title: Developing a mHealth intervention to promote uptake of HIV testing among African communities in the UK: a qualitative study.
abstract: HIV-related mHealth interventions have demonstrable efficacy in supporting treatment adherence, although the evidence base for promoting HIV testing is inconclusive. Progress is constrained by a limited understanding of processes used to develop interventions and weak theoretical underpinnings. This paper describes a research project that informed the development of a theory-based mHealth intervention to promote HIV testing amongst city-dwelling African communities in the conditions.
  
  
  
  A community-based participatory social marketing design was adopted. Six focus groups (48 participants in total) were undertaken and analysed using a thematic framework approach, guided by constructs from the Health Belief Model. Key themes were incorporated into a set of text messages, which were pre-tested and refined.
  
  
  
  The focus groups identified a relatively low perception of HIV risk, especially amongst men, and a range of social and structural barriers to HIV testing. In terms of self-efficacy around HIV testing, respondents highlighted a need for communities and professionals to work together to build a context of trust through co-location in, and co-involvement of, local communities which would in turn enhance confidence in, and support for, HIV testing activities of health professionals. Findings suggested that messages should: avoid an exclusive focus on HIV, be tailored and personalised, come from a trusted source, allay fears and focus on support and health benefits.
  
  
  
  HIV remains a stigmatized and de-prioritized issue within African migrant communities in the UK, posing barriers to HIV testing initiatives. A community-based participatory social marketing design can be successfully used to develop a culturally appropriate text messaging HIV intervention. Key challenges involved turning community research recommendations into brief text messages of only 160 characters. The intervention needs to be evaluated in a randomized control trial. Future research should explore the application of the processes and methodologies described in this paper within other communities.
authors.affiliation: School of Health Sciences, University of Nottingham, A Floor, South Block Link, Queen's Medical Centre, Nottingham, NG7 2HA, United Kingdom. catrin.evans@nottingham.ac.uk.
authors.forename: C
authors.identifier: 0000-0002-5338-2191
authors.initials: C
authors.lastname: Evans
authors.affiliation: School of Health Sciences, University of Nottingham, A Floor, South Block Link, Queen's Medical Centre, Nottingham, NG7 2HA, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Turner
authors.affiliation: BeCHANGE Research Group, Institute for Public Communication, Faculty of Communication Sciences, Università della Svizzera italiana, Lugano, Switzerland.
authors.forename: L S
authors.initials: LS
authors.lastname: Suggs
authors.affiliation: BeCHANGE Research Group, Institute for Public Communication, Faculty of Communication Sciences, Università della Svizzera italiana, Lugano, Switzerland.|School of Communication, University of Miami, Miami, USA.
authors.forename: A
authors.initials: A
authors.lastname: Occa
authors.affiliation: African Institute for Social Development, Nottingham, United Kingdom.
authors.forename: A
authors.initials: A
authors.lastname: Juma
authors.affiliation: School of Health Sciences, University of Nottingham, A Floor, South Block Link, Queen's Medical Centre, Nottingham, NG7 2HA, United Kingdom.
authors.forename: H
authors.initials: H
authors.lastname: Blake
mesh_terms: D000328:Adult; D000349:Africa; D044383:Black People / Q000523:psychology; D055812:Community-Based Participatory Research; D005260:Female; D017144:Focus Groups; D015658:HIV Infections / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010465:Perception; D036301:Qualitative Research; D040241:Social Marketing; D013240:Stereotyping; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D060145:Text Messaging
keywords: African; Community-based participatory research; HIV testing; Social marketing; Text messaging; mHealth