Streaming Weekly Soap Opera Video Episodes to Smartphones in a Randomized Controlled Trial to Reduce HIV Risk in Young Urban African American/Black Women

Background: This report describes deployment of smartphones for use by 238 urban, predominately African American, young adult women at high-risk for HIV.  Love, Sex, and Choices is a 12-episode soap opera video series created as an intervention to reduce HIV risk and evaluated in a randomized controlled trial. We discuss development of a mobile platform to deliver 12-weekly videos and comparison group messages to smartphones.

Objectives: To describe the development of a mobile platform to stream HIV prevention videos to smartphones.

Methods: The phones were used to access weekly videos or messages, respond to content-related questions, and email. Decisions on platform development required extensive pilot testing.  Viewing start-stop time was tracked using a Helix™ Session Manager to document the intervention was delivered as intended.

Results: This was a high risk sample of 238, 18-to-29 year old women, mean age of 22. The majority was African American (n =210, 88.2%).  Nearly all of the 117 in the video group enjoyed watching the video on smartphones (n =113, 96.6%) and felt they watched in privacy   (n =113, 96.6%). Only 2 missed episodes. Nearly all watched each episode at least once.  There were disadvantages. A sizable number of phones were damaged or stolen and at times there was asynchronous audio and video.

Conclusions: Data provided evidence of treatment adherence. Nearly all enjoyed watching on smartphones. Episodes were rarely missed; most replayed episodes.  There was a steep curve in time and expense during technical development.

Implications for Programs, Policy, and Research: This is the first study to report on streaming video episodes to smartphones. Once developed, the intervention is standardized, can be widely distributed, and access can be tracked. As smartphone use and video streaming capability increase, video access increases. With faster data transmission, problems with asynchronous video diminish, opening-up a new channel to address health disparities.