Global WACh

February 6, 2019

Drs. Anjuli Wagner, Irene Njuguna receive CFAR Int’l Pilot Award to engage hard-to-reach adolescents via WhatsApp

Drs. Anjuli Wagner, PhD (left) and Irene Njuguna, PhDc (right)

Congratulations Drs. Anjuli Wagner (Postdoctoral Research Fellow, Global Health) and Irene Njuguna (PhDc Epidemiology; Infectious disease researcher, Kenyatta National Hospital)!  They received a CFAR International Pilot Award for their project entitled, “WhatsApp focus group and respondent-driven sampling: novel approaches to engage diverse adolescents,” which aims to test new technology-based approaches to engage adolescents who do not typically seek HIV preventative and treatment services.  This one year project will take place in Nairobi, Kenya in collaboration with Kenyatta National Hospital.

In the HIV research field, there is a growing focus on engaging adolescents in the adaptation of interventions to address their high HIV incidence, suboptimal HIV testing, and poor engagement and retention in health care services.  Adolescents are a challenging population to engage as they fall in the gaps between pediatric and adult care systems, which fail to recognize their unique and distinct transition of physical, psychosocial, and neurocognitive development.  Recruiting adolescents at health facilities for interviews is one way to hear perspectives of what works and doesn’t work; however, it only captures the views of those who already are seeking services, leaving out other groups of adolescents who may be targets of future interventions.

This project will test respondent-driven sampling—a social network-based strategy used to collect data from hard-to-reach populations who may fear being identified with stigmatized behavior, such as injection drug users, female sex workers, and men having sex with men—in hopes of reaching adolescents from diverse backgrounds and health seeking behaviors.  Adolescents recruited from health facilities will act as “seeds” to recruit their peers for virtual focus groups through the popular mobile messaging WhatsApp application.  Each “wave” of participants will be compensated and given incentives to recruit the next wave of eligible peers for the project.  The team will determine whether adolescents recruited via WhatsApp are demographically distinct from those identified in a clinical setting.  They will also compare the WhatsApp virtual focus groups to traditional in-person focus groups in terms of content and depth of responses, and costs.

Adapting interventions to be specific and relevant to adolescent health needs, service delivery preferences, and outreach approaches is essential to link adolescents to care, reduce HIV transmission, and improve rates of survival.  We look forward to learning if the team’s novel approach can be cost-effective in resources and collects new insights on developing adolescent-friendly interventions.