Abstract:
Khuluma is a psychosocial and peer-to-peer mHealth intervention that uses text
messaging to facilitate support groups for adolescents living with HIV (ALWH) with the
aim of contributing toward positive health outcomes. Although use of mobile technology
in the form of mHealth interventions has proliferated recently in the field of health,
published literature describing methods and processes of its application are limited.
We present a set of methods and processes utilised to develop and pilot the Khuluma
mHealth intervention amongst young people (15–20 years) in South Africa. We recruited
and enrolled 52 adolescents (15–20-year olds) from four clinics in Pretoria and Cape
Town to participate in a 6-month pilot of Khuluma. Participants were ALWH, aware
of their status, on antiretroviral therapy for more than 12 months, and not suffering
from severe depression. We conducted four pre and post intervention focus group
discussions (FGDs) with a proportion of ALWH (n = 36) enrolled in the pilot study using
participatory methods. Several processes were utilised to then implement this pilot study.
These included engaging ALWH for minor study implementation modifications; forming
virtual groups; activating the mHealth platform; facilitating and delivering the Khuluma
intervention. The acceptability of the intervention was informed by follow-up focus group
discussions and text message data. The initial participatory processes helped to tailor
the intervention design to participants’ needs. The peer-led facilitation of the groups
allowed for the provision of sensitive psychosocial support that allowed young people
to express themselves freely, develop a sense of self-worth, and interact more. The
nature of themobile technology also allowed participants to build friendships beyond their
geographic area and interact with their peers in real time. Within the evolving context of COVID-19, establishing evidence-based processes and methods for intervention design
and curation in virtual spaces is critical.
