Table 3:
Crowdsourcing for HIV and sexual health implementation science based on the RE-AIM framework14
| Potential role for crowdsourcing | HIV examples and references | |
|---|---|---|
| Reach | 1. By using local and audience-friendly language suited for specific contexts, crowdsourcing can reach individuals from communities who may have language barriers. | CrowdOutAIDS led by UNAIDS organized open forums in all languages spoken in the BRICS countries (Brazil, Russia, India, China and South Africa) to minimize language difficulties. 6 |
| 2. Crowdsourcing engages at-risk targets groups during intervention development and evaluation, increasing the potential reach of the intervention. | 1. CrowdOutAIDS reached 3,295 youth participants from different regions worldwide online and 1,605 participants offline.6 2. Over 14 weeks, the in-person community events of an HIV cure open contest reached 144 participants in North Carolina. The online promotion channels reached 80,624 unique users.4 3. A crowdsourcing intervention study to promote HIV test among Chinese MSM showed that their messages reached 91.4% of men recruited in the study, and 67.1% of them shared at least one image or text.15 |
|
| Efficacy | HIV and sexual health interventions developed using crowdsourcing methods have increased HIV test uptake rates among MSM. | 1. One RCT showed that, compared to the control period, the crowdsourcing intervention significantly improved HIV test uptake rate among Chinese gay men, especially HIV self-testing. 16
2. Another RCT comparing the effects of crowdsourced HIV test promotion videos and expert driven health marketing videos found that the former had similar effects on improving HIV testing but higher community engagement.8 |
| Adoption | Crowdsourcing may increase adoption of an intervention by including key stakeholders, including key populations, in decision making roles. | 1. The child sexual abuse incident reporting program involved both church organizations and government in the program development process. This activity resulted in more actions against child sexual abuse by both churches (i.e., adopting guidelines and framework for preventing and managing child sexual abuse, as well as research project on the topic) and the government (i.e., amending laws to strengthen victims’ rights).12, 17 |
| Implementation | 1. At the individual level, crowdsourcing may be easier to implement because it draws on local user preferences, styles, and culture that are known to influence implementation. | 1. A RCT evaluating the effectiveness of a crowdsourcing intervention on HIV test uptake among an MSM sample showed that 62% of them tested for HIV during the study period.16 |
| 2. From an implementer perspective, an intervention designed for the local health system may be easier to implement. | 2. Following the guidance from the study team, local CDC and gay community organizations in all eight study sites in an intervention program implemented a story contest with contextual adaptations to promote HIV testing among local MSM,16 which resulted in increased likelihood of facility-based HIV testing behaviors.15 | |
| Maintenance | 1. From the individual perspective, crowdsourcing may increase trust in health services that is known to be important for maintaining an intervention over time. | 1. In a crowdsourcing intervention study, among MSM participants, the proportion who maintained HIV testing every three months after the intervention ranged from 32.0% to 39.4% at the end of the 12-month study, compared to 19.1% to 29.0% before the intervention.16 |
| 2. Crowdsourcing activities also have strong community ownership, resulting in more active engagement in maintaining or scaling a program. | 2. The open source electronic medical record application (OpenMRS) was established and applied to HIV/AIDS and Tuberculosis patients and treatment information management in developing countries. This system enabled local implementers and developers to freely collaborate and discuss technical issues pertaining to the development of OpenMRS system. This model has been maintained since its first establishment in South Africa in 2006 and replicated in several other African sites.18 |
R: Reach, ie proportion of the target population that participated
E: Efficacy, ie success rate at changing desired outcomes
A: Adoption, ie proportion of target settings involved
I: Implementation, ie extent to which the program was delivered as intended. Measures of implementation has both individual and program levels. Measures of individual-level implementation include participant follow-through or “adherence” to regimens, while measures of program-level implementation mainly include to what extent staff members deliver the intervention as intended.
M: Maintenance, ie extent to which the program outcomes (at the individual level) and program availability (at the setting level) were sustained over time