Supporting Adolescents With HIV in South Africa Through an Adherence-Supporting App: Mixed Methods Beta-Testing Study.
Supporting Adolescents With HIV in South Africa Through an Adherence-Supporting App: Mixed Methods Beta-Testing Study.
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DOI：
10.2196/47575
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发表时间：
2023-06-01
影响因子：
2.2
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智能手机应用程序提供的新型干预措施有可能提高艾滋病毒携带者青少年的艾滋病毒治疗依从性，尽管此类干预措施有限。我们的团队开发了Masakhane Siphucule Impilo Yethu(MASI；Xhosa的意思是“让我们相互增强能力，改善我们的健康”)，这是一种智能手机应用程序交付的干预措施，旨在提高南非艾滋病毒携带者青少年的治疗依从性。MASI使用HealthMULTURATION平台适应南非的文化背景，这是一个为美国青年开发的基于证据的数字健康干预措施。我们进行了这项Beta测试研究，以(1)探索MASI的初始可用性，(2)检查使用MASI功能的参与度和体验，以及(3)在随后的试点随机对照试验(RCT)之前，为APP和干预实施计划的改进提供信息。这项研究于2021年8月至2021年12月在南非开普敦进行。Beta测试参与者可以在3周内访问MASI。采用了混合方法，在应用程序安装前和应用程序测试1周至2周后进行了简短的问卷调查和半结构化的深度访谈。通过分析后端应用程序ParaData来衡量与MASI的参与度，并根据每位参与者的应用程序使用情况为他们量身定做后续深度访谈指南。贝塔测试研究的参与者(6名男性参与者，6名女性参与者，年龄16-19岁)总共在MASI花费了4.3个小时，在3周的时间内(1-51.8分钟)，每个参与者平均花费21.4分钟。在研究期间，参与者平均登录MASI 24.1次(范围10-75次)。系统可用性量表的平均得分为69.5(SD 18)，被认为略高于数字健康应用程序的平均水平。对定性结果的专题分析显示，整个MASI功能总体上都有积极的经验，尽管确定了完善APP和干预交付的机会。MASI最初的可用性很高，参与者描述了在MASI功能上总体上有积极的体验。系统地分析ParaData并使用访谈结果来探索参与者体验，使我们能够对参与者参与度模式获得更丰富的见解，使我们的团队能够进一步增强MASI。这项研究的结果导致了一些技术改进，以改善用户体验。还对干预执行计划进行了改进，为试点区域工作队做准备。从进行这项Beta测试研究中学到的经验教训可能会为未来开发、实施和评估类似的APP提供的干预措施提供参考。
Novel smartphone app–delivered interventions have the potential to improve HIV treatment adherence among adolescents with HIV, although such interventions are limited. Our team has developed Masakhane Siphucule Impilo Yethu (MASI; Xhosa for “Let's empower each other and improve our health”), a smartphone app–delivered intervention to improve treatment adherence among adolescents with HIV in South Africa. MASI was adapted to the South African cultural context using the HealthMpowerment platform, an evidence-based digital health intervention developed for and with youth in the United States. We conducted this beta-testing study to (1) explore the initial usability of MASI, (2) examine engagement and experiences using MASI features, and (3) inform refinements to the app and intervention implementation plan prior to a subsequent pilot randomized controlled trial (RCT). This study was conducted from August 2021 to December 2021 in Cape Town, South Africa. Beta-testing participants received access to MASI for 3 weeks. A mixed methods approach was used, with brief questionnaires and semistructured in-depth interviews conducted prior to app installation and after 1 week to 2 weeks of app testing. Engagement with MASI was measured through analysis of back-end app paradata, and follow-up in-depth interview guides were tailored to each participant based on their app use. Participants in the beta-testing study (6 male participants, 6 female participants; ages 16-19 years) collectively spent 4.3 hours in MASI, averaging 21.4 minutes per participant over the 3-week period (range 1-51.8 minutes). Participants logged into MASI an average of 24.1 (range 10-75) times during the study period. The mean System Usability Scale score was 69.5 (SD 18), which is considered slightly above average for digital health apps. Thematic analysis of qualitative results revealed generally positive experiences across MASI features, although opportunities to refine the app and intervention delivery were identified. Initial usability of MASI was high, and participants described having a generally positive experience across MASI features. Systematically analyzing paradata and using the interview findings to explore participant experiences allowed us to gain richer insights into patterns of participant engagement, enabling our team to further enhance MASI. The results from this study led to a few technological refinements to improve the user experience. Enhancements were also made to the intervention implementation plan in preparation for a pilot RCT. Lessons learned from the conduct of this beta-testing study may inform the development, implementation, and evaluation of similar app-delivered interventions in the future.