J Am Med Inform Assoc - A question of trust: user-centered design requirements for an informatics intervention to promote the sexual health of African-American youth.

Tópicos

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Resumo

JECTIVE: We investigated the user requirements of African-American youth (aged 14-24 years) to inform the design of a culturally appropriate, network-based informatics intervention for the prevention of HIV and other sexually transmitted infections (STI).MATERIALS AND METHODS: We conducted 10 focus groups with 75 African-American youth from a city with high HIV/STI prevalence. Data analyses involved coding using qualitative content analysis procedures and memo writing.RESULTS: Unexpectedly, the majority of participants' design recommendations concerned trust. Youth expressed distrust towards people and groups, which was amplified within the context of information technology-mediated interactions about HIV/STI. Participants expressed distrust in the reliability of condoms and the accuracy of HIV tests. They questioned the benevolence of many institutions, and some rejected authoritative HIV/STI information. Therefore, reputational information, including rumor, influenced HIV/STI-related decision making. Participants' design requirements also focused on trust-related concerns. Accordingly, we developed a novel trust-centered design framework to guide intervention design.DISCUSSION: Current approaches to online trust for health informatics do not consider group-level trusting patterns. Yet, trust was the central intervention-relevant issue among African-American youth, suggesting an important focus for culturally informed design. Our design framework incorporates: intervention objectives (eg, network embeddedness, participation); functional specifications (eg, decision support, collective action, credible question and answer services); and interaction design (eg, member control, offline network linkages, optional anonymity).CONCLUSIONS: Trust is a critical focus for HIV/STI informatics interventions for young African Americans. Our design framework offers practical, culturally relevant, and systematic guidance to designers to reach this underserved group better.

Resumo Limpo

jectiv investig user requir africanamerican youth age year inform design cultur appropri networkbas informat intervent prevent hiv sexual transmit infect stimateri method conduct focus group africanamerican youth citi high hivsti preval data analys involv code use qualit content analysi procedur memo writingresult unexpect major particip design recommend concern trust youth express distrust toward peopl group amplifi within context inform technologymedi interact hivsti particip express distrust reliabl condom accuraci hiv test question benevol mani institut reject authorit hivsti inform therefor reput inform includ rumor influenc hivstirel decis make particip design requir also focus trustrel concern accord develop novel trustcent design framework guid intervent designdiscuss current approach onlin trust health informat consid grouplevel trust pattern yet trust central interventionrelev issu among africanamerican youth suggest import focus cultur inform design design framework incorpor intervent object eg network embedded particip function specif eg decis support collect action credibl question answer servic interact design eg member control offlin network linkag option anonymityconclus trust critic focus hivsti informat intervent young african american design framework offer practic cultur relev systemat guidanc design reach underserv group better

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