TreatYoSelf: empathy-driven behavioral intervention for marginalized youth living with HIV

Behavioral intervention technologies are well suited to addressing health behavior such as medication adherence, but only if successfully integrated into a user's daily life. Little is known about how to design such technologies to be adoptable, adaptable, useful, and feasible in everyday life. We report on the design process for TreatYoSelf, a smartphone application designed to improve medication adherence among youth living with HIV through reminders and positive reinforcement. Using participatory design, our aim was to understand factors related to adoption and acceptance of behavioral intervention technology as part of daily life. Two challenges of living with HIV led to an empathy-driven approach in our design process: (1) HIV is a stigmatized condition, which (2) disproportionately affects the marginalized populations of young African American men who have sex with men and transgender women. We discuss five empathy-driven design strategies: positive and nonjudgmental tone; minimal, avatar-based gamification; motivational and corny messages; nondisclosure through neutral signifiers; and social support through camaraderie. Our approach enabled us to identify and work through factors, often related to stigma and marginalization, which would lead to rejection of TreatYoSelf use in daily life.

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