1. Use of Social Media to Improve Engagement, Retention, and Health Outcomes along the HIV Care Continuum Evaluation and Technical Assistance Center (ETAC) University of California, Los Angeles

2. Outline Brief recap from first meeting Goal of initiative Goal of cross-site evaluation Eligibility Primary outcomes Summary of cross-site evaluation methods New material More details on cross-site evaluation methods –Who, how, when, etc. 2

3. Goal of Initiative Use social media interventions to engage and retain underserved, underinsured, and hard-to-reach youth and young adults in HIV medical care Goal of Cross-site Evaluation To facilitate and conduct a rigorous evaluation of innovative and effective social media interventions across demonstration sites 3

4. Eligibility Consistent across sites –Age Youth (13-24) Young adults (25-34) –HIV positive Variable across sites –Gender and sexual orientation identity (MSM, transgender, etc.) 4

5. Primary Outcomes HIV Care Continuum HIV diagnosis Linkage to HIV medical care Retention in HIV medical care Antiretroviral therapy Viral suppression 5

6. Evaluation Methods Study participant survey –i.e., multi-site evaluation Medical chart data Cost assessment Intervention exposure data Qualitative evaluation –Covered in next presentation by Ron Brooks 6

7. New Material 7

8. Common elements of cross-site evaluation methods Global unique ID (GUI) –Used to identify participants across all evaluation methods i.e., participant survey, medical chart data, cost assessment, intervention exposure –Assigned by demonstration sites 8

9. Common elements of cross-site evaluation methods Data collection tools programmed / provided to demonstration sites by ETAC team Delivery dates –September 2016 Baseline participant survey Intervention exposure forms –November 2016 Medical chart forms Cost assessment forms 9

10. Study Participant Survey WHO Ideally, data collection staff will not be intervention staff. –If sites plan to conduct interviewer- administered surveys, these may NOT be conducted by intervention staff. 10

11. Study Participant Survey HOW Audio Computer-Assisted Self-Interviews (ACASI) Administered using Questionnaire Design Studio (QDS) Further discussion of technical details in later presentation on ACASI overview –How to use QDS, save files, etc. 11

12. Study Participant Survey WHEN Recruitment / enrollment begins Sept 2016 (beginning of Year 2) Eligible participants surveyed at baseline and every six months (6, 12, and 18 months) up to 18 months Data collection will end 6 months before the end of the study period in Year 4 (February 2019) Sites need to transfer data to secure web portal on weekly basis 12

13. Study Participant Survey Preparation for Sept 2016 rollout Today First draft of baseline ACASI assessment Encourage sites to try out / give feedback during Breakout Session 1 Next steps…. Edit / correct assessment –Fix skip patterns, typos, etc. NEED SITES TO PILOT TEST –Please see me / site liaisons during break if interested 13

14. Study Participant Survey WHY 18 MONTHS (not 12 months)? What we would like to see between an intervention (-) and control arm (-) for mean outcome levels over time Linear trend that holds over 12 or 18 months 14

15. Study Participant Survey WHY 18 MONTHS (not 12 months)? What we often see … May be difficult to tell story with 12 months of data 15

16. Medical Chart Data Abstraction Abstraction of routinely collected data from: –HIV testing –Patient care –HRSA Ryan White Services Report (RSR) 16

17. Medical Chart Data Abstraction WHO Demonstration sites will be responsible for uploading data for eligible participants HOW Excel spreadsheets WHEN Data for each follow-up period to be uploaded within 6 months of that follow-up period e.g., Baseline data to be uploaded within 6 months after baseline 17

18. Costing ETAC will work with demonstration sites to report the annual cost of planning and implementation of demonstration site interventions. Costing categories include: –Personnel –Recurring costs –Capital investment (one-time costs) –Infrastructure (space) 18

19. Costing Vital to capture ETAC team also understands costing info can be confusing in knowing how to report We will schedule webinars to go over reporting details Emphasize a few more points on this today… 19

20. Costing Demonstration sites will be asked to report on costs by: Period (pre-implementation vs. post- implementation) Activity (community engagement, testing, patient navigation, case management) Intervention target (identification, linkage, retention, etc.) Source of resources (HRSA SPNS grant vs. “in-kind” costs) 20

21. Costing Costs associated with local and cross-site evaluation will be represented separately and are not included in the cost of demonstration site intervention implementation. 21

22. Costing HOW (similar to medical chart extraction) Excel spreadsheets Uploaded through web portal Will schedule webinars to go over details WHEN Data collected annually Due one month after submission of FFR 22

23. Intervention Exposure Data on units of service provided by sites e.g., Medical care, care coordination, education Challenge for this initiative Service can happen –In-person similar to prior ETAC initiatives –Through social media How do we capture this? –Lay out tentative plan to address –Open discussion at end 23

24. Intervention Exposure WHO / WHEN Human engagement (social media / in-person) Demonstration sites to record two types of information (similar to prior HRSA initiatives) Participant staff time / entered monthly Individual encounters with participants / entered daily Social media component (e.g., backend data) New for this initiative 24

25. Intervention Exposure HOW Web-based data entry form –REDCap Key difference from other evaluation data –Web-based data entry Data upload step not required 25

26. Intervention Exposure Data elements for individual encounters Site Participant ID Date Intervention provider –Outreach worker, patient navigator, case manager, etc. Provider type –Peer, non-clinical provider, clinical provider Type of contact –Private message (social media), text, e-mail, in-person, telephone Number of contacts –e.g., 1, 2-5, 6-10, more than 10 private messages 26

27. Intervention Exposure Data elements for individual encounters Functions (activities) –Adherence, medical care, care coordination, support, education Location (if in-person visit) –Medical office, non-medical office, outside, e.g. street / event Targets –Adherence, linkage, re-engagement, retention, viral suppression, other Duration of visits (if in person) 27

28. Intervention Exposure Social media component: Two parts What is being offered to study participants Entire sample (not personalized) –Partly captured by typology –ETAC will need short write-up on details, e.g. how many messages were sent on a daily basis, etc. Personalized –Captured through backend data (automatically collected) Participant engagement –Backend data (where applicable) 28

29. Intervention Exposure Backend data on participant engagement (where applicable) Total # of times logging into app / website For each login, total time spent using app / website –Obviously easiest if participant logs in / out –If not logging out, make assumptions on inactive period before it is assumed participant “logged out” For each login, # activities engaged in e.g., Participant clicks on different content areas of website 29

30. Thank You Questions?