Date post: | 17-Dec-2014 |
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Adapting HIV Interventions for
Targeting MSM Online Populations
Joshua Fegley, LCSWNO/AIDS Task Force
New Orleans, LA
Purpose
Discuss agency’s experience with adapting “real world” interventions to online environment Outreach Popular Opinion Leader RESPECT
Discuss Lessons Learned
Issues
There is a need to adapt HIV prevention to changing technologiesAt-risk populations are onlineNo EBIs designed to reach these populations
Adaptation Components
Core ElementsKey CharacteristicsAdaptationTailoring‘Fidelity’ vs. ‘Reinvention’
Outreach
NO/AIDS began online outreach in 2000Conducted 20-30 conversations per weekApproximately 100 people per year came in to get tested because of encounter with online outreachBetween 2000 – 2004 approximately 150 first-time testers came in because of encounter with online outreach
Outreach
Not an EBIOnline outreach must still maintain fidelity to outreach modelsNO/AIDS developed online outreach protocol based on literature and agency knowledge
Outreach
Must create an agency online protocol Can use National Guidelines for Internet-
based STD/HIV Prevention – Outreach as a guide
http://www.ncsddc.org/upload/wysiwyg/documents/IGO.pdf
Website administrators will ask to review your protocol before you can set up an outreach/health profile
Popular Opinion Leader
Community Level InterventionBased on Diffusion of Innovation Theory“Friends Influencing Friends to Instill a Risk Reduction Norm Among Themselves”
Popular Opinion Leader
NO/AIDS funded for POL starting in 2004Forced to take a break in late summer of 2005Online trainings started in Summer 200710 POLs trained in first year Approximately 60 conversations submitted in
first year
Popular Opinion Leader
Core Elements Identifiable target population Ethnographic techniques used to identify
Popular Opinion Leaders (POLs) 15% of target population trained Teach POLs characteristics of effective
behavior change communication messages
Popular Opinion Leader
Core Elements Small group, weekly training sessions POLs set goals to engage in risk-reduction
conversations with friends & acquaintances POL conversations are reviewed, discussed,
reinforced at subsequent training sessions Logos or symbols used as conversation
starters for POL
Popular Opinion Leader
Online POL maintained fidelity to core elements Target population: MSM who frequent chat
rooms in the Gulf South Staff observed chat rooms and documented
observations Goal was to train 15% of chat room users Used POL training guide
Chat Room Estimation ReportChat Room User Estimation
Start Time: End Time: Date: Observer name: Each session one-hour observation Create a folder for each session: Nomenclature: Date-start time to end time If a chat room is not accessible, please observe a different chat room and make a note of the same in this sheet. Check the chat rooms you are observing. Gay.com: Chat rooms:
New Orleans LA Statewide Houston Atlanta
Do the observation through Chattage Maximum chat room users allowed ___ Number of users in Chat room: start, every 30 minutes, end Screen Shot (use print screen on the key board and copy paste to a WORD document): start, every 30 minutes, end Save the chat transcript: via Chattage Nomenclature: website-chatroom- Date-start time to end time initials Read the transcript. Write a summary of what was being discussed (relevant to the project). After reading the saved transcript do you think any one can be a
POL Focus Group Key Informant
Why? Check all that apply Screen Name A Screen Name B Screen Name C Greeted most often Greets others often “The life of the party” Trusted and well-liked by their network of friends Sought out for advice The center of what’s happening Spoken of respectfully by others Interacts with one primary social network Interacts with multiple social networks Elicits apparent interest from others Appears to enjoy the company of others Others appear to enjoy his company Others in the chat room ask him for opinions Others ask him about available HIV services Others ask him about available referral services Others ask him for information/discuss hurricanes Other ____________________________________
Blkgaychat.com and Adam4adam.com: Number of users and individuals: Copy and Paste into WORD document number of individuals in New Orleans area: start, every 30 minutes, and end.
Popular Opinion Leader
Online POL maintained fidelity to core elements Conducted online, small group, weekly
training sessions using distance learning platform
POLs attempted 10 conversations per month POLs used online form to submit conversation
summary Used symbol for conversation starter
Popular Opinion Leader
Popular Opinion LeaderPOL
POPULAR OPINION LEADER CONVERSATION CONTACT FORM
My POL/Screen Name is _______ __________________________
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
First Name or Screen Name:
Date of Conversation:
Place of Contact:
Age Race/Ethnicity
Summary of Conversation :
Popular Opinion Leader
Initially had great successOnline community excited about interventionTrained 10 POLsPOLs were having conversationsAnd then two things happened…
Popular Opinion Leader
Evacuation for Hurricane Gustav: “The Mother of All Storms” - Mayor C. Ray NaginGay.com radically revamped their platform
Popular Opinion Leader
As a result Users unable to get online Users quickly abandoned Gay.com Once users left Gay.com, no place to conduct
interventionEquivalent of only gay bar in town closing
RESPECT
Funded in 2010Agency decided there was still a need for online interventionPOL no longer viable option for agencyILI ideal for instant message, private chat format
RESPECT
Individual Level InterventionBrief, 2-session interventionFocuses on client’s personal riskCounselor uses prompts to help guide session
RESPECT
Core Elements 1:1 counseling, using RESPECT Prompts Teachable moments Explore circumstances and context of recent
risk behavior Negotiate achievable step which supports
larger risk-reduction goal Implement & maintain quality assurance
RESPECT
Online RESPECT maintains fidelity to Core Elements 1:1 sessions, using prompts, will be
conducted in chat room in secure, project website
Use teachable moments Explore recent risk behavior Negotiate achievable step Quality Assurance plan in place
RESPECT
RESPECT
Goals for Year 2 200 MSM, age 18+ who find sexual partners
online will complete the 2 RESPECT sessions 100 MSM, age 18+ will access HIV testing via
referrals from RESPECT
Lessons Learned
Interventions can be adapted successfully for use onlineMust carefully consider Core Elements of EBI
Lessons Learned
Must work closely with website administrators Websites have different requirements for
setting up outreach/health profileDo not expect to have an outreach profile established in just a few days
Lessons Learned
Money/Cost Must have up to date technology Cost for Outreach Profile on some sites Do you need a project specific website?
Staff must know how to use the technologyInclude in your budget or find way to get equipment and/or time donated
Lessons Learned
Interaction technology changes fast Chat rooms IM Mobile Apps
Online room/site/app that was hot today may be abandoned very quickly Users in Gulf South quickly left gay.com in
2008, switched to Manhunt & GrindrNot all online venues equally popular in all geographic areas
Lessons Learned
You will have the same challenges online that you have in “real world” Recruitment participants Retaining participants Record Keeping
Lessons Learned
Need to establish legitimacyMust build trust and rapportLet people know you and your agency are for real
Lessons Learned
It takes timeWith knowledge, initiative, and know how interventions can be successful online
Contact Information
Joshua Fegley, LCSW – CAN Project Coordinator [email protected]
Jean Redmann – Director of Prevention [email protected]