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

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.