Crowdsourcing A Public Health Campaign

Institute for Global Health & Infectious Diseases (IGHID) 11604 - Crowdsourcing to Promote HIV Testing: A Stepped Wedge Randomized Controlled Trial to Evaluate Promoting HIV Testing in China

The purpose of this stepped wedge randomized controlled trial is to evaluate the effectiveness of a crowdsourced intervention on promoting HIV testing among young Chinese men who have sex with men (MSM). The crowdsourced intervention will include an open contest, judging to determine finalists and prizes, a designathon, and contest-based MSM engagement. The hypothesis is that a crowdsourced intervention will be superior to conventional HIV test uptake campaigns in eliciting HIV test uptake.

Study Overview

• Status: Completed
• Conditions: HIV
• Intervention / Treatment: Behavioral: Crowdsourced intervention; Behavioral: Traditional intervention campaign

Detailed Description

This study will use an adaptation of the stepped wedge randomized controlled trial design. A total of eight major metropolitan cities will implement the crowdsourced intervention. These cities will be chosen based on the following criteria: 1) previous Centers for Disease Control and Prevention (CDC) MSM sentinel surveillance site; 2) capacity for campaign implementation; 3) capacity for intervention implementation at the community level. Four cities will implement more intensive in-person events to promote engagement (Guangzhou, Shenzhen in Guangdong Province, Qingdao, and Jinan in Shandong Province) during survey intervention stage. The Randomized controlled trial (RCT) will be evaluated using two different sources of data: 1) online survey data from MSM in the eight cities prior to and after the intervention; 2) CDC routine surveillance data in the eight cities prior to and after the intervention.

• Study Type: Interventional
• Enrollment (Actual): 1381
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Currently living and planning to live in one of the eight cities used in the study in the next 12 months.
• Not living with HIV
• No HIV test in the past three months
• Born biologically male and identify as either male or transgender female
• Had anal or oral sex with men at least once during their lifetime
• 16 years or older
• Willing to provide cell phone number
• Complete the informed consent document

Exclusion Criteria:

• Women are excluded from this study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Immediate Intervention; Men will be exposed immediately to a comprehensive intervention promoting HIV testing.	Behavioral: Crowdsourced intervention; The crowdsourced intervention is composed of three phases that cumulatively draw on crowd wisdom to engage the community: (1) a crowdsourcing contest to solicit optimal images/concepts/taglines; (2) a designathon to formulate optimal HIV testing campaigns; (3) a process of localization unique to each of the eight cities.
Experimental: Delayed Intervention; Men will be exposed to a comprehensive intervention promoting HIV testing after a delay period.	Behavioral: Crowdsourced intervention; The crowdsourced intervention is composed of three phases that cumulatively draw on crowd wisdom to engage the community: (1) a crowdsourcing contest to solicit optimal images/concepts/taglines; (2) a designathon to formulate optimal HIV testing campaigns; (3) a process of localization unique to each of the eight cities.; Behavioral: Traditional intervention campaign; The pre-intervention period will include conventional HIV testing campaigns organized by local CDC, Community-Based Organization (CBO), and partners. These are typically designed by experts and social marketing companies.; Other Names: Conventional HIV testing campaign

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Men Who Have Sex With Men (MSM) Reporting HIV Testing in the Past Three Months	This will be assessed by self-report during a follow-up survey	From implementation roll-out to three months after implementation of crowdsourced intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Men Reporting Condomless Sex at 3 Months Post-intervention		From implementation roll-out to three months after implementation of crowdsourced intervention
HIV Testing Social Norms	HIV testing social norms will be measured using six survey items that are each on a five-point Likert scale. Increased HIV testing social norms will be defined as having an increase from baseline in any two of these six survey items and dichotomized accordingly. Number of men who report higher score of social norms when comparing their pre-intervention and post-intervention values	From implementation roll-out to three months after implementation of crowdsourced intervention
Change in HIV Testing Self-efficacy	Number of men who report higher levels of self-efficacy when comparing their pre-intervention and post-intervention HIV testing norms	From implementation roll-out to three months after implementation of crowdsourced intervention
Community Engagement/ MSM Community Affiliation	Number of men, defined as an increase in closer affiliation with the MSM community (i.e., tongzhi circle, gay online networks or groups) when comparing their pre-intervention and post-intervention periods.	From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Engaged in HIV Testing Community Campaign in the Past 3 Months		From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Being Self-tested for HIV in the Last 3 Months Post-intervention		From implementation roll-out to three months after implementation of crowdsourced intervention
Mean Score of Anticipated HIV Stigma	Measured by a 7-item version of the anticipated HIV stigma scale, designed to measure the extent to which participants anticipated negative intrapersonal and interpersonal consequences were they to contract HIV in the future. All seven items were rated on a Likert-type scale (1=Strongly Disagree; 4=Strongly Agree). The mean score is reported, ranged from 1 to 4. Higher values indicate greater anticipated stigma.	From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Being Tested for Syphilis in the Last 3 Months Post-intervention		From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Weibo in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing		From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Wechat in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing		From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Tencent QQ (QQ) in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing		From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Using Mobile Apps in the Past Three Months Post-intervention to Give or Receive Information About HIV Testing	Frequency of men, defined as the number of men who reported using mobile apps in the past three months to give or receive information about HIV testing comparing their pre-intervention and post-intervention engagement	From implementation roll-out to three months after implementation of crowdsourced intervention
Number of Men Reporting Received HIV Self-testing Kits in the Last 3 Months Post-intervention		From implementation roll-out to three months after implementation of crowdsourced intervention

