BACKGROUND:
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.
1School of Social Work, University of Michigan, Ann Arbor, MI, United States. cordovad@umich.edu.
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