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HIV Prevention and Treatment Behavior Change and the Situated Information Motivation Behavioral Skills (sIMB) Model: A Qualitative Evaluation of a Community Health Worker Intervention in Rakai, Uganda

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Abstract

A community health worker (CHW) model can promote HIV prevention and treatment behaviors, especially in highly mobile populations. In a fishing community in Rakai, Uganda, the Rakai Health Sciences Program implemented a CHW HIV intervention called Health Scouts. The situated Information, Motivation, and Behavioral Skills (sIMB) framework informed the design and a qualitative evaluation of the intervention. We interviewed 51 intervention clients and coded transcripts informed by sIMB framework dimensions. Clients reported that Health Scouts provided information about HIV prevention and treatment behaviors and helped them manage personal and social motivations to carry out health-promoting behavior. Prominent barriers which moved clients away from behavior change included daily pill burdens, anticipated stigma, serostatus disclosure, substance use at social gatherings, and anticipated reactions of partners. Our study adds to the evidence establishing CHWs as facilitators of behavior change, positioned to offer supportive encouragement and navigate contextualized circumstances.

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Acknowledgements

We thank all participants and CHWs of the Health Scout intervention for their time and involvement in this study. We thank the RHSP department of Social and Behavioral Sciences leadership team and interviewers: William Ddaaki, Dauda Isabirye, Aminah Nambuusi, Ann Lindah Namuddu and Charles Ssekyewa.

Funding

This works was supported by the National Institute of Mental Health under Grant No. R01MH107275, the National Institute for Allergy and Infectious Diseases Division of Intramural Research, National Institutes of Health, and the Johns Hopkins University Center for AIDS Research under Grant No. P30AI094189.

Author information

Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, 1830 E. Monument St., 4th Floor, Baltimore, MD, 21205, USA

    Rose Pollard & Larry W. Chang

  2. Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Caitlin E. Kennedy & Larry W. Chang

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA

    Heidi E. Hutton

  4. Rakai Health Sciences Program, Rakai, Uganda

    Caitlin E. Kennedy, Jeremiah Mulamba, Ismail Mbabali, Aggrey Anok, Neema Nakyanjo & Larry W. Chang

  5. Department of Health Behavior Health Education, University of Michigan, Ann Arbor, MI, USA

    K. Rivet Amico

Authors
  1. Rose Pollard
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  2. Caitlin E. Kennedy
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  3. Heidi E. Hutton
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  4. Jeremiah Mulamba
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  5. Ismail Mbabali
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  6. Aggrey Anok
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  7. Neema Nakyanjo
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  8. Larry W. Chang
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  9. K. Rivet Amico
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were led by NN and RP, and supported by JM, IM, and AA. Data Analysis was performed by RP, CEK, LWC, and KRA. The first draft of the manuscript was written by RP and all authors commented on previous versions of the manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Rose Pollard.

Ethics declarations

Conflict of interest

Emocha Mobile Health Inc. is the company that developed and supported the smartphone application used in the Health Scouts intervention. Larry Chang is entitled to royalties on certain non-research revenue generated by this company and owns company equity. Specific to this study, Larry Chang will not receive royalties or compensation from emocha Mobile Health Inc. This arrangement has been reviewed and approved by the Johns Hopkins University in accordance with its conflict of interest policies. All other authors have no relevant financial or non-financial interests to disclose.

Ethical Approval

Ethical approval was obtained from the Johns Hopkins School of Medicine Institutional Review Board, the Research and Ethics Committee of the Uganda Virus Research Institute, and the Uganda National Council for Science and Technology.

Consent to Participate

Informed, written consent was obtained from all participants of this study.

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Not applicable.

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Pollard, R., Kennedy, C.E., Hutton, H.E. et al. HIV Prevention and Treatment Behavior Change and the Situated Information Motivation Behavioral Skills (sIMB) Model: A Qualitative Evaluation of a Community Health Worker Intervention in Rakai, Uganda. AIDS Behav 26, 375–384 (2022). https://doi.org/10.1007/s10461-021-03391-w

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  • DOI: https://doi.org/10.1007/s10461-021-03391-w

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