Collaborators and Investigators

• Sponsor: University of North Carolina, Chapel Hill
• Collaborators: London School of Hygiene and Tropical Medicine; National Institute of Allergy and Infectious Diseases (NIAID); Shandong University; University of Bristol; Guangdong Center for Disease Prevention and Control; UNC-South China STD Research Training Center; UNC Center for AIDS Research; SESH Global; Guangdong Provincial Center for Skin Diseases and STI Control; Shandong Province Centers for Disease Control and Prevention
• Investigators: Principal Investigator: Joseph D Tucker, MD, PhD, jdtucker@med.unc.edu

Publications and helpful links

General Publications

• Tang W, Han L, Best J, Zhang Y, Mollan K, Kim J, Liu F, Hudgens M, Bayus B, Terris-Prestholt F, Galler S, Yang L, Peeling R, Volberding P, Ma B, Xu H, Yang B, Huang S, Fenton K, Wei C, Tucker JD. Crowdsourcing HIV Test Promotion Videos: A Noninferiority Randomized Controlled Trial in China. Clin Infect Dis. 2016 Jun 1;62(11):1436-1442. doi: 10.1093/cid/ciw171. Epub 2016 Apr 29.
• Zhang Y, Kim JA, Liu F, Tso LS, Tang W, Wei C, Bayus BL, Tucker JD. Creative Contributory Contests to Spur Innovation in Sexual Health: 2 Cases and a Guide for Implementation. Sex Transm Dis. 2015 Nov;42(11):625-8. doi: 10.1097/OLQ.0000000000000349.
• Tang W, Wei C, Cao B, Wu D, Li KT, Lu H, Ma W, Kang D, Li H, Liao M, Mollan KR, Hudgens MG, Liu C, Huang W, Liu A, Zhang Y, Smith MK, Mitchell KM, Ong JJ, Fu H, Vickerman P, Yang L, Wang C, Zheng H, Yang B, Tucker JD. Crowdsourcing to expand HIV testing among men who have sex with men in China: A closed cohort stepped wedge cluster randomized controlled trial. PLoS Med. 2018 Aug 28;15(8):e1002645. doi: 10.1371/journal.pmed.1002645. eCollection 2018 Aug.
• SESH Study Group, Tucker JD. Crowdsourcing to promote HIV testing among MSM in China: study protocol for a stepped wedge randomized controlled trial. Trials. 2017 Oct 2;18(1):447. doi: 10.1186/s13063-017-2183-1. Erratum In: Trials. 2017 Oct 23;18(1):495.

Helpful Links

• University of North Carolina website

Study record dates

Study Major Dates

• Study Start (Actual): July 1, 2016
• Primary Completion (Actual): August 1, 2017
• Study Completion (Actual): August 1, 2017

Study Registration Dates

• First Submitted: May 23, 2016
• First Submitted That Met QC Criteria: June 7, 2016
• First Posted (Estimate): June 13, 2016

Study Record Updates

• Last Update Posted (Actual): August 28, 2019
• Last Update Submitted That Met QC Criteria: August 15, 2019
• Last Verified: February 1, 2018

More Information

Terms related to this study

• Keywords: HIV; MSM; test uptake; crowdsourcing
• Other Study ID Numbers: 16-0851; R01AI114310 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided