April 6-8, 2014 San Francisco, CA

Annual Conference on Youth + Tech + Health  

What’s in your toolbox? Simple and cost effective electronic tools for facilitating research with youth

Scott White, MPH Tulane University School of Public Health and Tropical Medicine

New Orleans, Louisiana

•  Member of the research team in the Infectious Diseases Section of the Dept. of Epidemiology at Tulane University School of Public Health and Tropical Medicine, New Orleans, LA

•  Research projects focus on STI/HIV and unintended pregnancy among hard to reach populations –  Young African American men –  Young African American women –  Latino migrant men and women –  Patients at a public STI clinics

My background

•  Formative research to understand the context, perspectives and priorities of the community

•  Work with community partners to refine protocols and build trust

•  Learn the language •  How to communicate the project? •  How to interest the target population? •  How to establish rapport? •  How to stay relevant and meaningful to youth? •  Social media

•  see Jakevia Green’s presentation on ‘Tweet Intercepts”

How do we engage youth in our research?

•  Field recruitment •  Go to community events •  Work with community partners •  Street intercept •  Peer referral

•  Clinic recruitment •  Potential participants referred to us from staff

Traditional methods used for recruitment

•  What can we add to our toolbox to engage youth? –  Smart phones and other mobile devices are increasingly used in

research as more and more young people have them –  Voicemail and email use are minimal –  Social media is growing and growing –  Translating traditional research methods and tools to new

technologies must make sense to youth, address privacy and data management concerns, and be cost-effective in order to be adopted and successful

•  This presentation will outline 4 electronic tools that we have incorporated in our research to help us improve the experience of youth and the success of our programs

Now + technology

1)  Visual text messages

2)  Podio – project management app

3)  Dashboard for network recruitment 4)  Diary app

4 tools

•  Translation of paper cards/email messages to electronic visual texts

•  NO COST TO YOU!

•  Easy to create and update often to keep fresh

1) Visual Text Messages

•  Simple way to reach participants or potential participants that youth find relevant and convenient

•  May be especially effective with hard to reach populations where social/sexual network recruitment (i.e., snowball recruitment) is key

Visual texts

•  Simple way to provide recruitment information at events

•  Facilitates social/sexual network recruitment

•  As referral cards

Visual texts

Use for checking in with participants to recognize their progress

Can quickly and easily notify people of changes in venues or events

1) Reformat your paper referral cards so that they optimally use the dimension of smart phones

•  In our cases we went from horizontal to vertical format •  Use any photo editor or publishing program •  Save as an image file (i.e., .jpeg or .png)

2) Email the image to yourself and open on your smartphone

3) Save the image on your smartphone

4) Text away!

How to create visual texts in 4 EASY steps

•  Free and low cost options •  Point and click app building functionality

–  No knowledge of coding required –  700 pre-built apps available for free

•  Online dashboard and mobile enabled apps –  Enables real-time monitoring of study activities on smartphones

•  Additional coordination and communications functionality –  Task management, file sharing, calendaring, team commenting

2) Podio – Project Management Software with App building Capabilities

Podio – App Building

Podio – Real-time monitoring

•  Built by Apptitude for Tulane to manage recruiters, link participants, and automatically send text message referrals for social network recruitment

•  Utilized for Check It! – community test and treat project for chlamydia and gonorrhea infections

•  Designed to be user friendly for the staff

•  Designed to overcome barriers in participation •  Immediate feedback •  Potential referral acceptability (i.e., not recognized as SPAM)

3) Dashboard for Network Recruitment

Referral Dashboard

Referral Activation Par$cipant  Receives   Referral  Receives  

Immediate  feedback  to  par0cipant!  

Naming  the  par0cipant,  their  neighborhood  and  the  university  establishes  trust  with    the  poten0al  referral!  

Referral Coupon •  Coupon includes public

health message, eligibility criteria, contact information and activation code

•  Activation code is based on the referring participant, which allows us to monitor referral success

Referral Monitoring Dashboard

•  When referrals present with their coupon, we can quickly activate them and repeat the process

•  Export functionality for data analysis

•  Need for a weekly diary that is easy to use •  Behaviors related to Trichomonas vaginalis treatment and

exposure

•  Diary taken each week between baseline and follow up visit at 4 weeks

•  Needed secure, mobile base option

•  App based vs. internet based •  Phone is easier to access

•  Push notifications can be sent easily as reminders

4) The Diary App

•  App developer – Apptitude worked with research team to design the app

•  Simplified content for phone

•  Discrete icon used

•  Password protected

•  Push notifications on day of survey

•  HIPAA compliant server

TWS sexual diary app

TWS sexual diary app •  Interactive survey design

•  Study team imports user specific variables to create unique skip patterns

•  Survey dynamically responds to participant responses to skip additional questions

•  Various question types •  Samples in next slides

Question example 1: Calendar function

Question example 2: Multiple choice function

Question example 3: Enter initials of partners

Pros and Cons UPSIDE   DOWNSIDE  

Visual  Text  Messages   -­‐  No  cost  -­‐  Easily  customizable  -­‐  Can  embed  in  social  media  

-­‐  Manual  distribu0on    

Podio  –    Project  Management  App  

-­‐  No/low  cost  -­‐  No  coding  required  -­‐  Various  tools  

-­‐  Not  a  good  op0on  for  study  par0cipants  

Dashboard  for  Network  Recruitment  

-­‐  Automa0c  tex0ng  -­‐  Link  par0cipants  with  

ac0va0on  codes    

-­‐  Cost  -­‐  Par0cipants  don’t  

recognize  phone  number  

TWS  Sexual  Diary  App   -­‐  Easy  to  use  and  access  by  par0cipants  

-­‐  Push  No0fica0ons  as  reminders  

-­‐  Cost  -­‐  Time  to  develop    

Conclusion •  Collaborations between innovative technology

companies, health researchers, and youth community advisory panels can result in the development of research tools that are cost effective for researchers and relevant to youth

•  Solutions like these are translatable to other projects to improve the health of young people.

•  Apptitude, New Orleans, LA •  Podio, San Francisco, CA (US Office)

Technology partners

For more information contact Scott White swhite1@tulane.edu, 504-988-2392

Thank you to the co-authors of this presentation: Patricia Kissinger, PhD Norine Schmidt, MPH Jakevia Green, MPH Jen Latimer, MPH Steffani Bangel, BA and all of the staff and students who helped develop these tools and used them in the field.