Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study

Evans, Catrin; Turner, K.; Suggs, L.S.; Occa, A.; Juma, A.; Blake, H.

Abstract

Background: HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the UK.
Methods: A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined.
Results: The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits.
Conclusions: HIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities.

Citation

Evans, C., Turner, K., Suggs, L., Occa, A., Juma, A., & Blake, H. (2016). Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study. BMC Public Health, 16, Article 656. https://doi.org/10.1186/s12889-016-3278-4

• Journal Article Type: Article
• Acceptance Date: Jun 24, 2016
• Publication Date: Jul 28, 2016
• Deposit Date: Nov 1, 2016
• Publicly Available Date: Nov 1, 2016
• Journal: BMC Public Health
• Electronic ISSN: 1471-2458
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Article Number: 656
• DOI: https://doi.org/10.1186/s12889-016-3278-4
• Keywords: HIV testing, mHealth, Text messaging, African, Community-based participatory research, Social marketing
• Public URL: https://nottingham-repository.worktribe.com/output/798615
• Publisher URL: http://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3278-4
• Contract Date: Nov 1, 2016