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Welcome to the BATLab’s Weekly Lit Review, where every week we post peer-reviewed papers relevant to our research projects.

This week, take a look at this interesting paper published in JMIR in 2015:

A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.

Key words: adolescent; primary prevention; HIV; STI; mHealth; telemedicine; primary health care; drug users; sexually transmitted infections

Abstract: 

Despite ongoing prevention efforts, HIV and other sexually transmitted infections (HIV/STIs) and drug use remain public health concerns. Urban adolescents, many of whom are underserved and racial minorities, are disproportionately affected. Recent changes in policy, including the Affordable Care Act, and advances in technology provide HIV/STI and drug abuse prevention scientists with unique opportunities to deliver mobile health (mHealth) preventive interventions in primary care.

Objectives: The purpose of this community-engaged study was to develop an mHealth version of the Storytelling for Empowerment preventive intervention for primary care (hereinafter referred to as “S4E”).

Methods: A total of 29 adolescents were recruited from a youth-centered primary care clinic in Southeast, Michigan, to participate in qualitative interviews. Participants were predominantly African American (n=19, 65.5%) and female (n=21, 72.4%) with a mean age of 16.23 (SD 2.09). The principles of community-based participatory research (CBPR), in conjunction with agile software development and the recommended core prevention principles of the National Institute on Drug Abuse (NIDA) were employed during S4E development. CBPR principles are aimed at improving the effectiveness of research by addressing locally relevant health problems, working with community strengths, and translating basic science into applied research. Complementing this approach, the NIDA prevention principles are derived from decades of drug abuse prevention research aimed at increasing the effectiveness and uptake of programs, through the development of culturally specific interventions and ensuring the structure, content, and delivery of the intervention fit the needs of the community. Data were analyzed using thematic analysis.

Results: A total of 5 themes emerged from the data: (1) acceptability of the mHealth app to adolescents in primary care, (2) inclusion of a risk assessment to improve clinician-adolescent HIV/STI and drug use communication, (3) incorporation of culturally specific HIV/STI and drug use content, (4) incorporation of interactive aspects in the app to engage youth, and (5) perspectives on the appearance of the app.

Conclusions: There is a dearth of mHealth HIV/STI and drug abuse preventive interventions for primary care. Incorporating the principles of CBPR in conjunction with agile software development and NIDA-recommended core prevention principles may be helpful in developing culturally specific mHealth interventions. An important next step in this program of research is to examine the feasibility, acceptability, and efficacy of S4E on adolescent sexual risk and drug use behaviors, and HIV/STI testing. Implications for prevention research and primary care practice are discussed in the context of the Affordable Care Act and technological advances.

This paper was written by David Cordova, PhD; Jose A Bauermeister, MPH, PhD; Kathryn Fessler, MD, PhD; Jorge Delva, MSW, PhD; Annabelle Nelson, PhD; Rachel Nurenberg, BA; Frania Mendoza Lua, BA; Francheska Alers-Rojas, JD; Christopher P Salas-Wright, PhD; and the Youth Leadership Council.

Contributors are from:

School of Social Work, University of Michigan, Ann Arbor, MI, United States

School of Public Health, University of Michigan, Ann Arbor, MI, United States

The Corner Health Center, Ypsilanti, MI, United States

School of Human & Organizational Development, Fielding Graduate University, Santa Barbara, CA, United States

Department of Psychology, University of Michigan, Ann Arbor, MI, United States

School of Social Work, The University of Texas at Austin, Austin, TX, United States

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