Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach

Will Kocur; Julie McLeod; Sonja Charlotte Margot Bloch; Jennifer J. MacDonald; Charlotte Woodward; Amelia McInnes-Dean; Jo J. Gibbs; John J. Saunders; Ann A. Blandford; Claudia Estcourt; Paul Flowers

doi:10.1071/SH23168

RESEARCH ARTICLE (Open Access)

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Improving digital partner notification for sexually transmitted infections and HIV through a systematic review and application of the Behaviour Change Wheel approach

Will Kocur

^A , Julie McLeod

^A , Sonja Charlotte Margot Bloch

^B , Jennifer J. MacDonald

^A , Charlotte Woodward ^B , Amelia McInnes-Dean ^B , Jo J. Gibbs

^B , John J. Saunders

^B ^C , Ann A. Blandford

^D , Claudia Estcourt

^A and Paul Flowers

^E ^*

+ Author Affiliations

- Author Affiliations

^A School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK.

^B Institute for Global Health, University College London, London, England, UK.

^C UK Health Security Agency, Colindale, England, UK.

^D UCLIC, University College London, London, England, UK.

^E Psychological Science and Health, University of Strathclyde, Glasgow, Scotland, UK.

^* Correspondence to: Paul.Flowers@strath.ac.uk

Handling Editor: Matthew Hogben

Sexual Health 21, SH23168 https://doi.org/10.1071/SH23168

Submitted: 26 September 2023 Accepted: 30 January 2024 Published: 26 February 2024

Abstract

Background

Partner notification (PN) is key to controlling sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). Digital PN options (e.g. social media, short message service (SMS), emails) are promising in increasing PN behaviour. However, their implementation is often challenging and studies report varied levels of acceptability and uptake of PN, highlighting the need to optimise digital PN interventions.

Methods

A systematic review of barriers and facilitators to digital PN interventions for STIs, including HIV, across eight research databases (from 2010 to 2023) identified eight relevant studies, two of which addressed HIV. Data extraction identified 98 barriers and 54 facilitators to the use of digital PN interventions. These were synthesised into 18 key barriers and 17 key facilitators that were each deemed amenable to change. We then used the Behaviour Change Wheel approach, the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity criteria, and multidisciplinary expert input, to systematically develop practical recommendations to optimise digital PN.

Results

Thirty-two specific recommendations clustered around three themes. Digital PN interventions should: (1) empower and support the index patient by providing a range of notification options, accompanied by clear instructions; (2) integrate into users’ existing habits and the digital landscape, meeting contemporary standards and expectations of usability; and (3) address the social context of PN both online and offline through normalising the act of PN, combating STI-related stigma and stressing the altruistic aspects of PN through consistent messaging to service users and the public.

Conclusions

Our evidence-based recommendations should be used to optimise existing digital PN interventions and inform the co-production of new ones.

Keywords: behaviour, Behaviour Change Wheel, community interventions, contact tracing, health promotion, health services, interventions, LGBT, men who have sex with men, partner notification, psychology, public health, STIs.

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