Accepted for/Published in: JMIR Formative Research
Date Submitted: May 27, 2019
Date Accepted: Mar 29, 2020
Feasibility of assessing economic and sexual risk behaviors using text message surveys in African-American young adults experiencing homelessness and unemployment: a single-group study
ABSTRACT
Background:
Text messages offer the potential of better evaluating HIV behavioral interventions using repeated longitudinal measures at lower cost and research burden. However, they have been underutilized in U.S. minority settings.
Objective:
We conducted a single-group study to examine the feasibility of assessing economic and sexual risk behaviors using text message surveys with 17 African-American young adults, aged 18 to 24, who were economically disadvantaged and reported prior unprotected sex.
Methods:
Participants received a text message survey once each week for 5 weeks. The survey contained 14 questions with yes-no and numeric responses on sexual risk behaviors (i.e., condomless sex, sex while high/drunk, sex exchange) and economic behaviors (i.e., income, employment, money spent on HIV services/products). Feasibility measures were: number responding to the survey in a given week; number of questions responded to in each survey; and number of hours from survey sending to completion in a given week. One discussion group was used to obtain feedback.
Results:
Sixty-five percent (65%, n=11) of participants responded to at least one text message survey compared to 35% (n=6) who did not. The majority (64%, n=7) of responders were women. The majority (67%, n=4) of non-responders were men. An average of 7.6 participants (69%) responded in a given week. Response rates among ever-responders ranged from 64% to 82% across the study period. The mean number of questions answered each week was 12.6 (90% of all questions), ranging from 72% to 100%. An average of 6.4 participants (84%) answered all 14 text message questions in a given week, ranging from 57% to 100%. Participants responded approximately 8.7 hours after receiving the survey. Participants were more likely to answer questions related to employment, condomless sex, and discussions with sex partners. Non-response or “skip” was more often used for questions at the end of the survey relating to sex exchange and money spent on HIV prevention services or products. Strengths of the text message survey were convenience, readability, short completion time, having repeated measures over time, and having incentives.
Conclusions:
Longitudinal text message surveys may be a valuable tool for assessing HIV-related economic and sexual risk behaviors. Clinical Trial: NCT03237871.
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