TY - JOUR
T1 - Behavioral intervention grounded in motivational interviewing and behavioral economics shows promise with Black and English-speaking Latino persons living with HIV with unsuppressed HIV viral load in New York City
T2 - A mixed methods pilot study
AU - Gwadz, Marya
AU - Serrano, Samantha
AU - Linnemayr, Sebastian
AU - Cleland, Charles M.
AU - Cluesman, Sabrina R.
AU - Freeman, Robin M.
AU - Kellam, Kinsey
AU - De Stefano, Corey
AU - Israel, Khadija
AU - Pan, Emily
N1 - Funding Information:
We gratefully acknowledge our Program Official at NIDA, Dr. Richard Jenkins, for guidance throughout the study, as well as Dr. Shoshana Kahana at NIDA, and Bruss Del Valle, Nicholas Reed, Pauline Lee, and Maria Ponce Sevilla in the Office for Research at the NYU Silver School of Social Work. We wish to acknowledge Dr. Gail Melkus, Mindy Belkin, William McCormack, and Mary Lou Atkinson at the NYU Meyers College of Nursing for their support of the project. Amanda Applegate provided editorial assistance. The IIT-Lab Research Team, past and present, includes: Yvette Allen, Mariam Ayvazyan, Nico Bobb, Dr. Scott Braithwaite, Dr. Charles M. Cleland, Sabrina Cluesman, Camille Collett, Dr. Linda M. Collins, Dr. Caroline Dorsen, Brooks Fassett, Krystel Francis, Robert Freeman, Dr. Robert L. Hawkins, Ning He, Elona Hoffeld, Khadija Israel, Sarah Kaufman, Kinsey Kellam, Daniel Kelly, Donna Kennedy, Alexis Korman, Dr. Alix Kutnick, Dr. Noelle Leonard, Maria Levine, Zobaida Maria, Belkis Y. Martinez, Dr. Michelle Munson, Sarah Ory, Shantae Owens, Emily Pan, Danny Quinones, Amanda Ritchie, Samantha Serrano, Dawa Sherpa, Elizabeth Silverman, Stephen Sorgi, Aradhana Srinagesh, Karen Torbjornsen, Catherine Tumminello, Dr. Leo Wilton, and Andrea Wade. Last, we gratefully acknowledge the individuals who participated in the study.
Funding Information:
This study was funded by the New York University Research Challenge Fund and the New York University Mega-grants Initiative in the Provost's Office, and supported by the NIDA-funded Center for Drug Use and HIV Research (CDUHR) at the NYU School of Global Public Health (P30DA011041; Holly Hagan, Ph.D., Principal Investigator. The NYU Silver School of Social Work provided valuable support throughout the study.
Publisher Copyright:
Copyright © 2022 Gwadz, Serrano, Linnemayr, Cleland, Cluesman, Freeman, Kellam, De Stefano, Israel and Pan.
PY - 2022/9/15
Y1 - 2022/9/15
N2 - Introduction: Sustained HIV viral suppression is the ultimate goal of HIV treatment. African American/Black and Latino persons with HIV (PWH) in the United States are less likely than their White peers to achieve and sustain viral suppression. To address these disparities, we developed a “low-touch” behavioral intervention drawing on motivational interviewing and behavioral economics. The intervention had three main components: (1) a motivational interviewing counseling session, (2) 16 weeks of automated text messages and quiz questions about HIV management, where participants earned points by answering quiz questions, and 3) a lottery prize, based on viral suppression status, number of points earned, and chance (max. $275). Materials and methods: The intervention was tested in a pre-test/post-test design. The present pilot study used mixed methods to explore the intervention's feasibility, acceptability, impact, and ways it could be improved. Participants engaged in a baseline assessment, qualitative interview, and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. We carried out descriptive quantitative analyses. Qualitative data were analyzed using a directed content analysis approach. Data integration was carried out using the joint display method. Findings: Participants (N = 40) were 50 years old, on average (SD = 11), and approximately half (58%) were male. Close to two-thirds (68%) were African American/Black and 32% were Latino. Participants were diagnosed with HIV 22 years ago on average (SD = 8). The intervention was feasible (e.g., mean number of quiz questions answered = 13/16) and highly acceptable. While not powered to assess efficacy, the proportion with suppressed HIV viral load increased from baseline to follow-up (46% participants at the first, 52% participants at the second follow-up evidenced HIV viral suppression). In qualitative analyses, perspectives included that overall, the intervention was acceptable and useful, it was distinct from other programs, lottery prizes were interesting and appreciated but not sufficient to motivate behavior change, and the structure of lottery prizes was not sufficiently clear. Regarding data integration, qualitative data shed light on and extended quantitative results, and added richness and context. Conclusion: This low-touch intervention approach is sufficiently promising to warrant refinement and study in future research.
AB - Introduction: Sustained HIV viral suppression is the ultimate goal of HIV treatment. African American/Black and Latino persons with HIV (PWH) in the United States are less likely than their White peers to achieve and sustain viral suppression. To address these disparities, we developed a “low-touch” behavioral intervention drawing on motivational interviewing and behavioral economics. The intervention had three main components: (1) a motivational interviewing counseling session, (2) 16 weeks of automated text messages and quiz questions about HIV management, where participants earned points by answering quiz questions, and 3) a lottery prize, based on viral suppression status, number of points earned, and chance (max. $275). Materials and methods: The intervention was tested in a pre-test/post-test design. The present pilot study used mixed methods to explore the intervention's feasibility, acceptability, impact, and ways it could be improved. Participants engaged in a baseline assessment, qualitative interview, and two structured follow-up assessments over an 8-month period, and provided laboratory reports to document HIV viral load. We carried out descriptive quantitative analyses. Qualitative data were analyzed using a directed content analysis approach. Data integration was carried out using the joint display method. Findings: Participants (N = 40) were 50 years old, on average (SD = 11), and approximately half (58%) were male. Close to two-thirds (68%) were African American/Black and 32% were Latino. Participants were diagnosed with HIV 22 years ago on average (SD = 8). The intervention was feasible (e.g., mean number of quiz questions answered = 13/16) and highly acceptable. While not powered to assess efficacy, the proportion with suppressed HIV viral load increased from baseline to follow-up (46% participants at the first, 52% participants at the second follow-up evidenced HIV viral suppression). In qualitative analyses, perspectives included that overall, the intervention was acceptable and useful, it was distinct from other programs, lottery prizes were interesting and appreciated but not sufficient to motivate behavior change, and the structure of lottery prizes was not sufficiently clear. Regarding data integration, qualitative data shed light on and extended quantitative results, and added richness and context. Conclusion: This low-touch intervention approach is sufficiently promising to warrant refinement and study in future research.
KW - HIV care continuum
KW - HIV viral suppression
KW - behavioral economics
KW - conditional economic incentives
KW - intervention
KW - motivational interviewing
KW - racial/ethnic disparities
KW - text message
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U2 - 10.3389/fpubh.2022.916224
DO - 10.3389/fpubh.2022.916224
M3 - Article
C2 - 36187648
AN - SCOPUS:85139104304
VL - 10
JO - Frontiers in Public Health
JF - Frontiers in Public Health
SN - 2296-2565
M1 - 916224
ER -