# A Pragmatic Trial of An Adaptive eHealth HIV Prevention Program for Diverse Adolescent MSM

> **NIH NIH U01** · NORTHWESTERN UNIVERSITY · 2020 · $1,639,110

## Abstract

Project Summary
 Adolescent (ages 13-18) men who have sex with men (AMSM) experience a dramatic health disparity
as they represent 2% of young people but account for almost 80% of HIV diagnoses. Despite this
disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs.
Implementation issues are critical as traditional HIV prevention delivery channels (community organizations,
schools, parents), have significant limitations when it comes to AMSM. eHealth interventions represent an
excellent modality for delivering AMSM-specific intervention material where youth “are.”
 We should not continue to deliver the same intervention when a participant is not responding. Rather,
stepped-care strategies increase in intensity to meet the needs of those who do not respond to a less intense
intervention. Using a Sequential Multiple Assignment Randomized Trial (SMART) design, we will evaluate the
impact of a package of increasingly intensive interventions that have already shown evidence of efficacy with
diverse adolescent and young adult MSM. The SMART design is an ideal approach to achieve the goals of this
RFA because SMART designs mimic treatment decisions as they are made in real-world clinical
settings. Collectively we brand our package of eHealth interventions as the SMART Program (Sexual Minority
Adolescent Risk Taking). The Program package includes: (1) a universally-delivered, brief, online sexual health
education program designed for sexual and gender minority youth regardless of whether they are sexually
active (Queer Sex Ed); (2) a more intensive online intervention designed for diverse AMSM engaging in HIV
transmission risk behaviors (Keep It Up!), and (3) the most intensive is a motivational interviewing (MI)
intervention that will be delivered by MI therapists via online videochat (Young Men's Health Project). We will
evaluate SMART Program impact and inform future implementation with three specific aims.
 Aim 1 is to test impact of the SMART Program and its constituent components on reducing HIV risk and
increasing testing among. We will developmentally adapt existing content for AMSM using the ADAPT-ITT
framework and linguistically adapt the SMART Program to Spanish speaking Latino AMSM. We will enroll a
national sample of 1,878 diverse AMSM and test the efficacy of the Program using a SMART design.
 Aim 2 is to test if the SMART Program has differential efficacy across important sub-groups of AMSM
based on race/ethnicity, urban/rural, age, socioeconomic status, and language.
 Aim 3 is to evaluate the delivery of the SMART Program nationally to inform its implementation and
cost-effectiveness. To minimize the science-practice gap, we will utilize mixed methods to identify facilitators
and barriers to the implementation of the SMART Program and its core components by collecting measures
from the RE-AIM framework and performing cost analysis.

## Key facts

- **NIH application ID:** 9870799
- **Project number:** 5U01MD011281-05
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Brian Mustanski
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $1,639,110
- **Award type:** 5
- **Project period:** 2016-07-28 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9870799

## Citation

> US National Institutes of Health, RePORTER application 9870799, A Pragmatic Trial of An Adaptive eHealth HIV Prevention Program for Diverse Adolescent MSM (5U01MD011281-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9870799. Licensed CC0.

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