PT  - JOURNAL ARTICLE
AU  - Mukherjee, Trena I.
AU  - Zerbe, Allison
AU  - Falcao, Joanna
AU  - Carey, Shauna
AU  - Iaccarino, Alexandra
AU  - Kolada, Brynn
AU  - Olmedo, Bruno
AU  - Shadwick, Cady
AU  - Singhal, Hitesh
AU  - Weinstein, Lauren
AU  - Vitale, Mirriah
AU  - De Gusmao, Eduarda De Pimentel
AU  - Abrams, Elaine J.
TI  - Human-Centered Design for Public Health Innovation: Codesigning a Multicomponent Intervention to Support Youth Across the HIV Care Continuum in Mozambique
AID  - 10.9745/GHSP-D-21-00664
DP  - 2022 Apr 28
TA  - Global Health: Science and Practice
PG  - e2100664
VI  - 10
IP  - 2
4099  - http://www.ghspjournal.org/content/10/2/e2100664.short
4100  - http://www.ghspjournal.org/content/10/2/e2100664.full
SO  - GLOB HEALTH SCI PRACT2022 Apr 28; 10
AB  - Key FindingsUsing human-centered design (HCD), key learnings identified opportunities for intervention to promote viral suppression and improve ART adherence and retention in care among adolescents and young people living with HIV (AYAHIV). Opportunities included fostering a sense of belonging and peer connectedness with other AYAHIV, providing contextually resonant medical knowledge that fits the unique context of adolescence and young adulthood, reducing misconceptions and stigma surrounding HIV, and cultivating a sense of hope for AYAHIV.Intervention components include a media campaign to reduce HIV stigma and increase medical literacy; a toolkit to help providers communicate and address the unique needs of AYAHIV clients; peer-support groups to improve medical literacy, empower youth, and provide positive role models for people living with HIV; support groups for parents/caregivers; and discreet pill containers to promote adherence outside the home.Key ImplicationsPublic health practitioners should consider how HCD provides a pathway for public health innovation, shortens the research to practice gap, engages marginalized communities, and integrates novel interventions into existing complex systems when coupled with other synergistic research methods such as implementation science.Adolescents and young people represent a growing proportion of people living with HIV (AYAHIV), and there is an urgent need to design, implement, and test interventions that retain AYAHIV in care. Using a human-centered design (HCD) approach, we codesigned CombinADO, an intervention to promote HIV viral suppression and improve antiretroviral therapy (ART) adherence and retention in care among AYAHIV in Nampula, Mozambique. The HCD process involves formative design research with AYAHIV, health care providers, parents/caretakers, and experts in adolescent HIV; synthesis of findings to generate action-oriented insights; ideation and prototyping of intervention components; and a pilot study to assess feasibility, acceptability, and uptake of intervention components.CombinADO promotes ART adherence and retention in care by fostering peer connectedness and belonging, providing accessible medical knowledge, demystifying and destigmatizing HIV, and cultivating a sense of hope among AYAHIV. Successful prototypes included a media campaign to reduce HIV stigma and increase medical literacy; a toolkit to help providers communicate and address the unique needs of AYAHIV clients; peer-support groups to improve medical literacy, empower youth, and provide positive role models for people living with HIV; support groups for parents/caregivers; and discreet pill containers to promote adherence outside the home. In the next phase, the effectiveness of CombinaADO on retention in care, ART adherence, and viral suppression will be evaluated using a cluster-randomized control trial.We demonstrate the utility of using HCD to cocreate a multicomponent intervention to retain AYAHIV in care. We also discuss how the HCD methodology enriches participatory methods and community engagement. This is then illustrated by the youth-driven intervention development of CombinADO by fostering youth empowerment, addressing power imbalances between youth and adult stakeholders, and ensuring that language and content remain adolescent friendly.