Microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices in economically-vulnerable African-American young adults (EMERGE): Protocol for a feasibility randomized clinical trial

Larissa Jennings Mayo-Wilson, Nancy Ellen Glass, Fred M. Ssewamala, Sebastian Linnemayr, Jessica Coleman, Fatmata Timbo, Matthew W Johnson, Melissa Davoust, Alain B Labrique, Gayane Yenokyan, Brian Dodge, Carl A Latkin

Research output: Contribution to journalArticle

Abstract

Background: Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages ("nudges") that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods/design: In total, 40 young adults who are African-American, aged 18-24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group ("comparison") will receive text messages with information on job openings. The second group ("experimental") will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. Discussion: This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. Trial registration: ClinicalTrials.gov, NCT03766165. Registered on 4 December 2018.

Original languageEnglish (US)
Article number439
JournalTrials
Volume20
Issue number1
DOIs
StatePublished - Jul 17 2019

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Small Business
Health Resources
Risk-Taking
Sexual Behavior
African Americans
Text Messaging
Young Adult
Randomized Controlled Trials
HIV
Behavioral Economics
Unsafe Sex
Homeless Persons
Economics
Power (Psychology)
Baltimore
Cell Phones
Unemployment
Organized Financing
Risk Reduction Behavior
Random Allocation

Keywords

  • Baltimore
  • Clinical trial
  • Economic
  • Feasibility
  • HIV
  • Homeless
  • Sexual risk behaviors
  • Text messages
  • Unemployment
  • Young adults

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Pharmacology (medical)

Cite this

Microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices in economically-vulnerable African-American young adults (EMERGE) : Protocol for a feasibility randomized clinical trial. / Mayo-Wilson, Larissa Jennings; Glass, Nancy Ellen; Ssewamala, Fred M.; Linnemayr, Sebastian; Coleman, Jessica; Timbo, Fatmata; Johnson, Matthew W; Davoust, Melissa; Labrique, Alain B; Yenokyan, Gayane; Dodge, Brian; Latkin, Carl A.

In: Trials, Vol. 20, No. 1, 439, 17.07.2019.

Research output: Contribution to journalArticle

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abstract = "Background: Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages ({"}nudges{"}) that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods/design: In total, 40 young adults who are African-American, aged 18-24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group ({"}comparison{"}) will receive text messages with information on job openings. The second group ({"}experimental{"}) will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. Discussion: This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. Trial registration: ClinicalTrials.gov, NCT03766165. Registered on 4 December 2018.",
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T2 - Protocol for a feasibility randomized clinical trial

AU - Mayo-Wilson, Larissa Jennings

AU - Glass, Nancy Ellen

AU - Ssewamala, Fred M.

AU - Linnemayr, Sebastian

AU - Coleman, Jessica

AU - Timbo, Fatmata

AU - Johnson, Matthew W

AU - Davoust, Melissa

AU - Labrique, Alain B

AU - Yenokyan, Gayane

AU - Dodge, Brian

AU - Latkin, Carl A

PY - 2019/7/17

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N2 - Background: Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages ("nudges") that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. Methods/design: In total, 40 young adults who are African-American, aged 18-24, live in Baltimore City, have experienced at least one episode of homelessness in the last 12 months, are unemployed or underemployed (fewer than 10 h per week), are not enrolled in school, own a cell phone with text messaging, and report at least one episode of unprotected or unsafe sex in the prior 12 months will be recruited from two community-based organizations providing residential supportive services to urban youth. Participants will undergo a 3-week run-in period and thereafter be randomly assigned to one of two groups with active interventions for 20 weeks. The first group ("comparison") will receive text messages with information on job openings. The second group ("experimental") will receive text messages with information on job openings plus information on HIV prevention and business educational sessions, a mentored apprenticeship, and a start-up grant, and business and HIV prevention text messages based on principles from behavioral economics. The two primary outcomes relate to the feasibility of conducting a larger trial. Secondary outcomes relate to employment, sexual risk behaviors, and HIV preventive practices. All participants will be assessed using an in-person questionnaire at pre-intervention (prior to randomization) and at 3 weeks post-intervention. To obtain repeated, longitudinal measures, participants will be assessed weekly using text message surveys from pre-intervention up to 3 weeks post-intervention. Discussion: This study will be one of the first U.S.-based feasibility randomized clinical trials of an HIV prevention microenterprise intervention for economically-vulnerable African-American young adults. The findings will inform whether and how to conduct a larger efficacy trial for HIV risk reduction in this population. Trial registration: ClinicalTrials.gov, NCT03766165. Registered on 4 December 2018.

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KW - Feasibility

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KW - Sexual risk behaviors

KW - Text messages

KW - Unemployment

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