The purpose of this stepped wedge randomized controlled trial is to evaluate the effectiveness of a crowdsourced intervention on promoting HIV testing among young Chinese men who have sex with men (MSM). The crowdsourced intervention will include an open contest, judging to determine finalists and prizes, a designathon, and contest-based MSM engagement. The hypothesis is that a crowdsourced intervention will be superior to conventional HIV test uptake campaigns in eliciting HIV test uptake.
This study will use an adaptation of the stepped wedge randomized controlled trial design. A total of eight major metropolitan cities will implement the crowdsourced intervention. These cities will be chosen based on the following criteria: 1) previous Centers for Disease Control and Prevention (CDC) MSM sentinel surveillance site; 2) capacity for campaign implementation; 3) capacity for intervention implementation at the community level. Four cities will implement more intensive in-person events to promote engagement (Guangzhou, Shenzhen in Guangdong Province, Qingdao, and Jinan in Shandong Province) during survey intervention stage. The Randomized controlled trial (RCT) will be evaluated using two different sources of data: 1) online survey data from MSM in the eight cities prior to and after the intervention; 2) CDC routine surveillance data in the eight cities prior to and after the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
1,381
The crowdsourced intervention is composed of three phases that cumulatively draw on crowd wisdom to engage the community: (1) a crowdsourcing contest to solicit optimal images/concepts/taglines; (2) a designathon to formulate optimal HIV testing campaigns; (3) a process of localization unique to each of the eight cities.
The pre-intervention period will include conventional HIV testing campaigns organized by local CDC, Community-Based Organization (CBO), and partners. These are typically designed by experts and social marketing companies.
Number of Men Who Have Sex With Men (MSM) Reporting HIV Testing in the Past Three Months
This will be assessed by self-report during a follow-up survey
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Condomless Sex at 3 Months Post-intervention
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
HIV Testing Social Norms
HIV testing social norms will be measured using six survey items that are each on a five-point Likert scale. Increased HIV testing social norms will be defined as having an increase from baseline in any two of these six survey items and dichotomized accordingly. Number of men who report higher score of social norms when comparing their pre-intervention and post-intervention values
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Change in HIV Testing Self-efficacy
Number of men who report higher levels of self-efficacy when comparing their pre-intervention and post-intervention HIV testing norms
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Community Engagement/ MSM Community Affiliation
Number of men, defined as an increase in closer affiliation with the MSM community (i.e., tongzhi circle, gay online networks or groups) when comparing their pre-intervention and post-intervention periods.
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Engaged in HIV Testing Community Campaign in the Past 3 Months
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Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Being Self-tested for HIV in the Last 3 Months Post-intervention
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Mean Score of Anticipated HIV Stigma
Measured by a 7-item version of the anticipated HIV stigma scale, designed to measure the extent to which participants anticipated negative intrapersonal and interpersonal consequences were they to contract HIV in the future. All seven items were rated on a Likert-type scale (1=Strongly Disagree; 4=Strongly Agree). The mean score is reported, ranged from 1 to 4. Higher values indicate greater anticipated stigma.
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Being Tested for Syphilis in the Last 3 Months Post-intervention
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Weibo in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Wechat in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Tencent QQ (QQ) in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Mobile Apps in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing
Frequency of men, defined as the number of men who reported using mobile apps in the past three months to give or receive information about HIV testing comparing their pre-intervention and post-intervention engagement
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Received HIV Self-testing Kits in the Last 3 Months Post-intervention
Time frame: From implementation roll-out to three months after implementation of crowdsourced intervention