Evaluation of the Positive Peers Mobile App for Supporting the Viral Suppression of Young People With HIV: Protocol for a Concurrent Mixed Methods Evaluation With Randomized Controlled Clinical Trial and Observational Cohort
Bibliographic record
Abstract
BACKGROUND: People at greatest risk for poor HIV outcomes include young (13-34) people of color who have sex with men. Individuals in this population are least likely to be aware of their HIV status and are at the highest risk for disengaging from medical care and antiretroviral therapy. The Positive Peers mobile app (PPA) was designed to engage this population with real-time social support, HIV and healthy lifestyle information, and medical management tools. We expect that greater PPA engagement will predict key HIV care outcomes. Study predictions are grounded in a user-centric model of digital media use and the perceived affordances of the PPA. OBJECTIVE: This study aims to determine the optimal deployment of the PPA in clinical settings (at enrollment vs delayed start) and to compare intervention outcomes with a no-intervention, observation-only condition. The PPA is designed specifically for key HIV disparity populations, including younger sexual, gender, racial, and ethnic minorities. METHODS: The Positive Peers Intervention Trial (PoPIT) is a multisite, randomized clinical trial designed to evaluate the effectiveness of the PPA as a tool for use in clinical settings. Trial arms compare the immediate deployment of the PPA with usual care and observation only. This protocol outlines a mixed methods design consisting of concurrent prospective self-report questionnaires, in-depth interviews with PPA users, and medical record review. PoPIT questionnaires include measures of social determinants of health, HIV-related stigma, perceptions of digital media use, self-efficacy, substance use, and social support. Multiple aspects of PPA intervention engagement are measured natively within the app. Outcomes include HIV National Quality Forum indicators and perceived HIV-related stigma. RESULTS: The research protocol (1R01MD019185-01) was funded for US $903,363.00 in direct costs by the National Institute for Minority Health and Health Disparities on September 24, 2023, for 5 years. The study began recruiting patients on June 3, 2024, and will continue accrual until November 27, 2026. CONCLUSIONS: Findings will provide evidence of the usefulness of the PPA as a support tool in HIV clinical care. Primary results will inform optimization of PPA deployment and evaluate a theoretical model of user engagement with a mobile health management app. Qualitative data will provide a phenomenological description of intervention engagement and perceived user efficacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT06388109; https://clinicaltrials.gov/ct2/show/NCT06388109. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/87601.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.084 | 0.065 |
| Meta-epidemiology (narrow) | 0.008 | 0.004 |
| Meta-epidemiology (broad) | 0.010 | 0.008 |
| Bibliometrics | 0.004 | 0.005 |
| Science and technology studies | 0.006 | 0.005 |
| Scholarly communication | 0.008 | 0.005 |
| Open science | 0.005 | 0.004 |
| Research integrity | 0.008 | 0.010 |
| Insufficient payload (model declined to judge) | 0.076 | 0.018 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".