1. Wellness web 2.0 Coastal Bend Wellness Foundation
Alison Johnson & Hillary Vallejo

2. Outreach and Recruitment
Target population
Youth and young adults ages HIV+ MSM of Color
Our data shows:
In Texas -
African Americans and Hispanics account for 79% of new HIV infections in Texas
Youth and young adults account for 57% of all new HIV infections in Texas
80% of new positives identified in 2014 reported MSM sexual activity as their primary risk

3. Outreach and Recruitment
Target population: South Texas Area
3,309 people living with HIV (PLWH)
257 were newly diagnosed with HIV
159 reported MSM as the primary mode of exposure (64%)
61 newly diagnosed HIV+ were ages13-24 (24%)
Corpus Christi HSDA:
831 PLWH (25%)
54 newly diagnosed (21%)
565 Black or Hispanic PLWH (68%)
41 PLWH were ages (5%)
439 PLWH reported MSM (53%)
Corpus Christi HSDA Counties: Aransas, Bee, Brooks, Duval, Jim Wells, Kenedy, Kleberg, Live Oak, McMullen, Nueces, Refugio, San Patricio (Web Wellness 2.0 Service Area)
2014 Texas DSHS Data

4. 2014 Texas DSHS Data

5. Outreach and recruitment strategies
Collaborate with separately funded CBWF Outreach programs:
DSHS funded HIV testing programs targeting MSM and African American
YNOT – LGBT youth advocacy program
Collaborate with CBWF FQHC Clinical staff & Ryan White Case Managers
Collaborate with DIS & HIV Surveillance
Maintain an active presence on social media platforms and social networking apps
Raise awareness about Wellness Web program
Campaigns to promote HIV status awareness, care engagement and retention
Peer Volunteers
Collaborate with separately funded CBWF Outreach programs: identify those infected with HIV but unaware of their HIV status
Project CARE – testing program that targets MSMs and African Americans
Project FREE – testing program that targets MSM substance users
YNOT – LGBT youth advocacy program
Collaborate with CBWF FQHC Clinical staff & Ryan White Case Managers
Seek referrals for patients who have been referred for HIV medical care, dropped out of care
Collaborate with local Health Department:
Seek referrals for individuals newly identified as HIV positive identified in partner services and public health follow-up, HIV surveillance identifies those who have are not retained in care, not had at least one visit, not achieved viral suppression, etc.
Maintain an active presence on social media and social networking apps
Raise awareness about Wellness Web program
Encourage linkage to care and medication adherence
Recruit individuals who are unaware of their status to come in for testing
Peer Volunteers: “health promotora model”, recruit and train target population on WW2.0 and disseminate within their “social network”, promote HIV status awareness, promote linkage to care, train community peer volunteers to reach out to individuals within their social networks and engage in case and case management, retention

6. Outreach & Recruitment Settings
CBWF Outreach Programs:
Streets, bars, clubs, LiveChat
Pass out flyers, brochures on Wellness Web
Community mobilization events
Example: National HIV Testing Day
CBWF FQHC Clinical Staff & Ryan White Case Managers
Flyer, brochures, etc.
In-reach; in-person introduction by Social Media Specialist
Local Health Department
In-person introduction when possible by Social Media Specialist
Referral made by DIS or HIV Surveillance
(DSHS funded HIV testing programs) Community engagement to those they identify to be eligible for WW2.0 (newly HIV+, out of care, etc), promote the importance of community mobilization events using social media platforms
In-reach, using existing databases to identify potential patients who have missed appointments, who are have seen the doctor, etc; the clinical staff and case managers can make a in-person introduction prior to establish online support to increase access to and retention in care
In-reach, using existing databases to identify potential patients who have missed appointments, who are have seen the doctor, etc; the clinical staff and case managers can make a in-person introduction prior to establish online support to increase access to and retention in care (partner services and public health follow-up)

