A Community-Engaged Approach to Developing a Primary Care Substance Abuse Prevention and Sexual Health Promotion App

Individual Poster

Development and Testing of Interventions 

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Introduction: Urban adolescents in the U.S. disproportionately engage in substance use and sexual risk behaviors, which place them at increased risk of sexually transmitted infections including HIV. With the passing of the Affordable Care Act, primary care visits are projected to significantly increase. As such, primary care settings offer an innovative context to deliver prevention services to adolescents who otherwise may not participate in prevention programs. To date, few e-health interventions have been developed to prevent and reduce drug abuse and sex risk behaviors this population in a primary care setting (e.g., Mason et al., 2011). This study aimed to develop an e-health app and examine the acceptability and feasibility of delivering an e-health preventive intervention in a primary care setting.    

Methods:The present study consisted of a community-engaged (Minkler & Wallerstein, 2010) approach to developing an e-health app. As such, recruitment activities, data collection and analysis were completed in collaboration with the Youth Leadership Council. The study design consisted of three phases: formative focus group interviews, app development, and acceptability and feasibility. Guided by the principals of agile software development (Dyba & Dingsoyer, 2008), the formative focus group data collection (n=30) and intervention development phases were synergistic. Therefore, while the focus group data were collected, the interface was built and the messaging was incorporated into the interface once all data were collected. To examine the feasibility and acceptability of the e-health preventive intervention, participants (n=30) were assessed using the Session Evaluation Form, Children’s Intervention Rating Profile, and in-depth individual interviews. Qualitative data were analyzed using Nvivo 8 software and were coded across three main domains: format, content and the module main message. Quantitative intervention acceptability data were analyzed by examining means on the acceptability measures in SPSS. 

Results:Formative focus group data indicate that the intervention app should be brief, focus on specific substances and sex risk behaviors relevant to the community, include clay animation videos, include interactive components, and be delivered in a private area. Mixed methods preliminary results indicate that the e-health app is valuable and acceptable to participants. Additionally, data suggest that delivering an e-health app preventive intervention in a primary care setting is feasible.

Conclusions:Community-engaged approaches to developing e-health preventive interventions may be an effective method to increase participation and acceptability of interventions. The principals of agile software development have great utility for continuous design improvement and testing based on rapid feedback and change (Dyba & Dingsoyer, 2008). Given that preliminary results indicate that the e-health app is acceptable and feasible, a next step in this program of research is to examine the efficacy of the intervention in preventing and reducing substance abuse and sex risk behaviors among urban adolescents in a primary care setting.