A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.
A Community-Engaged Approach to Developing an mHealth HIV/STI and Drug Abuse Preventive Intervention for Primary Care: A Qualitative Study.
复制标题
一种社区参与的方法，用于开发MHealth HIV/STI和药物滥用预防性干预初级保健：一项定性研究。
DOI：
10.2196/mhealth.4620
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发表时间：
2015-12-18
影响因子：
5
通讯作者：
Youth Leadership Council
中科院分区：
文献类型：
--
作者：
Cordova D;Bauermeister JA;Fessler K;Delva J;Nelson A;Nurenberg R;Mendoza Lua F;Alers-Rojas F;Salas-Wright CP;Youth Leadership Council
尽管预防工作不断开展，艾滋病毒和其他性传播感染 (HIV/STI) 以及吸毒仍然是公共卫生问题。城市青少年受到的影响尤为严重，其中许多人服务不足，而且是少数族裔。最近的政策变化（包括平价医疗法案）以及技术进步为艾滋病毒/性传播感染和药物滥用预防科学家提供了在初级保健中提供移动医疗（mHealth）预防干预措施的独特机会。这项社区参与研究的目的是开发一个移动医疗版本的初级保健赋权预防干预讲故事（以下简称“S4E”）。从密歇根州东南部一家以青少年为中心的初级保健诊所招募了总共 29 名青少年来参加定性访谈。参与者主要是非裔美国人 (n=19, 65.5%) 和女性 (n=21, 72.4%)，平均年龄为 16.23 岁 (SD 2.09)。 S4E 开发过程中采用了基于社区的参与性研究 (CBPR) 原则，结合敏捷软件开发和国家药物滥用研究所 (NIDA) 推荐的核心预防原则。 CBPR 原则旨在通过解决当地相关的健康问题、与社区优势合作以及将基础科学转化为应用研究来提高研究的有效性。作为对这一方法的补充，NIDA 预防原则源自数十年的药物滥用预防研究，旨在通过制定针对文化的干预措施并确保干预措施的结构、内容和实施符合社区的需求，提高项目的有效性和采用率。使用主题分析对数据进行分析。数据中总共出现了 5 个主题：(1) 初级保健青少年对移动医疗应用程序的可接受性，(2) 纳入风险评估，以改善临床医生与青少年艾滋病毒/性传播感染和吸毒方面的沟通，(3) 纳入特定文化的艾滋病毒/性传播感染和吸毒内容，(4) 在应用程序中纳入互动方面以吸引青少年，以及 (5) 对应用程序外观的看法。初级保健缺乏移动医疗艾滋病毒/性传播感染和药物滥用预防干预措施。将 CBPR 原则与敏捷软件开发和 NIDA 推荐的核心预防原则相结合可能有助于开发针对特定文化的移动医疗干预措施。该研究计划的重要下一步是检验 S4E 对青少年性风险和吸毒行为以及 HIV/STI 检测的可行性、可接受性和有效性。在《平价医疗法案》和技术进步的背景下讨论了对预防研究和初级保健实践的影响。
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. 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”). 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. 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. 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.