7. Outreach & Recruitment Settings
Social Media Platforms: Facebook, Twitter, Instagram, YouTube
Campaign messages: promoting linkage to care, social support, medication adherence and HIV-related health information
Example campaigns targeted towards linkage to care: “Live longer. Live Stronger.” “Get connected.” “Are you in?”
Managed by Social Media Coordinator & Social Media Specialists
Social Networks Apps: Grindr, Growlr, Jack’d, Scruff and Adam4Adam
Active presence – Passive approach
Schedule HIV testing appointments
Connect and retain target population at different stages of the HIV care continuum
Social media platforms:
Select content may be “boosted” to target a specific demographic (advertisement on FB, twitter, etc.)
Media content present to community stakeholders on a frequent basis to ask for feedback, make sure it is relevant, appropriate, etc.
Social Network Apps:
Passive Approach-The preferred approach is more passive. This approach involves sitting in a chat room after a brief introduction or allowing online clients to initiate contact. Some apps have an exception, like Adam4Adam & GROWLr, which logs a “view” to a member’s profile once it is clicked on increasing the likelihood of further interaction. This approach may be less effective in terms of reaching significant numbers of people in a cost-effective manner; however, it creates a receptive environment of respect and trust.
Active Approach-An active approach is generally more aggressive and can involve techniques that entice users to communicate in private messaging sessions. The most common techniques involves sending frequent mass communications, posting health-related messages regularly and openly in public chat sessions, and actively contacting online clients suspected of high-risk behavior based on their profile or chat conversation.
Different stages of HIV care continuum: 1) unaware of HIV status, encourage/link to testing, 2) diagnosed HIV+ but out of care, promote HIV medical care/link to care/ARTAS, 3) in-care but non-compliant with treatment, provide support and encourage (mobile wellness), 4) in care but not achieved viral suppression, mobile wellness/appt reminders/support services

8. Outreach & Recruitment Challenges
Access to Social Media Platforms and/or Social Networking Apps
Internet/Smart phones with data plans and/or WiFi
Frequently changing numbers, limited number of text messages
Language barriers – Large Hispanic, Spanish-speaking population
Cultural influences & common occurrence of individuals seeking health care only once an illness has severely progressed
Peer Volunteers: Guide individuals to places where Internet is readily available, such as public libraries and local businesses with free Wi-fi
Social Media Specialists and Peer Volunteers: Pop-up Internet Cafés where individuals can access Internet and health information through provided iPads and laptops
Bilingual staff are available to deliver intervention in Spanish and translate social media content in English and Spanish; Bilingual and culturally competent staff members; Community stakeholders will review social media campaign messages to make sure they are relevant and appropriate; Peer volunteer program link us to communities, volunteers will be of the population
Late diagnosis of HIV+, late stage AIDS

9. Outreach & Recruitment Challenges
Mistrust of online information
Frequently changing screennames on social networking apps could make follow-up difficult
Social Networking Apps Guidelines & Restrictions
Change the purpose of social media and social networking engagement
Age Demographic-wide range 13 years to 34 years
Policies in place to ensure information posted to social media is accurate, Strict privacy and confidentiality policies, Social Media staff will uphold CBWF’s professional reputation and maintain strict standards of communication
Run the risk of being blocked or banned for engaging in “outreach” and soliciting purposes
“entertainment”, “hook-up” vs. “health information” seeking “social support” “positive”
When targeting outreach and recruitment on a large, general scale for the whole age range the needs for the entire group are much different across the spectrum

10. Determining Eligibility
Minority - African American/Black; Hispanic/Latino
Men who have sex with Men
Youth and Young Adults, ages 13 to 34 years old
HIV status:
Aware of their HIV status, but have never been engaged in care
Aware HIV+ but have refused referral to care
HIV+ ,out of care
HIV+ but are unaware of their HIV status
HIV+ but have not achieved viral load suppression
Willing and able to access social media/social networking information

11. Screening & Enrollment Process
Screening will take a series of questions, a dialogue of open-ended questions
Demographics (DOB, Race/Ethnicity)
Sexual history, sexual orientation, sexual preference, etc.
Technology/device most used to access internet
Social media/social networking accounts used
HIV medical history
First diagnosed HIV+
Last medical appointment
Demographics can be collected based on profile
Identify MSM
This is not a exclusive or inclusive list to replace the ETAC multi-site survey
Identify if the client is already using a SM platform of SN app the intervention is using or willing to create an account to access the intervention

12. Screening & Enrollment Process
What is your screening and enrollment process?
Screening
In-Social Media/Social Network App engagement
Eligibility
Questionnaire
Inform about program criteria
Referral
Eligible: WW2.0
Non-Eligible: Ryan White
Enrollment
In-person
Social Media Specialists

13. Challenges in determining eligibility
Potential challenges:
Documentation/Identification of age
Proof of HIV+ status
Defining those “out of care” and “retained in care”
Disclosure of MSM sexual risk
Ages 13-34
for those who do not have documentation of their HIV+ status, it may take a while to obtain such from CBWF testing programs
“retained in care” – did not have 2 episodes of HIV care & treatment in 12 month period; “out of care” – at least one HIV care & treatment
MSM activity not disclosed to other partners, past experience, etc.

14. Discussion Alison Johnson | alisonj@cbwellness.org
Hillary Vallejo |