The History of HealthMpowerment
Tested strategies. Proven results. The HealthMpowerment platform’s risk reduction findings.
Overview of HealthMpowerment Findings
Reductions in Condomless Anal Intercourse
HMP has effectively reduced condomless anal intercourse (CAI) and HIV-related stigma among young Black men who have sex with men (YBMSM) living with and at-risk for HIV.
HMP 1.0 was tested in a statewide randomized controlled trial (RCT) in North Carolina with 474 Black men who have sex with men (MSM) aged 18-30 and found statistically significant reductions in CAI.
More Effective When Used 60+ Minutes
The intervention was more effective for participants who used HMP for more than 60 minutes during the 3-month intervention period.
Improved HIV Care Outcomes
In subsequent mixed-methods analysis, online discussions around HIV stigma were associated with HIV-related communication (e.g., provider communication, HIV status disclosure to sexual partners) and improved HIV care outcomes (e.g., perceived barriers to treatment access, engagement in care, self-reported adherence) over time.
Perceptions of HIV Stigma
In HMP 1.0, participants living with HIV whose posts in the forum challenged HIV stigma were more likely to report easier access to treatment and more likely to be in care. Conversely, participants whose posts reflected anticipated HIV stigma were less likely to be in care and to have had a recent viral load test. Participants who shared experiences of HIV stigma were more likely to report lower ART adherence over time.6
Primary Outcome
High levels of user satisfaction and interest and low levels of website difficulty and frustration.
Secondary Outcome
A trend in greater behavioral intentions to use condoms and engage in preparatory condom use behaviors in the intervention group (p 0.10).
Secondary Outcome
A reduction in mean scores on the CES-D scale among those in the intervention group (not statistically significant).
Recommendations for Improvement
Through participant feedback and input, we iteratively refine the HealthMpowerment platform to ensure it meets the evolving needs of our research initiatives.
The thoughtful recommendations below from participants in HMP 1.0 have guided significant platform improvements and new feature development.
Timeline of Development
HealthMpowerment Mobile
In 2013, we launched a trial for a mobile phone optimized, online intervention for young Black men who have sex with men (YBMSM) aged 18-30, designed to reduce risky sexual behaviors and promote health and wellness. The mobile app was based on behavior change theories and incorporated gamification principles to drive participation and engagement.
Randomized Controlled Trial
The randomized controlled trial (RCT) enrolled 474 YBMSM and transgender women with high risk sexual activity within 6 months of screening.
Fostering Community
The research study built community networks by including peer support based on shared experiences, reinforcing positive behavioral norms, reducing social isolation, and bringing together YBMSM.
Updated Features
The forum was the most popular feature; topics included HIV testing, STI testing, dealing with depression, and HIV medications. The next most popular feature was Ask Dr. W. Participants described the reward elements of exceeding their previous scores and earning points toward prizes as highly motivating.
The Results
At baseline, 40% were living with HIV, 56% were not living with HIV, and 4% didn’t know their status. The RCT found statistically significant reductions in condomless anal intercourse.
HMP group (IR 0.68, 95% CI: 0.43, 0.93) and the intervention was more effective for participants who used HMP for more than 60 minutes during the 3-month intervention period.
In subsequent mixed-methods analysis, online discussions around HIV stigma were associated with HIV-related communication (e.g., provider communication, HIV status disclosure to sexual partners) and improved HIV care outcomes (e.g., perceived barriers to treatment access, engagement in care, self-reported adherence) over time.
HMP Stigma
Building upon HMP 1.0, HealthMpowerment 2.0, also known as HMP Stigma, is an app-delivered intervention designed with and for young, Black and Latinx gay, bisexual and other men who have sex with men and transgender women. The intervention aims to improve HIV prevention and care by providing a platform where participants can find social support, build community, and engage with issues that matter to them.
The app includes educational information on a range of health and lifestyle topics, delivered in a variety of formats (e.g. articles, quizzes, activities). HIV testing, prevention, and care resources are provided through an “Ask the Expert” feature hosted by a health navigator and board-certified infectious disease physician. The HMP approach strives to amplify resilience among participants by bringing diverse people together in dialogue as a critical step toward change.
HMP NextGen
HMP NextGen
IDHI and One Cow Standing have received a $1.9 million Small Business Innovation Research (SBIR) grant from the National Institute on Minority Health and Health Disparities.
Building on years of prior human-centered design and research for our HealthMpowerment platform, this grant allows us to refine and evaluate our digital health intervention, HMP NextGen.
Digital health intervention creators face major barriers when developing, maintaining, disseminating, and scaling evidence-based tailored interventions. This grant will allow HMP NextGen to deliver significant efficiencies to intervention developers, and improve the likelihood of efficacy across a wide range of potential populations and health conditions.
With a goal of improving health outcomes, HMP NextGen will pave the way for:
Aim 1
Optimize HMP by developing cloud-based content management system and real-time analytics dashboard
Aim 2
Using a human-centered design approach, develop and integrate new tools to streamline app onboarding and configuration for faster launch timelines
Aim 3
Rigorously evaluate HMP NextGen’s impact through a series of simulated studies run with our collaborative partners who have utilized HMP in both past and ongoing projects