A Neuro-Influence Experiment to Evaluate the Persuasiveness of Pre-Exposure Prophylaxis Promotion Messages Among Men Who Have Sex With Men: Protocol for a Randomized Controlled Trial.

BACKGROUND: Pre-exposure prophylaxis (PrEP) is recommended by the US Centers for Disease Control and Prevention, but behavioral factors limit uptake, especially among men who have sex with men. A better understanding of how humans cognitively process information may inform health message development to promote PrEP uptake. OBJECTIVE: This paper is informed by the neuroscience of persuasion and influence and describes the protocol of a neuro-influence experiment using functional near-infrared spectroscopy (fNIRS) to evaluate the persuasiveness of PrEP promotion messages among men who have sex with men in Baltimore, Maryland. METHODS: We will conduct a randomized controlled trial using fNIRS to measure brain activation among 60 participants viewing PrEP promotion messages either developed through a crowdsourcing open contest implemented by the study team or developed with a traditional social marketing approach. We will evaluate the effectiveness of PrEP promotion messages by assessing brain activation in the regions associated with persuasion and changes in PrEP willingness, behavioral intention, initiation, and action between the 2 groups. RESULTS: This study is funded by the National Institutes of Health (National Institute of Mental Health: R34MH116725). Participant recruitment and data collection were completed in October 2023. The first results are expected to be submitted for publication in 2024. CONCLUSIONS: In addition to providing insight into the effectiveness of PrEP promotion messages, this study will examine the feasibility, acceptability, and utility of neuroimaging techniques to evaluate PrEP promotion messages for high-risk men who have sex with men. The findings can also demonstrate the utility of fNIRS as a tool for preproduct testing of health campaigns and enable the public health community to deliver more effective messages to improve health outcomes. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/52546.

Crowdsourced PrEP Promotion Messages for an HIV High-Burden Area: A Framework-Based Content Analysis.

Pre-exposure prophylaxis (PrEP) is an important and highly effective HIV prevention strategy, but its uptake remains low, particularly among marginalized populations at high risk of HIV. Innovative and community-driven promotion strategies, such as open contests, are needed to address disparities. This directed content analysis uses a PrEP-specific adaptation of the Information-Motivation-Behavioral Skills (IMB) model to identify themes related to PrEP use reflected in community-generated submissions (n = 73) from an open contest conducted to elicit crowdsourced health promotion messages on PrEP in Baltimore, Maryland. In addition to identifying eight of the themes from the adapted IMB model, this analysis also identified two novel salient themes in the motivation category: self-worth/self-love and self-care practice. Findings from this analysis can inform PrEP promotion efforts by pointing to salient themes identified from a community-driven approach that are less well represented in existing research.

A Crowdsourcing Open Contest to Design Pre-Exposure Prophylaxis Promotion Messages: Protocol for an Exploratory Mixed Methods Study.

BACKGROUND: In the United States, black men who have sex with men (BMSM) are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) can reduce HIV incidence. However, real-world implementation of PrEP outside of clinical trials has identified racial disparities in PrEP awareness, uptake, and adherence. In the context of a long history of medical mistrust and power imbalances between scientists and community members, strategies to increase uptake of PrEP among BMSM should consider ways to ensure messages address the needs and priorities of the community. Crowdsourcing contests shift traditional individual tasks to a large group and may enhance community engagement. OBJECTIVE: This paper describes the research protocol of a contest approach to soliciting PrEP promotion messages among BMSM in Baltimore. METHODS: Open-contest implementation and evaluation will proceed as follows: (1) organize a community steering group; (2) develop platforms to solicit crowd input; (3) engage the community to contribute ideas through a Web-based forum and in-person events; (4) evaluate contest entries using both community panel judge assessment and crowd voting; (5) utilize mixed methods to evaluate feasibility, acceptability, and community engagement; and (6) disseminate contest results. RESULTS: This study was funded by the National Institutes of Health (National Institute of Mental Health: R34MH116725) in May 2018 and was approved by the institutional review board in April 2018. The open contest started in February 2019, and data analyses for the mixed method evaluation are expected to complete in December 2019. CONCLUSIONS: The contest will potentially bring new ideas in developing more impactful and locally defined PrEP promotion campaigns. We will determine whether an open-contest approach is acceptable among BMSM in Baltimore. If successful, this study can inform future projects using a similar approach on how to identify and implement programs and policies that are more responsive to community needs and that build up community assets. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/15590.