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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Jul 6, 2020
Date Accepted: May 16, 2021

The final, peer-reviewed published version of this preprint can be found here:

Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study

Williamson A, Barbarin A, Campbell B, Campbell T, Franzen S, Reischl TM, Zimmerman M, Veinot T

Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study

J Med Internet Res 2021;23(7):e22203

DOI: 10.2196/22203

PMID: 34269689

PMCID: 8325088

HOPE eIntervention: Uptake and Engagement in an Online Sexual Health Intervention among African-American Young Adults

  • Alicia Williamson; 
  • Andrea Barbarin; 
  • Bettina Campbell; 
  • Terrance Campbell; 
  • Susan Franzen; 
  • Thomas M. Reischl; 
  • Marc Zimmerman; 
  • Tiffany Veinot

ABSTRACT

Background:

African American young adults have low rates of uptake and engagement with health technologies, which may further widen sexual health inequalities.

Objective:

We examined factors influencing uptake and engagement for a consumer health informatics (CHI) intervention for HIV/STI prevention among African American young adults using the diffusion of innovation theory, the trust-centered design framework and O’Brien and Toms’ model of engagement.

Methods:

This community-based participatory research, mixed-methods study included surveys at four time points (N=315; 280 African-American) of young adults aged 18 to 24 involved in an HIV/STI prevention intervention described as “parties”. Qualitative interviews were conducted with a subset of participants (N=19) after initial surveys, website server logs, and social media accounts indicated low uptake and engagement. A generalized linear mixed-effects model identified predictors of eIntervention uptake, server logs were summarized to describe use over time, and interview transcripts were coded and thematically analyzed to identify factors affecting uptake and engagement.

Results:

Self-reported eIntervention uptake was low, but increased significantly over time, Demographic factors and HIV/STI-related behaviors were not significantly correlated with uptake. The most frequent activity was visiting the website, followed by visiting the Facebook page. Factors driving uptake were the desire to share HIV/STI prevention information with others, trust in the intervention, and gender homophily. Factors undermining uptake were personal and group distrust online. Factors driving initial engagement were audience-targeted website aesthetics and appealing visuals; long-term engagement was impeded by insufficiently frequent updates.

Conclusions:

To encourage uptake, CHI interventions for African-American young adults can leverage users’ desire to share information about HIV/STI prevention with others. Ensuring implementation through trusted organizations is also important, though there is a need for vigorous promotion. Visual appeal and targeted content foster engagement at first, but ongoing engagement may require continual content changes. A thorough analysis of CHI intervention use can inform the development of future interventions in order to promote uptake and engagement. To guide future analyses, we present an expanded uptake and engagement model for CHI interventions targeting African American young adults based on the empirical results presented here.


 Citation

Please cite as:

Williamson A, Barbarin A, Campbell B, Campbell T, Franzen S, Reischl TM, Zimmerman M, Veinot T

Uptake of and Engagement With an Online Sexual Health Intervention (HOPE eIntervention) Among African American Young Adults: Mixed Methods Study

J Med Internet Res 2021;23(7):e22203

DOI: 10.2196/22203

PMID: 34269689

PMCID: 8325088

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