38299 Developing the HIV Risk Reduction Tool, Beta Version: A User-Centered Design Approach

Jennifer Uhrig, PhD1, Jocelyn Taylor, MPH2, Jennie Harris, MPH1, Chassidy Hanley, MPH2 and Jo Ellen Stryker, PhD3, 1Center for Communication Science, RTI International, Research Triangle Park, NC, 2NCHHSTP, Division of HIV/AIDS Prevention, Prevention Communication Branch, Research & Evaluation Team, Centers for Disease Control and Prevention, Atlanta, GA, 3NCHHSTP, Division of HIV/AIDS Prevention, Prevention Communication Branch, Centers for Disease Control and Prevention, Atlanta, GA

Theoretical Background and research questions/hypothesis: The increasing number of HIV prevention strategies and new or updated estimates of HIV risk create novel challenges for communicating about risk reduction. The web-based HIV Risk Reduction Tool (HRRT) was designed to deliver comprehensive, tailored prevention messages to the public and features an interactive graphic to explore HIV risk. We implemented a user-centered design approach with the goal of ensuring visitors find HRRT to be valuable (i.e., useful, usable, desirable, findable, accessible and credible) as represented in Morville’s User Experience Honeycomb.

Methods: Nine rounds of iterative user-centered evaluation were conducted (n=1,820); eight rounds involved qualitative methods and preceded the HRRT Beta Version launch. Round 1 explored proposed topics, a framework, and tested preliminary messages (n=24). The framework proposed in Round 1 was examined in Round 2 while also investigating message format, content tailoring, and risk comprehension (n=108). Round 3 tested content developed based on findings from previous rounds (n=92). Rounds 4 and 5 included scenario-based usability testing of the framework and interactive risk graphic (n=12). Round 6 assessed user experience with the proposed interface and comprehension of risk estimates and interactive risk graphic (n=43). Round 7 explored HRRT with transgender people (n=64). Round 8 assessed risk presentation formats and the interactive risk graphic (n=112). Findings from Rounds 1-8 were incorporated into a Beta Version HRRT launched to the public and evaluated in Round 9 with a national, online study consisting of a pre-test survey, free exploration of HRRT, and post-test survey measuring qualities described in Morville’s User Experience Honeycomb (n=1,365).

Results: Round 1 findings elucidated users’ mental models for topics, preferences for message presentation, and suggested a potential product framework. Round 2 users were receptive to the updated framework, highlighted considerations for anonymity with tailoring, and requested reduced statistical complexity. Round 3 users were knowledgeable about HIV prevention topics, but unaware of the range of available options. Rounds 4 and 5 illustrated that interactive elements proposed to reduce message density were functional, though messages and the interactive risk graphic needed additional simplification. Updates to the interactive risk graphic resulted in round 6 users demonstrating increased comprehension from previous rounds, though some users misinterpreted risk estimate data. Users in Round 7 revealed the need for content and graphics more inclusive of the transgender community. Round 8 findings informed final revisions to the interactive risk graphic and the inclusion of multiple formats for the presentation of risk data. Round 9 results showed high user receptivity and satisfaction with the tool. Users found the Beta Version useful (i.e., learned something new 84%), usable (i.e., information easy to understand 93%), desirable (i.e., liked HRRT overall 92%), findable (i.e., easy to navigate 89%), and credible (i.e., believed [89%] and trusted the information [87%]). Section 508 compliance confirmed accessibility.

Conclusions: By taking an iterative, user-centered approach to development, we created a tool that provides users with a valuable experience according to the elements of Morville’s User Experience Honeycomb.

Implications for research and/or practice: User-centered design is relevant for large- and small-scale communication product development and helps ensure tools are considered valuable to users.