Video-phone delivery of an effective behavioral intervention for women living with HIV at community-located intervention stations: Adaptation and implementation challenges and strategies

Issues: Numerous behavioral interventions have been developed and found effective for primary and secondary prevention of HIV infection. However, many were designed for in-person delivery, which is not always feasible. Group-based video-conferencing using Internet-based video-phones could expand access to efficacious HIV prevention interventions; yet, the literature provides little guidance regarding adapting interventions for video-phone and implementing video-phone interventions at community-based intervention stations.

Description: The present study explores challenges and solutions for adapting an efficacious HIV prevention intervention, Healthy Relationships, for video-phone delivery and subsequent implementation. Intervention adaption was guided by the ADAPT-IT model (Wingood & DiClemente, 2008) and involved a community advisory board (CAB). The adapted intervention was tested during a single-group pilot trial (n=4) and is currently being tested in a randomized controlled trial.

Lessons Learned: The ADAPT-IT model provided a useful framework for this technology-based adaptation. Major challenges for adaptation and implementation were: 1) video clip transmission--key to Healthy Relationships—was delayed over video-phone; 2) although text could be projected as with an in-person white board, the video-phone's small screen limited text quantity and visibility; and 3) not all group facilitators were well-suited to video-group delivery. Critical implementation elements included a dedicated Internet line, real-time technical support, a staff monitor at each intervention station location, and extensive coordination.

Recommendations: Group video-conferencing could expand access to effective behavioral interventions for HIV prevention. Implementing video-groups presents unique challenges; thus, creative solutions are paramount. Additional work must identify the infrastructure and human resources necessary for widespread video-phone intervention delivery.