An Accessible Digital Intervention to Promote HIV Testing/Counseling and Prevention Among Adolescents

Abstract HIV disproportionately impacts minority adolescentsand most of them have neither undergone HIV testing and counselingHTCnor know their statusAdolescence is a "window of opportunity" to intervene with HIV behavior change interventionsChallenges to implementing and disseminating some effective HIV prevention programs in adolescents may limit their impactTo address these challengesinnovative digital technologies can be used as interventions to improve health related behaviorsThey meet adolescents "where they are at " are engagingprovide more consistent fidelity to the interventionand are easier to disseminateleading to potentially greater reach at a lower costThereforethe goal of this proposal is to build on the work completed with a Phase I project to further adapt an existing iPad based HIV prevention intervention with demonstrated efficacyPlayForwardElm City Storiesdeveloped for adolescents agedand focused on sexual risk reductionto create a new intervention focused on promoting access to and uptake of HTC in adolescentsagedIn the original PlayForwardparticipants create a virtual character they use to travel through lifefacing challenges and making decisions that bring different risksbenefitsand consequencesThe participants can see how their actions influence their futureThe intervention involves a series of realistic stories representing risky situations faced by adolescents in middle or high schooland participants successfully resolve each story to acquire "senses" and "powers " The subsequent Phase I study adapted the intervention for a greater focus on HTC with enhanced storylines and conducted a pilot study that demonstrated efficacy in increasing actual HTCintentionsand knowledgeFor the proposed Phase II studywe will conduct additional formative work with focus groupsand our team of product developers and researchers will expand on the content and scope of the intervention while translating the intervention to a web based platformWe will move towards commercialization of the digital intervention by working with implementation and marketing partnersWe will evaluate the adapted intervention in a randomized controlled trial withracial ethnic minority adolescentsdetermining its efficacy as a web based intervention for impacting their intention to seek HTCactual obtaining of HTCand knowledge about HIV AIDS and testingThey will interact with the intervention forhours per week forweeksand standardized assessment data will be collected at baselineweeksandmonthsGiven the compelling evidence supporting the efficacy of technology in health promotion and disease preventionand their increased accessfidelityand potential cost effectivenessthis proposal holds the promise of an effectiveengagingtailoredand highly accessible prevention intervention with the potential for greater sustainable dissemination and considerable impact on this vulnerable population of adolescents