Testing the Efficacy of a Social Networking Gamification App to Improve Pre-Exposure Prophylaxis Adherence (P3: Prepared, Protected, emPowered): Protocol for a Randomized Controlled Trial

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Abstract

Background

HIV prevalence is high among young men who have sex with men (YMSM) and young transgender women who have sex with men (YTWSM), particularly among minorities. Despite its proven efficacy and safety, the uptake of and adherence to pre-exposure prophylaxis (PrEP) among YMSM and YTWSM is currently limited. To date, evidence-based interventions to promote and sustain PrEP adherence have been limited and not shown to be highly efficacious. Given the widespread adoption of smartphones, mobile apps can be utilized to increase PrEP adherence for many YMSM and YTWSM.

Objective

The study consists of a formative research phase to develop an app-based intervention, P3 (Prepared, Protected, emPowered), to increase PrEP adherence, and a randomized controlled trial (RCT) to test its efficacy. P3 is a mobile app built on an established health platform, which includes social networking and game-based components to encourage PrEP adherence among YMSM and YTWSM. P3+ includes all P3 features plus adherence counseling delivered via two-way text messaging (short message service, SMS) through the app.

Methods

The formative research phase includes usability testing to assess users’ comprehension of P3’s educational content, understanding and use of intervention features, and overall impressions of app functionality, followed by app refinements. A subsequent field trial will identify and resolve any remaining technical challenges. A three-arm RCT (P3, P3+, and standard of care) will then be conducted at 6 iTech subject recruitment venues to assess intervention efficacy and to conduct a comparison of costs to deliver the 2 intervention arms.

Results

This is an ongoing research project with initial results from the formative work expected in 2020 and those from the RCT in 2021.

Conclusions

P3 aims to provide an engaging, interactive experience that is highly appealing for the target population, leveraging technology already heavily integrated into the lives of young people, and thus meeting users’ needs in a familiar, stimulating way. If efficacious, P3 could be a sustainable, easily disseminated, lower-cost PrEP intervention for YMSM and YTWSM. Further, the research aims to determine the processes that are essential to developing and implementing future health-related gamification interventions.

Trial Registration

ClinicalTrials.gov NCT03320512; https://clinicaltrials.gov/ct2/show/NCT03320512 (Archived by WebCite at http://www.webcitation.org/74OVZkICl)

International Registered Report Identifier (IRRID)

DERR1-10.2196/10448

Related collections

Most cited references 49

Record: found
Abstract: not found
Article: not found

Doing It Now or Later

Ted O’donoghue, Matthew Rabin (1999)

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Record: found
Abstract: found
Article: not found

HIV prevalence, risk behaviors, health care use, and mental health status of transgender persons: implications for public health intervention.

K Clements-Nolle, R Marx, R. Guzman … (2001)

This study described HIV prevalence, risk behaviors, health care use, and mental health status of male-to-female and female-to-male transgender persons and determined factors associated with HIV. We recruited transgender persons through targeted sampling, respondent-driven sampling, and agency referrals; 392 male-to-female and 123 female-to-male transgender persons were interviewed and tested for HIV. HIV prevalence among male-to-female transgender persons was 35%. African American race (adjusted odds ratio [OR] = 5.81; 95% confidence interval [CI] = 2.82, 11.96), a history of injection drug use (OR = 2.69; 95% CI = 1.56, 4.62), multiple sex partners (adjusted OR = 2.64; 95% CI = 1.50, 4.62), and low education (adjusted OR = 2.08; 95% CI = 1.17, 3.68) were independently associated with HIV. Among female-to-male transgender persons, HIV prevalence (2%) and risk behaviors were much lower. Most male-to-female (78%) and female-to-male (83%) transgender persons had seen a medical provider in the past 6 months. Sixty-two percent of the male-to-female and 55% of the female-to-male transgender persons were depressed; 32% of each population had attempted suicide. High HIV prevalence suggests an urgent need for risk reduction interventions for male-to-female transgender persons. Recent contact with medical providers was observed, suggesting that medical providers could provide an important link to needed prevention, health, and social services.

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Is Open Access

Gamification: What It Is and Why It Matters to Digital Health Behavior Change Developers

Brian Cugelman (2013)

This editorial provides a behavioral science view on gamification and health behavior change, describes its principles and mechanisms, and reviews some of the evidence for its efficacy. Furthermore, this editorial explores the relation between gamification and behavior change frameworks used in the health sciences and shows how gamification principles are closely related to principles that have been proven to work in health behavior change technology. Finally, this editorial provides criteria that can be used to assess when gamification provides a potentially promising framework for digital health interventions.

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Author and article information

Contributors

Sara LeGrand:

Center for Health Policy and Inequalities ResearchDuke Global Health InstituteDuke University310 Trent DriveRoom 305Durham, NC, 27710United States1 91943804481 9196810714sara.legrand@duke.edu

ORCID: http://orcid.org/0000-0002-2590-516X

Journal

Journal ID (nlm-ta): JMIR Res Protoc

Journal ID (iso-abbrev): JMIR Res Protoc

Journal ID (publisher-id): ResProt

Title: JMIR Research Protocols

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 1929-0748

Publication date Collection: December 2018

Publication date (Electronic): 18 December 2018

Volume: 7

Issue: 12

Electronic Location Identifier: e10448

Affiliations

[1 ] Center for Health Policy and Inequalities Research Duke Global Health Institute Duke University Durham, NC United States

[2 ] Behavior and Technology Lab Institute for Global Health and Infectious Diseases University of North Carolina at Chapel Hill Chapel Hill, NC United States

[3 ] Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta, GA United States

[4 ] Department of Health Behavior Gillings School of Global Public Health University of North Carolina at Chapel Hill Chapel Hill, NC United States

[5 ] Department of Epidemiology Rollins School of Public Health Emory University Atlanta, GA United States

Author notes

Corresponding Author: Sara LeGrand sara.legrand@ 123456duke.edu

Author information

Sara LeGrand http://orcid.org/0000-0002-2590-516X

Kelly Knudtson http://orcid.org/0000-0002-5293-1961

David Benkeser http://orcid.org/0000-0002-1019-8343

Kathryn Muessig http://orcid.org/0000-0002-8522-3240

Andrew Mcgee http://orcid.org/0000-0001-6717-5639

Patrick S Sullivan http://orcid.org/0000-0002-7728-0587

Lisa Hightow-Weidman http://orcid.org/0000-0002-2421-923X

Article

Publisher ID: v7i12e10448

DOI: 10.2196/10448

PMC ID: 6315253

PubMed ID: 30563818

SO-VID: cfebf94c-c3af-48e6-a190-9625b9b02647

Copyright © ©Sara LeGrand, Kelly Knudtson, David Benkeser, Kathryn Muessig, Andrew Mcgee, Patrick S Sullivan, Lisa Hightow-Weidman. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 18.12.2018.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on http://www.researchprotocols.org.as well as this copyright and license information must be included.

History

Date received : 19 March 2018

Date revision requested : 6 May 2018

Date revision received : 1 July 2018

Date accepted : 7 August 2018

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