TY - JOUR
T1 - Building Community in the HIV Online Intervention Space
T2 - Lessons From the HealthMPowerment Intervention
AU - Blackburn, Natalie A.
AU - Dong, Willa
AU - Threats, Megan
AU - Barry, Megan
AU - LeGrand, Sara
AU - Hightow-Weidman, Lisa B.
AU - Soni, Karina
AU - Pulley, Deren V.
AU - Bauermeister, Jose A.
AU - Muessig, Kate
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported in full by Federal grant money from the National Institute of Mental Health of the United States of America National Institutes of Health under award numbers R21MH105292 and R01MH093275. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Funding Information:
We would like to thank all those who participated in the study and project staff for all their work and Dr. Shelley Golden for her advice and support. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Research reported in this publication was supported in full by Federal grant money from the National Institute of Mental Health of the United States of America National Institutes of Health under award numbers R21MH105292 and R01MH093275. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© The Author(s) 2021.
PY - 2021/10
Y1 - 2021/10
N2 - Background: Mobile health platforms can facilitate social support and address HIV (human immunodeficiency virus) stigma but pose challenges for intervention design and participant engagement. Giddens’s structuration theory, that individuals are shaped by—and shape—their communities through rules and resources that give them power to operate within these environments, provides a useful analytic framework for exploring these dynamic intervention spaces. Method: Data were drawn from an online randomized controlled trial intervention (HealthMpowerment) for young Black men who have sex with men to reduce condomless anal intercourse. We applied a conversational analysis informed by structuration theory to 65 user-generated conversations that included stigma content. We aimed to understand how the interdependent relationship between the intervention space and participants’ contributions might contribute to behavior change. Results: Thirty five intervention participants contributed to the analyzed conversations. Our analysis identified three types of conversational processes that may underlie behavior change: (1) Through intervention engagement, participants established norms and expectations that shaped their discussions; (2) participants used anecdotes and anonymity to reinforce norms; and (3) intervention staff members sought to improve engagement and build knowledge by initiating discussions and correcting misinformation, thus playing an integral role in the online community. Conclusions: The lens of structuration theory usefully reveals potential behavior change mechanisms within the social interactions of an online intervention. Future design of these interventions to address HIV stigma should explicitly characterize the context in which individuals (study staff and participants) engage with one another in order to assess whether these processes are associated with improved intervention outcomes.
AB - Background: Mobile health platforms can facilitate social support and address HIV (human immunodeficiency virus) stigma but pose challenges for intervention design and participant engagement. Giddens’s structuration theory, that individuals are shaped by—and shape—their communities through rules and resources that give them power to operate within these environments, provides a useful analytic framework for exploring these dynamic intervention spaces. Method: Data were drawn from an online randomized controlled trial intervention (HealthMpowerment) for young Black men who have sex with men to reduce condomless anal intercourse. We applied a conversational analysis informed by structuration theory to 65 user-generated conversations that included stigma content. We aimed to understand how the interdependent relationship between the intervention space and participants’ contributions might contribute to behavior change. Results: Thirty five intervention participants contributed to the analyzed conversations. Our analysis identified three types of conversational processes that may underlie behavior change: (1) Through intervention engagement, participants established norms and expectations that shaped their discussions; (2) participants used anecdotes and anonymity to reinforce norms; and (3) intervention staff members sought to improve engagement and build knowledge by initiating discussions and correcting misinformation, thus playing an integral role in the online community. Conclusions: The lens of structuration theory usefully reveals potential behavior change mechanisms within the social interactions of an online intervention. Future design of these interventions to address HIV stigma should explicitly characterize the context in which individuals (study staff and participants) engage with one another in order to assess whether these processes are associated with improved intervention outcomes.
KW - Black men who have sex with men
KW - HIV
KW - HealthMPowerment
KW - behavioral intervention
KW - conversational analysis
KW - eHealth
KW - structuration theory
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U2 - 10.1177/10901981211003859
DO - 10.1177/10901981211003859
M3 - Article
C2 - 33834892
AN - SCOPUS:85104253273
SN - 1090-1981
VL - 48
SP - 604
EP - 614
JO - Health Education Quarterly
JF - Health Education Quarterly
IS - 5
ER -