Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study
BackgroundAssisted partner services (APSs; sometimes called index testing) are now being brought to scale as a high-yield HIV testing strategy in many nations. However, the success of APSs is often hampered by low levels of partner elicitation. The Computer-Assisted Self-Inte...
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JMIR Publications
2025-01-01
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| Series: | JMIR Formative Research |
| Online Access: | https://formative.jmir.org/2025/1/e66132 |
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| author | Nancy Puttkammer Elizabeth Dunbar Myroslava Germanovych Mariia Rosol Matthew Golden Anna Hubashova Vladyslav Fedorchenko Larisa Hetman Liudmyla Legkostup Jan Flowers Olena Nesterova |
| author_facet | Nancy Puttkammer Elizabeth Dunbar Myroslava Germanovych Mariia Rosol Matthew Golden Anna Hubashova Vladyslav Fedorchenko Larisa Hetman Liudmyla Legkostup Jan Flowers Olena Nesterova |
| author_sort | Nancy Puttkammer |
| collection | DOAJ |
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BackgroundAssisted partner services (APSs; sometimes called index testing) are now being brought to scale as a high-yield HIV testing strategy in many nations. However, the success of APSs is often hampered by low levels of partner elicitation. The Computer-Assisted Self-Interview (CASI)–Plus study sought to develop and test a mobile health (mHealth) tool to increase the elicitation of sexual and needle-sharing partners among persons with newly diagnosed HIV. CASI-Plus provides client-facing information on APS methods and uses a standardized, self-guided questionnaire with nonjudgmental language for clients to list partners who would benefit from HIV testing. The tool also enables health care workers (HCWs) to see summarized data to facilitate partner tracking.
ObjectiveThe formative research phase of the CASI-Plus study aimed to gather client and HCW input on the design of the CASI-Plus tool to ensure its acceptability, feasibility, and usability.
MethodsThis study gathered input to prioritize features and tested the usability of CASI-Plus with HCWs and clients receiving HIV services in public health clinics in wartime Ukraine. The CASI-Plus study’s formative phase, carried out from May 2023 to July 2024, adapted human-centered design (HCD) methods grounded in principles of empathy, iteration, and creative ideation. The study involved 3 steps: formative HCD, including in-depth individual interviews with clients, such as men who have sex with men and people who inject drugs, and internet-based design workshops with HCWs from rural and urban HIV clinics in Chernihiv and Dnipro; software platform assessment and heuristic evaluation, including assessment of open-source mHealth platforms against CASI-Plus requirements, prototype development, and testing of the REDCap (Research Electronic Data Capture) prototype based on usability heuristics; and usability walk-throughs, including simulated cases with HCWs and clients.
ResultsThe formative phase of the CASI-Plus study included in-depth individual interviews with 10 clients and 3 workshops with 22 HCWs. This study demonstrated how simplified HCD methods, adapted to the wartime context, gathered rich input on prioritized features and tool design. The CASI-Plus design reflected features that are both culturally sensitive and in alignment with the constraints of Ukraine’s wartime setting. Prioritized features included information about the benefits of HIV index testing; a nonjudgmental, self-guided questionnaire to report partners; client stories; and bright images to accompany the text. Two-way SMS text messaging between clients and HCWs was deemed impractical based on risks of privacy breaches, national patient privacy regulations, and HCW workload.
