In-the-kNOW (Novel approaches to Optimizing Women’s Health): A mobile application to optimize HIV prevention and sexual/reproductive health communication among Black women in the Southern U.S.

在美国，黑人女性的艾滋病毒新感染率仅次于与男性发生性行为的男性，在美国南部(例如佐治亚州)女性中，黑人女性的艾滋病毒感染率占所有艾滋病毒诊断病例的69%。这项拟议研究的目标是提炼和测试In-the-Know(优化女性健康的新方法)，这是一种专门为符合PrEP条件的黑人女性设计的基于证据和理论驱动的移动应用程序(APP)。该应用程序响应RFA-MH-21-150健康通信和服务研究的优先事项，结合便携、文化和上下文相关的消息传递策略。我们对符合预防接种计划资格的定义是基于疾控中心对黑人妇女的指导，即生活在艾滋病毒高发区(特别是终止佐治亚州的艾滋病毒流行辖区：富尔顿、德卡尔布、格温内特或科布县)的妇女。在我们的初步研究中，参与者支持我们的移动应用干预，知情，并表达了对完全开发和集成版本的渴望。在基于社区的参与研究(CBPR)原则和大众传播的社会认知理论(SCT-MC)的指导下，我们将通过知情人应用程序解决PrEP健康沟通差距，该应用程序提供个性化消息传递，以促进南方黑人妇女的艾滋病毒预防行为。我们假设知情干预和控制条件(例如，转介到疾控中心的在线艾滋病毒风险降低工具)对黑人妇女是可行的。在符合PrEP条件的黑人女性(18-44岁)样本中，我们提出了以下目标：目标1.完善符合PrEP条件的黑人女性的知情移动应用程序。使用以人为中心的设计方法27，我们将在n=10名符合PrEP条件的黑人女性中进行单臂技术可用性预测试，以优化应用程序的可用性、技术功能和性能。移动应用程序将根据预测反馈进行改进。目标2a。评估精细化的知情移动应用程序的可行性、可接受性和可用性。我们将使用实验条件(n=20)和控制条件(n=20)来确定APP和控制条件(例如，参考疾控中心的在线艾滋病毒风险降低工具)的可行性和可接受性(保留率和满意度)。目标2b。确定收集R01的次要结果测量(例如PrEP污点)的可行性。

Black women have the second highest rate of all new HIV infections in the U.S. after men who have sex with men, and they account for 69% of all HIV diagnoses among women in the South (e.g., Georgia). The objective of the proposed research is to refine and test in-the-kNOW (Novel approaches to Optimizing Women's Health), an evidence-based and theory-driven mobile application (app) specifically designed for PrEP-eligible Black women. This app responds to RFA-MH-21-150 Health Communication and Services Research priorities by incorporating portable, culturally- and contextually-relevant messaging strategies. Our definition of PrEP-eligible is based on CDC guidance for Black women, namely women who live in high HIV prevalence areas (specifically Ending the HIV Epidemic jurisdictions in Georgia: Fulton, Dekalb, Gwinnett, or Cobb counties). In our preliminary study, participants endorsed our mobile app intervention, in-the-kNOW, and expressed a desire for a fully developed and integrated version. Guided by Community-based Participatory Research (CBPR) principles and the Social Cognitive Theory of Mass Communication (SCT-MC), we will address the PrEP health communication gap with the in-the-Know app, which offers personalized messaging to promote HIV preventive behaviors among Black women in the South. We hypothesize that the in-the-kNOW intervention and the control condition (e.g. referral to the CDC's online HIV risk reduction tools) will be feasible to Black women. In a sample of PrEP-eligible Black women (ages 18-44), we propose the following aims: Aim 1. Refine the in-the-kNOW mobile app for PrEP-eligible Black women. Using a human-centered design approach 27, we will conduct a single-arm technology usability pretest to optimize usability, technical functionality, and performance of the app, among n = 10 PrEP-eligible Black women. The mobile app will be refined per pretest feedback. Aim 2a. Evaluate the feasibility, acceptability, and usability of the refined in-the-kNOW mobile app. We will employ experimental (n = 20) and control (n = 20) conditions to determine the feasibility and acceptability (retention rates and satisfaction) of both the app and the control condition (e.g., referral to the CDC's online HIV risk reduction tools). Aim 2b. Determine feasibility of collecting secondary outcome measures (e.g. PrEP Stigma) for a R01.