Abstract
Introduction:
Using human-centered design strategies and a strong theoretical framework, we describe the formative development of a mobile-phone-based intervention: InTSHA (Interactive Transition Support for Adolescents with HIV).
Methods
We performed in-depth, semi-structured interviews with adolescents (n = 20), caregivers (n = 10), and healthcare providers (n = 10) to develop an intervention based on modifiable factors within the Socioecological Model for Adolescent and young Adult Readiness Transition (SMART) and delivered through social media. We then created a preliminary digital, interactive intervention based on modifiable factors in the SMART along with existing transition protocols and adolescent support group curricula to be delivered through mobile phones. We then theatre-tested the intervention with new groups of adolescents (n = 19), caregivers (n = 10), and healthcare providers (n = 7) to obtain feedback on content, delivery, and redesign.
Results
Participants expressed that moderated, small, mixed-gender, closed group chats with focused content facilitated weekly through WhatsApp would likely increase peer support and connection to clinical staff. Separate, closed group chat discussions among only caregivers of the adolescents in the InTSHA group could improve communication with their adolescents. Major concerns included internet and phone security, cost of data plans, and potential accidental disclosure of HIV status. Individual messaging with healthcare providers was seen as potentially beneficial; however, some healthcare providers voiced concern about procedures in the event of disclosure of medical and/or psychiatric emergencies.
Conclusion
The preliminary InTSHA intervention was developed through human-centered design focused on adolescents with HIV during transition to adult care that will use group WhatsApp chats to improve engagement in care.