ConclusionsIt was feasible to conduct HCD research in Ukraine in a wartime setting. The CASI-Plus mHealth tool was acceptable to both HCWs and clients. The next step for this research is a randomized clinical trial of the effect of the REDCap-based CASI-Plus tool on the number of partners named and the rate of partners completing HIV testing. |
| format | Article |
| id | doaj-art-f3f79c35147141ab93a0839c646d9e48 |
| institution | Kabale University |
| issn | 2561-326X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
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| series | JMIR Formative Research |
| spelling | doaj-art-f3f79c35147141ab93a0839c646d9e482025-01-30T21:00:36ZengJMIR PublicationsJMIR Formative Research2561-326X2025-01-019e6613210.2196/66132Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case StudyNancy Puttkammerhttps://orcid.org/0000-0002-6693-9278Elizabeth Dunbarhttps://orcid.org/0000-0003-2483-7625Myroslava Germanovychhttps://orcid.org/0009-0002-4079-205XMariia Rosolhttps://orcid.org/0009-0009-8798-4009Matthew Goldenhttps://orcid.org/0000-0001-7449-3774Anna Hubashovahttps://orcid.org/0009-0001-6524-0801Vladyslav Fedorchenkohttps://orcid.org/0009-0005-0893-5737Larisa Hetmanhttps://orcid.org/0009-0002-4474-2500Liudmyla Legkostuphttps://orcid.org/0009-0009-7165-0661Jan Flowershttps://orcid.org/0000-0001-5076-8569Olena Nesterovahttps://orcid.org/0000-0002-6815-7894 BackgroundAssisted partner services (APSs; sometimes called index testing) are now being brought to scale as a high-yield HIV testing strategy in many nations. However, the success of APSs is often hampered by low levels of partner elicitation. The Computer-Assisted Self-Interview (CASI)–Plus study sought to develop and test a mobile health (mHealth) tool to increase the elicitation of sexual and needle-sharing partners among persons with newly diagnosed HIV. CASI-Plus provides client-facing information on APS methods and uses a standardized, self-guided questionnaire with nonjudgmental language for clients to list partners who would benefit from HIV testing. The tool also enables health care workers (HCWs) to see summarized data to facilitate partner tracking. ObjectiveThe formative research phase of the CASI-Plus study aimed to gather client and HCW input on the design of the CASI-Plus tool to ensure its acceptability, feasibility, and usability. MethodsThis study gathered input to prioritize features and tested the usability of CASI-Plus with HCWs and clients receiving HIV services in public health clinics in wartime Ukraine. The CASI-Plus study’s formative phase, carried out from May 2023 to July 2024, adapted human-centered design (HCD) methods grounded in principles of empathy, iteration, and creative ideation. The study involved 3 steps: formative HCD, including in-depth individual interviews with clients, such as men who have sex with men and people who inject drugs, and internet-based design workshops with HCWs from rural and urban HIV clinics in Chernihiv and Dnipro; software platform assessment and heuristic evaluation, including assessment of open-source mHealth platforms against CASI-Plus requirements, prototype development, and testing of the REDCap (Research Electronic Data Capture) prototype based on usability heuristics; and usability walk-throughs, including simulated cases with HCWs and clients. ResultsThe formative phase of the CASI-Plus study included in-depth individual interviews with 10 clients and 3 workshops with 22 HCWs. This study demonstrated how simplified HCD methods, adapted to the wartime context, gathered rich input on prioritized features and tool design. The CASI-Plus design reflected features that are both culturally sensitive and in alignment with the constraints of Ukraine’s wartime setting. Prioritized features included information about the benefits of HIV index testing; a nonjudgmental, self-guided questionnaire to report partners; client stories; and bright images to accompany the text. Two-way SMS text messaging between clients and HCWs was deemed impractical based on risks of privacy breaches, national patient privacy regulations, and HCW workload. ConclusionsIt was feasible to conduct HCD research in Ukraine in a wartime setting. The CASI-Plus mHealth tool was acceptable to both HCWs and clients. The next step for this research is a randomized clinical trial of the effect of the REDCap-based CASI-Plus tool on the number of partners named and the rate of partners completing HIV testing.https://formative.jmir.org/2025/1/e66132 |
| spellingShingle | Nancy Puttkammer Elizabeth Dunbar Myroslava Germanovych Mariia Rosol Matthew Golden Anna Hubashova Vladyslav Fedorchenko Larisa Hetman Liudmyla Legkostup Jan Flowers Olena Nesterova Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study JMIR Formative Research |
| title | Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study |
| title_full | Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study |
| title_fullStr | Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study |
| title_full_unstemmed | Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study |
| title_short | Human-Centered Design of an mHealth Tool for Optimizing HIV Index Testing in Wartime Ukraine: Formative Research Case Study |
| title_sort | human centered design of an mhealth tool for optimizing hiv index testing in wartime ukraine formative research case study |
| url | https://formative.jmir.org/2025/1/e66132 |
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