Testing an Mhealth Intervention for Young African American Women Who Use Substances and Are at Risk for HIV/STIs: Preliminary Usability, Acceptability and Satisfaction

Introduction: HIV/STIs continue to disproportionately affect young African American women compared to young women of other races/ethnicities in the U.S. South. While in-person behavioral interventions that address the intersecting HIV/STI-risk factors have shown promise and efficacy among African American young women, less attention has been devoted to developing innovative, mHealth interventions for this key population. The implementation of mHealth interventions may address some of the challenges with in-person interventions, such as staff training, scheduling, transportation and childcare. Moreover, while smartphones and tablets are widely-used by this population, it is imperative to assess usability, acceptability and satisfaction of technology-based interventions.

Methods: The NIDA-funded North Carolina Young Women’s CoOp (NC YWC) is testing two delivery methods (in-person and mHealth) of an adapted evidence-based, gender-focused intervention—the Young Women’s CoOp (YWC)— in a cross-over randomized trial. Since its inception, the YWC has been delivered via in-person with a trained interventionist. Through extensive formative research, an mHealth, tablet-based app was developed to mirror the in-person intervention. Enrollment and 6-month follow-ups from the first cycle of this trial are complete and preliminary mHealth usability and acceptability data from the participants who received the tablet with the intervention and completed the 6-month follow-up have been analyzed (n = 51).

Results: The mean score of the adapted System Usability Scale was 71.6, which is higher than the average usability threshold of 68 (scale: 0 to 100). Approximately 78% reported the app was easy or very easy to use, 76% were satisfied with the app’s intended purpose and functionality, and 86% reported there were no aspects of the app that were difficult to complete. Moreover, 62% reported showing the material to their friends or others. Additional mHealth satisfaction data collected from the tablet from the sample who completed the intervention indicated intervention acceptability and delivery were high because of convenience, ease of use, and portability; only one participant reported difficulty with the application.

Discussion: These preliminary findings indicate the YWC mHealth app has high acceptability and usability and is a delivery method that resonates with this population. Notably, the majority reported showing the information to others suggesting the importance of peers even in technology-based interventions and the potential for greater reach and dissemination. Once data collection is complete for this trial, outcome analyses will be conducted to examine the efficacy of the mHealth intervention in reducing HIV/STI-related risk behavior.