Examine the feasibility and acceptability of delivering the S4E intervention to 20 African-American youths between the ages 16-21 in Flint, Michigan. The investigators will examine the preliminary efficacy of the S4E intervention in improving the uptake of HIV self-testing immediately post-intervention.
HIV is a significant public health concern in the US, and African American youth (defined as the adolescent and young adults 16-21 years of age) are disproportionately affected. Furthermore, HIV risk behaviors, including substance use and sexual risk behaviors are prominent. Despite the disproportionately high rates of HIV infection and risk behaviors in youth, few youth report having ever been tested for HIV and many are not routinely screened for asymptomatic STIs as recommended by the Center for Disease Control. To address these significant public health concerns, a mobile-health (mHealth) intervention, Storytelling 4 Empowerment (S4E) was developed for health clinic settings. S4E has demonstrated high feasibility, acceptability, and preliminary efficacy among youth in clinic settings. The proposed research will determine the feasibility and acceptability of delivering S4E via near peers, as well as determine the preliminary efficacy of S4E to improve HIV self-testing immediately post-intervention in a community sample (n=20) of at-risk youth ages 16-21 living in Flint, Michigan by conducting a phase I, one-arm pilot study to examine the feasibility and preliminary efficacy of S4E in improving the uptake of HIV self-testing immediately post-intervention. A University-Community approach was taken to employ principles of Community Based Participatory Research (CBPR) to determine the accessibility and acceptability of S4E when delivered by Near Peers.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
S4E application was developed in collaboration with youth in Southeast Michigan. S4E aims to prevent and reduce HIV/STI risk behaviors, including drug use and sexual risk behaviors, and increase HIV testing among youth. Content produced for the application is based on scientific prevention principles in conjunction with youth input. To date, we have developed modules focused on youth alcohol \& drug use, HIV \& STIs, and tobacco prevention and cessation.
University of Michigan
Ann Arbor, Michigan, United States
YOUR Center
Flint, Michigan, United States
Lifetime HIV Testing
At baseline we will assess binary outcome of participant's lifetime HIV testing and collect date of most recent HIV test using an item adapted from the Centers for Disease Control (CDC) Youth Behavior Risk Survey (YRBS). A sample question for youth is "Have you every been tested for HIV?". Responses consist of "1=Yes", "0=No", and "98=Refuse to Answer".
Time frame: Baseline
HIV Self-Testing
Immediately post-intervention, we will assess the binary outcome of HIV self-testing using items adopted from Lightfoot and colleagues (2018).
Time frame: Immediately post-intervention
HIV Self-Test Results Disclosure
Post-intervention we will asses the percentage of youth that disclose their HIV self-test results to the Near Peer.
Time frame: Immediately post-intervention
Change in Sexual Risk Beliefs from baseline to immediately post-intervention
Beliefs regarding sexual behaviors (e.g., intended sex, condom use, and other contraceptives) will be assessed. A sample question for the youth is, "Condoms help prevent pregnancy." Responses range from "1=Strongly disagree" to "5=Strongly Agree".
Time frame: baseline and immediatly post-intervention
Change in Sexual Risk Attitudes from baseline to immediately post-intervention
Attitudes about sexual behaviors (e.g., intended sex, condom use, and other contraceptives) will be assessed. A sample question for the youth is "If I used a condom, sex would not feel as good." Responses range from "1=Strongly disagree" to "5=Strongly Agree".
Time frame: baseline and immediatly post-intervention
Change in Future intentions regarding sexual risk from baseline to immediately post-intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Change in future intentions of sexual behaviors (e.g., intended sex, condom use, and other contraceptives) will be assessed. A sample question for the youth is, "How likely is it that you will decide to have sex in the next 90 days?"." Responses range from "1=Very Unlikely" to "5=Very Likely".
Time frame: baseline and immediatly post-intervention
Linkage to Care and Prevention
The percent of youth who are referred to substance use, mental health, and sexual health services will be assessed.
Time frame: immediately post-intervention
Eligibility rates for the Near Peer
During the recruitment period of Near Peers, we will monitor and record the percentage of potential near peer participants who meet eligibility criteria to be enrolled in the study.
Time frame: enrollment period pre-intervention
Percent of Enrollment for Near Peer
During the recruitment period of Near Peers, we will monitor and record the percentage of those potential near peers eligible to participate who decide to enroll in the study.
Time frame: enrollment period pre-intervention
Intervention Completion Rates for Near Peer
Immediately post intervention we will assess the rate of intervention completion of Near Peers.
Time frame: immediately-post intervention
Eligibility rates for the Youth
Immediately post-intervention, we will assess the percentage of participants who meet eligibility criteria for our study.
Time frame: enrollment period pre-intervention
Percent of Enrollment for Youth
We will assess the percentage of those youth eligible to participate who are enrolled in the study.
Time frame: enrollment period pre-intervention
Intervention Completion Rates for Youth
Immediately post intervention, we will assess the rate of intervention completion of youth participants.
Time frame: immediately post-intervention
Near Peer Satisfaction of the S4E app: Client Satisfaction Questionnaire (CSQ)
Satisfaction is defined as how much the Near Peer enjoyed using the app and will be measured by the Client Satisfaction Questionnaire (CSQ). The CSQ is a eight item survey adapted from Larsen and colleagues (1979) that has been shown to be reliable and valid, and was previously used in a primary care intervention (Cordova et al., 2018). In our previous studies the alphas have ranged from 0.87 to 0.92. A sample question is "How would you rate the app you have received?". Responses range from "1=Poor" to "4=Excellent".
Time frame: immediately-post intervention
Acceptability of S4E Session for Near Peer: Session Evaluation Form (SEF)
Acceptability is defined as how much the Near Peer enjoyed the intervention and will be measured by the Session Evaluation Form (SEF). The SEF is a 13-item survey, modified from Harper and colleagues (2008), that has been shown to be reliable and valid, and was previously used in a primary care intervention (Cordova et al., 2018). In our previous studies the alpha of SEF was 0.89. A sample question is "The session was enjoyable". Responses range from "1=Strongly Agree" to "4=Strongly Disagree".
Time frame: immediately-post intervention
Youth Satisfaction of the S4E app: Client Satisfaction Questionnaire (CSQ
Satisfaction is defined as how much the youth enjoyed using the app and will be measured by the Client Satisfaction Questionnaire (CSQ). The CSQ is a eight item survey adapted from Larsen and colleagues (1979) that has been shown to be reliable and valid, and was previously used in a primary care intervention (Cordova et al., 2018). In our previous studies the alphas have ranged from 0.87 to 0.92. A sample question is "How would you rate the app you have received?". Responses range from "1=Poor" to "4=Excellent".
Time frame: immediately-post intervention
Acceptability of S4E Session for Youth: Session Evaluation Form (SEF)
Acceptability is defined as how much the youth enjoyed the interview session and will be measured by the Session Evaluation Form (SEF). The SEF is a 13-item survey, modified from Harper and colleagues (2008), that has been shown to be reliable and valid, and was previously used in a primary care intervention (Cordova et al., 2018). In our previous studies the alpha of SEF was 0.89. A sample question is "The session was enjoyable". Responses Range from "1=Strongly Agree" to "4=Strongly Disagree".
Time frame: immediately-post intervention