Preparing Social Media Interventions for Replication Dallas Swendeman

HRSA Expectations in RFA Page 2, “Additionally, successful applicants will be expected to document the social media project’s implementation, including any manuals, tools, policies and protocols developed to administer the project for potential replication by others” Page 5, “Evaluation staff, with input from other staff, will be required to develop a manual to support replication of successful social media based interventions by other organizations within their State and by other Ryan White grantees.”

Overview: Timeline Nov 2016-Feb 2017 Feb – 2017 Jan to Jun 2017 Sites assemble existing materials in preliminary outline Feb – 2017 ETAC webinar for questions and suggestions from sites Jan to Jun 2017 At site visits and monthly calls sites/ETAC review and provide feedback on progress Jun 2017 Sites complete draft versions for peer review, sharing, and feedback during all-recipient DC meeting Nov 2017 Sites complete final versions

Why Manuals? Social media interventions seem easy to replicate Apps make available on app/play stores Automated text-messages – make message libraries available, maybe with a delivery platform/portal (if funds provided) Many components still require manuals, written protocols to be replicated by others Social marketing engagement (outreach and recruitment) strategies will require processes that can be replicated for quickly evolving and locally customized content Framework for conducting chat rooms / online discussion groups Procedures for “Live” or person-mediated text-/instant-messaging Strategies and procedures to enhance In-person interactions

Manual Components / Sections Introduction 2-3 pages Intervention Description Enough to support replication (use appendices for details) Lessons from the Field / Implementation Tips 1 to 3 pages Monitoring and Evaluation Enough to support replication (use appendices for measures & methods) Include progress indicators, milestones, or timelines Appendices All specific sample documents and other materials with details

Introduction – Road Map Rationale and Description of Need / Scope of Problem 1 - 2 pages “What is the problem being addressed?” “Why is intervention needed? What are the broad goals?” Epidemiologic evidence of need; Evidence for intervention approach Results of needs assessment Target Audience Up to ½ page “For whom was this intervention designed?” May not be the same as the evaluation inclusion/exclusion criteria “In which setting will the intervention occur?” Intervention Overview ½ to 1 page Briefly describe all elements of the intervention Provide intervention goals and key objectives and  how it connects to the care continuum outcome goals

Intervention Typology

Intervention Description Intervention Approach / Theoretical Framework Describe the overall intervention approach and theory (if applicable) “How and why is this intervention supposed to be effective?” Target Population Describe the diversity of patients intervention designed with and delivered to “Who is this intervention designed for?” “Will this intervention be appropriate for my population of patients/clients?” Make clear distinction between who designed for broadly versus evaluation Evaluation inclusion criteria may be more narrowly focused on those at highest need to ensure we detect impacts (i.e., room for improvement). Pre-Implementation Activities Describe processes and resources needed to prepare org and staff to adapt and deliver the intervention “What do we need to do to prepare to implement this intervention?”

Staffing, Training, & Partners Staffing Roles Describe different types staff needed for project “Who on our staff needs to be involved?” “Who do we need to hire?” Describe roles and responsibilities, and provide a project org chart Overview in text for each role - Job Descriptions in Appendices Key Staff Attributes “What have you learned about key attributes of successful staff in different roles?” “What attributes do I need to select for when hiring, partnering, contracting?” Training Overview of activities, scope, and time needed - protocols in appendix “What aspects of intervention can and need to be trained?” “How much time will it take?” Partners Describe types of partners that might be needed from outside an organization Technology partners, community partners, clinical partners, etc. “Who do we need to contract and partner with to implement this intervention?

Community Engagement Youth and Community Advisory Boards Describe roles, responsibilities and activities of the YAB/CAB “How did you work with CAB to optimize intervention design and delivery?” Describe how advisory board members are identified and incentivized “We already have a CAB. Do we need a new one for this project?” Outreach and Recruitment Describe outreach and recruitment methods “How do we get people to participate in this project?” Marketing / Social Marketing Describe and show examples of marketing strategies and materials “How did you market or promote this project?” Describe processes and refer to resources for designing marketing strategies “How can we best design a marketing campaign for our local project?”

