Developing an m-Health Primary Care HIV/STI Preventive Intervention for Urban Adolescents: Methodological Considerations in the Context of Policy and Technological Advances

Introduction: Despite efforts aimed at curbing the tide of HIV/STI, rates remain alarmingly high. Indeed, urban adolescents in the United States disproportionately engage in drug use and sexual risk behaviors, which place them at increased risk of HIV/STI. Recent shifts in policy, including the Affordable Care Act, combined with technological advances provide researchers with innovative contexts and tools to engage adolescents in prevention programs. While researchers have demonstrated the utility of primary care settings (Mason et al., 2011) and m-health modalities (Muessig et al., 2013) to deliver preventive interventions, relatively little research has focused on methodological considerations to work toward best practices. This study will describe key methodological considerations for developing an m-health primary care HIV/STI preventive intervention for urban adolescents.  

Methods: This community-university research partnership consisted of three phases, including formative focus groups (n=30), application development, and acceptability and feasibility (n=30). Agile software development (Dyba & Dingsoyer, 2008) was employed such that the formative focus group data collection and application development occurred simultaneously. Participants were primarily African American (66.7%), female (73.3%), with a mean age of 16.23 (SD= 2.09). Participants completed both qualitative interviews and quantitative measures to inform the application development and acceptability and feasibility of an m-health HIV/STI primary care preventive intervention for urban adolescents.

Results: Five themes with respect to methodological considerations emerged: (1) “You Want What, for How Much?”: App Development Expectations and the Realities of the Budget, (2) The Ebb and Flow of Data Collection and App Development, (3) Bridging Science and Art: Incorporating Participants’ Feedback and the Creative Side of Directors and Developers, (4) Challenges and Facilitators of Delivering an m-Health Preventive Intervention in a Primary Care Setting, and (5) Tech Support and Updating of the Application in the Context of Technological Advances.

Conclusions: The results provide insight with respect to methodological considerations and lessons learned from a community-university approach to developing an m-health HIV/STI primary care preventive intervention. With policy and technological advances, more now than ever, researchers are adapting and developing interventions for primary care settings, as well as using technological platforms to deliver these programs. Yet, the methodological literature remains underdeveloped. Research findings contribute to working toward best practices for the development of m-health primary care preventive interventions.