforts nationally as it (1) provides a pragmatic alternative to the traditional face-to-face intervention model, (2) facilitates engagement with a wider, more diverse pool of high-risk YMSM, including underserved rural populations, and (3) provides a feasible and culturally acceptable protocol for online intervention trials among high-risk YMSM to public health/service agencies, allowing them to circumvent budget, time and staffing constraints.

描述（由申请人提供）：该项目建议重新配置传统的艾滋病毒预防干预机制，以更好地为男男性行为者（YMSM）提供服务，他们的社会和性模式越来越受到社交网络的影响。借鉴信息动机行为模型和动机访谈 (MI) 原则，该项目将让 HIV 阴性 YMSM（18-29 岁）参与一项干预措施，旨在影响他们改变可能感染 HIV 的行为的准备程度，即吸毒和性风险。拟议的项目是对现有干预措施（青年男性健康项目或 YMHP）的修改，其中同意参与纵向评估的人中有 24% 拒绝参与干预部分。该群体报告的性危险行为明显多于干预参与者，但是，他们没有发现我们当前的干预实施模式（每周四次与训练有素的顾问进行办公室访问）适合他们的生活方式或偏好。为了响应从这些参与者收集的试点数据，拟议的项目调整了现有的干预措施，以支持以下方面的变化：(1) 干预定制过程（纳入关键知情者反馈，而不是仅提供研究人员设计的会议）和 (2) 干预空间干预是在线进行的，而不是面对面的。该研究将反复调整和试点测试现有的面对面干预措施，通过 Facebook 等社交网站进行干预，以提高高风险 YMSM 的参与度，因为他们很难参加传统的干预工作。这项试点研究需要两个阶段的过程。在第一阶段，15 名前 YMHP 参与者（干预拒绝者和仅完成一次疗程的参与者）将参加焦点小组，就通过 Facebook 即时消息 (IM) 功能收到的 HIV 预防干预措施的可行性和务实规范向我们提供建议。将审查这些焦点小组的记录，以找出修改交付方式、结构和程序的关键建议。一旦干预措施被修改，焦点小组将重新召集以获取更多反馈，我们将据此进一步调整干预措施。在第二阶段，30 名 Facebook 用户的高风险 YMSM（18-29 岁）将参加修改后的干预试点。干预将持续 4 周，包含 8 次每两周一次、每次 30 分钟的 MI 聊天窗口会议，其中包括针对每个参与者改变吸毒和高风险性行为的准备情况而定制的连续进展的干预方法。第二阶段的数据将包括干预前后的行为风险评估，以及对所有 30 名干预参与者的个人访谈，以对干预过程、结构和内容的可行性和可接受性进行定性评估。拟议的设计提供了一个理想的论坛，用于开发、实施和迭代微调通过社交网络提供的开创性的交互式干预措施，这反过来将为更大规模的疗效试验奠定基础。 公共健康相关性：拟议研究的结果将为针对男男性行为高危吸毒年轻男性 (YMSM) 的现有艾滋病毒预防干预措施提供信息，以使这些干预措施更容易被该人群接受、在文化上更适宜、更容易获得。这种通过社交网络进行的面对面干预的迭代修改将有助于更成功地招募难以参与的艾滋病毒阴性、有行为风险的 YMSM。该模式对全国范围内减少性风险和毒品使用的努力具有实实在在的好处，因为它 (1) 为传统的面对面干预模式提供了一种务实的替代方案，(2) 促进与更广泛、更多样化的高风险群体的接触YMSM，包括服务不足的农村人口，(3) 为公共卫生/服务机构在高风险 YMSM 中进行在线干预试验提供可行且文化上可接受的方案，使他们能够规避预算、时间和人员配置限制。