Intervention Design Core Elements / Components Describe what aspects of the intervention can’t be changed to maintain integrity and efficacy “What can’t we change in this intervention?” Describe the aspects of the intervention can or should be tailored Adaptable Key Characteristics / Components Describe aspects of the intervention can or should be tailored, and how “What can and should we tailor for our population, here and now?” Describe procedures and strategies for adapting/tailoring components “How do we best adapt and tailor the functions and content?” Procedures / Protocols Describe the specific processes, instructions, etc. for delivery “How do we implement the intervention components, step-by-step?”

Core Elements Functions, not “Sessions”: From the Typology: Communication: Two-way interactive communication between participants and service providers Education: Two-way or interactive teaching of information or content. Sites briefly describe education strategy and content focus, etc. Information: One-way or "push" of content to inform participants (e.g. tips, referral resources, etc.) Gaming: "Gamification" functions embedded in the social media tools (e.g. point systems, rewards, incentives, or games). May have reference to other participants (competition) or not

Core Elements (cont.) Reminders Self-monitoring / tracking: general (other than HIV care): Reminders other than for HIV care appointments or ART adherence medical appointments: Appointment reminders for HIV medical care, delivered via the social media intervention tool medication adherence: Antiretroviral medication reminders: automated, live, auto & live Self-monitoring / tracking: Participants record or report information via the social media tool(s) (i.e. self-monitoring, logging, self-tracking) Skills building: Social media tools specifically designed to build skills through demonstration and practice Social support/networking: Provides opportunities to receive social support from peers, family, service providers or others

Technology Platforms / Channels How the functions are delivered From the Typology Mobile App: Smartphone applications (Apps), excluding social networking Apps/Sites (see Social Networking Apps) Social Media: Use of other social media and networking Apps/sites, excluding dating Apps Social Networking Sites/Apps: Use of existing social networking/dating mobile Apps/Websites (e.g. Grindr, Jack'd, Adam4Adam, etc.) Text Messaging: Via short message service (SMS) or private messaging (PM) Apps (e.g. What's App, Kik), or PM functions in mobile-web Apps or social media Apps/Sites Website: Websites that may be optimized for mobile device browsers or not (i.e., designed only for PC browsers)

Core Elements & Key Characteristics Core Elements might typically be: Adaptable Key Characteristics might be: Functions (from the typology) Platforms (specific channels) Tracking / Self-monitoring Specific domains tracked & how Core topics in information, education, and communication content Specific language and framing used in information, education, and communication content Processes for adaptation – procedures for tailoring and developing content Results from adaptation processes for tailoring and developing content Required staff characteristics Optional/preferred characteristics

Monitoring & Evaluation Evaluation plans and procedures Local and national Outcome/Impact indicators Process/Progress indicators Methods overview

Lessons from the Field Successes Challenges/Barriers “What were the impacts of the intervention?” Evaluation results – preliminary and final eventually Can include implementation successes – i.e., “Process Outcomes” – how many reached, served, etc. Give specific examples, case studies, stories Convince stakeholders, admin and funders Challenges/Barriers “What are the pitfalls we should be prepared to avoid?” “What are challenges that we can’t avoid and how can we be best be prepared to overcome them?” Tips for Future Implementation Recommendations for modifications for different delivery settings Summarize key points that supported successes and overcame barriers

Appendices Supporting Documentation (examples, not limited to): Intervention Protocol Communication Protocol Training Materials Job Descriptions Evaluation plans Forms (examples but not limited to): Referral forms Encounter forms for data collection Patient enrollment forms Progress notes Evaluation forms

Getting more detailed and design oriented: The Behavior Change Taxonomy

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