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A youth-centred approach to improving engagement in HIV services: humancentred design methods and outcomes in a research trial in Kisumu County, Kenya

Publication Year: 2023
Contributing Organisation: Kenya Medical Research Institute
Authors: Eliud Omondi Akama, Laura K Beres, and Jayne Lewis Kulzer
Learning Themes: Adolescent Insights

Innovative interventions are needed to improve HIV outcomes among adolescents and young adults (AYAs)
living with HIV. Engaging AYAs in intervention development could increase effectiveness and youth acceptance, yet research is limited. We applied human-centred design (HCD) to refine adherence-support interventions pretrial and assessed HCD workshop acceptability.
Methods We applied an iterative, four-phased HCD process in Kenya that included: (1) systematic review of extant knowledge, (2) prioritisation of design challenges, (3) a co-creation workshop and (4) translation tables to pair insights with trial intervention adaptations. The co-creation workshop was co-led by youth facilitators employing participatory activities to inform intervention adaptations. Iterative data analysis included rapid
thematic analysis of visualised workshop outputs and notes using affinity mapping and dialogue to identify key themes. We conducted a survey to assess workshop acceptability among participants.
Twenty-two participants engaged in the 4-day workshop. Co-creation activities yielded recommendations
for improving planned interventions (eg, message frequency and content; strategies to engage hard-to-reach participants), critical principles to employ across interventions (eg, personalisation, AYA empowerment) and identification of unanticipated AYA HIV treatment priorities (eg, drug holidays, transition from adolescent to adult services). We revised intervention content, peer navigator training materials and study inclusion criteria in response to findings. The youth-led HCD workshop was highly acceptable to participants.
Research employing HCD among youth can improve interventions pre-implementation through empathy, youth-led inquiry and real-time problem solving. Peer navigation may be most influential in improving retention
when engagement with young people is based on mutual trust, respect, privacy and extends beyond HIV-specific
support. Identifying opportunities for personalisation and adaptation within intervention delivery is important for
AYAs.

Related Resources

Adolescent Insights
Global Health
Measurement & Evaluation
Quality & Standards
Youth Integration

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