Is there a sexual health intervention that you would like to implement using mobile technology? Do you want to move a traditional intervention to an mHealth intervention? Are you interested in intervention adaption? There are numerous evidence-based interventions that can be moved from traditional teaching/learning styles to those using technologically advanced methods of delivery. Learn how to effectively adapt interventions for mHealth delivery. Stop reinventing the wheel.
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Stop Reinventing the Wheel: Adapting Evidence-Based Sexual Health Interventions for mHealth Delivery
1. Stop Reinventing theWheel:
Adapting Evidence-Based Sexual Health
Interventions for mHealth Delivery
Tiffany M. Montgomery, MSN, RNC-OB, C-EFM
University of California, Los Angeles School of
Nursing
April 26-28, 2015
San Francisco, CA
#YTHLive
Annual Conference on Youth + Tech + Health
2. Objectives
1. Discuss the importance of intervention adaptation
2. Describe the phases of the ADAPT-ITT model
3. Differentiate among acceptability, feasibility, and
efficacy of adapted interventions.
5. WhyText Messages?
• Young adults often prefer technologically-advanced
methods of learning and social engagement [1]
• Decreased organizational costs associated with
personnel and resources needed for intervention
implementation [2]
• Standardized text messages ensure the intervention
fidelity [2]
6. WhyText Messages? (cont.)
• Utilization of mHealth is encouraged by the CDC [3]
• Removes barriers to healthcare [2]
• Sexual health text messaging interventions have been
shown to be effective [4-7]
• Texts can be sent/received without a broadband
connection
7. WhyText Messages? (cont.)
• 95% of young adults own a mobile phone [8]
• Not everyone owns a smartphone…
63% of women; 85% of young adults, ages 18-29; 70% of
Blacks [9]
• …But EVERYONE texts!!!
100% of young adult mobile phone owners engage in
texting [9]
8. Why Adaptation?
• Adoption = ready to implement “as is”
• Adaptation = changing an established intervention
for implementation among a population of a
different age, ethnicity, gender, etc.
• Instead of creating entirely new interventions,
adaptation of effective interventions is
recommended [10-15]
9. The ADAPT-ITT Model
• Created by HIV/STD prevention interventionists,
Wingood and DiClemente, whose SiSTA
intervention has been successfully adapted for
various populations [16-21]
• Emphasizes acceptability, feasibility, and efficacy
testing
10. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
11. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
12. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
13. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
14. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
15. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
16. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
17. ADAPT-ITT Model Phases
1. Assessment 2. Decision 3. Adaptation
4. Production
5.Topical
Experts
6. Integration
7.Training 8.Testing
18. So,What’s the Point of it All?
• Acceptability – Do they like it?
• Feasibility – Can it be implemented successfully?
• Efficacy – Does it do what it was created to do?
19. Tiffany M. Montgomery
Factor Building, Room 3-650
700Tiverton Avenue
Los Angeles, CA 90024
Tiffany.Montgomery@ucla.edu
#YTHLive
20. Acknowledgement of Funding Sources
• National Institute of Mental Health, Grant #:
P30MH58107
UCLA Center for HIV Identification, Prevention, and
Treatment Services
• SigmaThetaTau International Honor Society of
Nursing, GammaTau-at-Large Chapter Pilot Study
Grant
21. References
1. Rosen, L. (2009). Rewired: Understanding the iGeneration and the way they learn.
Paper presented at the Chronic IllnessConference, Norfolk,VA.
2. Bull, S.,Technology-based health promotion. 2011,Thousand Oaks, CA: SAGE
Publications.
3. Centers for Disease Control and Prevention, The health communicator's social
media toolkit. 2011, U.S. Department of Health and Human Services.
4. Gold, J., et al., A randomised controlled trial using mobile advertising to promote
safer sex and sun safety to young people. Health Education Research, 2011.
26(5): p. 782-794.
5. Gold, J., et al., Determining the impact of text messaging for sexual health
promotion to young people. SexuallyTransmitted Diseases, 2011. 38(4): p. 247-
252.
22. References (cont.)
6. Lim, M.S.C., et al., Impact of text and email messaging on the sexual health of
young people: a randomised controlled trial. Journal of Epidemiology &
Community Health, 2012. 66(1): p. 69-74.
7. Suffoletto, B., et al., A sex risk reduction text-message program for young adult
females discharged from the emergency department. Journal of Adolescent
Health, 2013. 53(3): p. 387-393.
8. Smith,A. (2011). Americans and text messaging. Pew Internet and American Life
Project.Washington, D.C.: Pew Research Center.
9. Smith,A., U.S. smartphone use in 2015. 2015, Pew Research Center:Washington,
D.C.
10. Card, J.J., J. Solomon, and S.D. Cunningham, How to adapt effective programs
for use in new contexts. Health Promotion Practice, 2011. 12(1): p. 25-35.
23. References (cont.)
11. Castro, F.G., M. Barrera, and L.K.H. Steiker, Issues and challenges in the design of culturally
adapted evidence-based Interventions, in Annual Review of Clinical Psychology,Vol 6, S. Nolen
Hoeksema,T.D. Cannon, andT. Widiger, Editors. 2010. p. 213-239.
12. Chen, E.K., et al., Tailoring evidence-based interventions for new populations: A method for
program adaptation through community engagement. Evaluation & the Health Professions, 2013.
36(1): p. 73-92.
13. McKleroy,V.S., et al., Adapting evidence-based behavioral interventions for new settings and
target populations. AIDS Education and Prevention, 2006. 18(4): p. 59-73.
14. Villarruel, A.M., L.S. Jemmott, and J.B. Jemmott, III, Designing a culturally based intervention to
reduce HIV sexual risk for Latino adolescents. JANAC: Journal of the Association of Nurses in AIDS
Care, 2005. 16(2): p. 23-31.
15. Wingood, G.M. and R.J. DiClemente, The ADAPT-ITT model: a novel method of adapting
evidence-based HIV Interventions. Journal of Acquired Immune Deficiency Syndromes, 2008. 47:
p. S40-S46.
24. References (cont.)
16. Belgrave, F.Z., et al., An evaluation of an enhanced Sisters Informing Sisters aboutTopics on AIDS
(SISTA) HIV prevention curriculum:The role of drug education. Journal of HIV/AIDS & Social
Services, 2008. 7(4): p. 313-327.
17. Card, J.J., et al., Translating an effective group-based HIV prevention program to a program
delivered primarily by a computer: Methods and outcomes. AIDS Education and Prevention, 2011.
23(2): p. 159-174.
18. Cornelius, J.B., L. Moneyham, and S. LeGrand,Adaptation of an HIV prevention curriculum for
use with older African American women. Journal of the Association of Nurses in AIDS Care,
2008. 19(1): p. 16-27.
19. Saleh-Onoya, D., et al., SISTA South Africa:The adaptation of an efficacious HIV prevention trial
conducted with African-American women for isiXhosa-speaking South African women. SAHARA-J:
Journal of Social Aspects of HIV-AIDS, 2008. 5(4): p. 186-191.
20. Wingood, G.M., et al., Efficacy of a health educator-delivered HIV prevention intervention for
Latina women: A randomized controlled trial. American Journal of Public Health, 2011. 101(12): p.
2245-2252.
25. References (cont.)
21. Wingood, G.M., et al., Comparative effectiveness of a faith-based HIV intervention for African
American women: Importance of enhancing religious social capital. American Journal of Public
Health, 2013. 103(12): p. 2226-2233.