Name of Intervention/ Program
Positively Quit Recruitment

Background and Situation Analysis
The Positively Quit Study is a randomized control trial that will test two protocols against each other to help people living with HIV quit smoking. People living with HIV smoke at rates much higher than the general population, and the effects of cigarettes on their health is pronounced, reducing life expectancy by as much as 16 years. The study was already underway through the University of South Florida. The study runners were having difficult recruiting participants, and had only recruited about 20% of the total number needed (88 of 482). While the process for participants is conducted online via video groups, the pandemic complicated efforts to reach out to people and let them know about the study. Originally they had focused on trying to recruit from within the state of Florida, but were getting lukewarm responses. Strengths and Weaknesses: The core team was passionate about the research they were doing, and had a good reputation in the HIV research community and with service providers. The protocol is evidence-based and effective, but they had taken a scattershot approach to their recruitment efforts. In addition, the proposed audience was too broad (anyone over 18 living with HIV who smoked), and the study has a 3-interview process for participants to be accepted. While there is financial compensation for participants ($370), it is doled over the course of several months. Some of the people working on the project were students and volunteers who had other duties, and there was also some organizational turnover. Opportunities and Threats: Smoking is a well-known threat for people living with HIV. There were possibilities to partner with county and state service providers, and also to get more participants through ResearchMatch. Prospective participants often faced barriers to quitting smoking, including stigma around living with HIV, other pressing health concerns, lack of proper technology (cell phone) or privacy, and a culture around smoking that discouraged them from quitting. Distrust of the medical establishment and other health disparities (racism, poverty, unemployment, homelessness) also made it difficult for people to commit to the trial.

Priority Audiences(s)
The Live On campaign’s priority audiences include: 1. General Market Utah; and highest risk 2. LGBTQ community; 3. Military The staff and volunteers were given three choices for audience segmentation: People over 50 living with HIV who were (1) lonely, (2) impoverished or (3) experiencing other health issues. Health issues/scares was ultimately chosen as the group that was highest in both level of impact and likelihood of adoption.

Behavioral Objectives
The behavioral objective was straightforward and simple: to get people to sign up for, and complete, the Positively Quit Trial.

Description of Strategy/Intervention
Formative research was conducted with eight participants over the course of a few months to understand why people smoked, and their barriers to quitting. All participants lived on the east coast, and all were African American. Data was coded and analyzed using NVivo qualitative research software. From there, we identified four messages that might appeal to prospective participants: (1) being in a group with others living with HIV would be comfortable, (2) respecting people’s busy lives by offering several different group times/days, (3) living with HIV and other health issues makes it hard to quit smoking, and (4) techniques taught in the group can help to reduce stress and anxiety, which was one of the main reasons people gave for quitting smoking. We created four ads from these messages, and went back to participants to ask them questions about which ad would be most likely to get them to sign up for the study. All the ads featured older African-Americans, and study participants gave positive feedback about it. When asked to choose their favorite ad, three of the eight participants chose ad (3) and four of the eight participants chose ad (4). The strategy of lowering the barrier to quitting was the winning approach.

A marketing mix was created to advise how best to disseminate the message. The study was positioned as gaining the tools to manage anxiety and stress is a better alternative to continuing to smoke. Product: The core product was peace of mind and better health. The actual product was the video group, nicotine patches, gift certificates for compensation, and phone support. The augmented product was the tools for coping with stress and anxiety. Price: the non-monetary barrier of people being short on time is addressed by offering several time and day group options. Another emotional barrier was the stigma of being a smoker, and emphasizing the empathy of the staff members. A benefit of participating was the gift certificates people earned via participation, in addition to the money people saved by quitting smoking. Place was identified as people’s phones or tablets utilized at home, work, or in the car. Making sure that ads and websites included several prompts for people to sign up was important. Promotion: Primary messaging is around gaining the tools to deal with stress and anxiety that can replace smoking. The best messenger for Positively Quit remains health care providers and case workers. First-person testimonials from others who had gone through the study could be effective. Creative strategy is one of support and empathy, and tone is hopeful and encouraging. Communication channels included doctors offices and clinics, mobile advertising via Facebook and Instagram, outdoor advertising/flyers in areas with high population of people living with HIV, and banner ads on websites for people living with HIV. Continued outreach and presentations by Positively Quit staff was also important. Personas and a creative brief were also created to guide implementation of the campaign.

Evaluation Methods and Results
This social-marketing project did not include a section on evaluation methods, as it was outside of what I was asked to create. The project was finalized and submitted in November of 2023, and I stopped working with the team at that point – I had continued to volunteer for the study without pay and after I had graduated to finish it. Last month I reached out to see how things were going, and was informed that the study was about to start a new initiative that would utilize the findings of the social-marketing project to recruit new participants for the Positively Quit study.

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Entry Letter: F