Barriers and Facilitators to Implementing Keep It Up!, A Digital Health Intervention, in Community-Based Organizations

Alithia Zamantakis, Juan Pablo Zapata, Isaac Greenawalt, Ashley A. Knapp, Nanette Benbow, Brian Mustanski*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Despite ongoing investments in the development and testing of new digital interventions for HIV prevention, the widespread use of interventions with proven effectiveness remains limited. This study assessed real-world implementation of a digital HIV prevention intervention, Keep It Up!. The study aimed to identify barriers and facilitators to implementing Keep It Up! within community-based organizations (CBOs) serving racially diverse sexual and gender minoritized populations. The Keep It Up! trial is a type III effectiveness-implementation hybrid trial to compare two delivery approaches: direct-to-consumer and CBO-based implementation. This manuscript focuses on the CBO-based approach through interviews with CBO staff members before and during implementation (n = 37 and n = 25, respectively). Interviews were coded according to the Consolidated Framework for Implementation Research and thematically analyzed. Staff highlighted adaptability, leadership engagement, compatibility, and organizational culture as facilitators of Keep It Up! implementation. Identified barriers included self-efficacy, motivation, staff turnover, and partnerships and connections. CBO infrastructure, capacity, research experience, and processes influenced the relative importance of these barriers and facilitators. This study is one of the first to detail barriers and facilitators experienced by staff implementing a digital HIV prevention intervention in CBOs. Interviews illuminated the need for interventions like Keep It Up! for young men who have sex with men and detailed the need for additional strategies to assist CBOs unfamiliar with implementing digital health interventions. Trial Registration Number: NCT03896776.

Original languageEnglish (US)
Pages (from-to)3944-3955
Number of pages12
JournalAIDS and behavior
Volume28
Issue number12
DOIs
StatePublished - Dec 2024

Funding

Research reported in this publication was supported by the National Institute of Mental Health, National Institute on Drug Abuse, and Office of the Director of the National Institutes of Health under Award Number R01 MH118213. AAK\u2019s contributions were also supported by the National Institute of Mental Health (K01 MH121854). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Keywords

  • Consolidated framework for implementation research
  • Determinants of implementation
  • Digital health interventions
  • HIV prevention
  • Implementation science
  • Qualitative research

ASJC Scopus subject areas

  • Social Psychology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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