J. Med. Internet Res. - Enhancing retention of an Internet-based cohort study of men who have sex with men (MSM) via text messaging: randomized controlled trial.

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Resumo

CKGROUND: Black and Hispanic men who have sex with men (MSM) are disproportionately affected by HIV in the United States. The Internet is a promising vehicle for delivery of HIV prevention interventions to these men, but retention of MSM of color in longitudinal Internet-based studies has been problematic. Text message follow-up may enhance retention in these studies.OBJECTIVE: To compare retention in a 12-month prospective Internet-based study of HIV-negative MSM randomized to receive bimonthly follow-up surveys either through an Internet browser online or through text messages.METHODS: Internet-using MSM were recruited through banner advertisements on social networking and Internet-dating sites. White, black, and Hispanic men who were =18, completed an online baseline survey, and returned an at-home HIV test kit, which tested HIV negative, were eligible. Men were randomized to receive follow-up surveys every 2 months on the Internet or by text message for 12 months (unblinded). We used time-to-event methods to compare the rate of loss-to-follow-up (defined as non-response to a follow-up survey after multiple systematically-delivered contact attempts) in the 2 follow-up groups, overall and by race/ethnicity. Results are reported as hazard ratios (HR) and 95% confidence intervals (CI) of the rate of loss-to-follow-up for men randomized to text message follow-up compared to online follow-up.RESULTS: Of 1489 eligible and consenting men who started the online baseline survey, 895 (60%) completed the survey and were sent an at-home HIV test kit. Of these, 710 of the 895 (79%) returned the at-home HIV test kit, tested HIV-negative, and were followed prospectively. The study cohort comprised 66% white men (470/710), 15% (106/710) black men, and 19% (134/710) Hispanic men. At 12 months, 77% (282/366) of men randomized to online follow-up were retained in the study, compared to 70% (241/344) men randomized to text message follow-up (HR=1.30, 95% CI 0.97-1.73). The rate of loss-to-follow-up was non-significantly higher in the text message arm compared to the online arm for both white (HR=1.43, 95% CI 0.97-1.73) and Hispanic men (HR=1.71, 95% CI 0.91-3.23); however, loss-to-follow-up among black men was non-significantly lower among those who received text message follow-up compared to online follow-up (HR=0.78, 95% CI 0.41-1.50). In the online arm, black men were significantly more likely to be lost to follow-up compared to white men (HR=2.25, 95% CI 1.36-3.71), but this was not the case in the text message arm (HR=1.23, 95% CI 0.70-2.16).CONCLUSIONS: We retained >70% of MSM enrolled in an online study for 12 months; thus, engaging men in online studies for a sufficient time to assess sustained outcomes is possible. Text message follow-up of an online cohort of MSM is feasible, and may result in higher retention among black MSM.

Resumo Limpo

ckground black hispan men sex men msm disproportion affect hiv unit state internet promis vehicl deliveri hiv prevent intervent men retent msm color longitudin internetbas studi problemat text messag followup may enhanc retent studiesobject compar retent month prospect internetbas studi hivneg msm random receiv bimonth followup survey either internet browser onlin text messagesmethod internetus msm recruit banner advertis social network internetd site white black hispan men complet onlin baselin survey return athom hiv test kit test hiv negat elig men random receiv followup survey everi month internet text messag month unblind use timetoev method compar rate losstofollowup defin nonrespons followup survey multipl systematicallydeliv contact attempt followup group overal raceethn result report hazard ratio hr confid interv ci rate losstofollowup men random text messag followup compar onlin followupresult elig consent men start onlin baselin survey complet survey sent athom hiv test kit return athom hiv test kit test hivneg follow prospect studi cohort compris white men black men hispan men month men random onlin followup retain studi compar men random text messag followup hr ci rate losstofollowup nonsignific higher text messag arm compar onlin arm white hr ci hispan men hr ci howev losstofollowup among black men nonsignific lower among receiv text messag followup compar onlin followup hr ci onlin arm black men signific like lost followup compar white men hr ci case text messag arm hr ci conclus retain msm enrol onlin studi month thus engag men onlin studi suffici time assess sustain outcom possibl text messag followup onlin cohort msm feasibl may result higher retent among black msm

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