Fitzpatrick, Thomas, et al. "A crowdsourced intervention to promote hepatitis B and C testing among men who have sex with men in China: study protocol for a nationwide online randomized controlled trial." BMC infectious diseases 18.1 (2018): 489.
Background
Crowdsourcing may be an effective strategy to develop test promotion materials. We conducted an online randomized controlled trial (RCT) to evaluate a crowdsourced intervention to promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men (MSM) in China.
Methods
MSM never previously tested for hepatitis were recruited through social media. Eligible men were randomized to receive an online crowdsourced intervention or no testing promotion materials. Outcomes including self-reported and confirmed HBV and HCV test uptake were assessed after four weeks. Odds ratios (OR) with 95% confidence intervals (95% CI) of men achieving primary and secondary outcomes between the intervention and control arms were calculated.
Findings
556 eligible men were enrolled. Overall, 17•4% (97/556) of men self-reported HBV and HCV testing and 7•9% (44/556) confirmed HBV and HCV test uptake. The intervention was seen by 72•1% and 29•0% of men in the intervention and control arms, respectively. In intention-to-treat analysis, confirmed HBV and HCV test uptake was similar between the two arms, both when using a missing=failure approach (OR 0•98, 95% CI 0•53–1•82) or multiple imputation (OR 1•46, 95% CI 0•72–2•95).
Interpretation
This RCT extends the literature by developing and evaluating an intervention to spur hepatitis testing in a middle-income country with a high burden of hepatitis. Overall test uptake among MSM in China was similar to previous interventions promoting hepatitis testing in high-income countries. We found frequent intervention sharing, complicating interpretation of the results, and the role of crowdsourcing to promote hepatitis testing remains unclear.
Crowdsourcing may be an effective strategy to develop hepatitis test promotion materials. Public challenge contests solicit slogans, images, or strategies from the public (including, but not limited to, at-risk groups) to address a particular problem . By actively engaging affected communities, crowdsourcing contests may generate more culturally appropriate and locally relevant materials than traditional social health marketing approaches. Public challenge contests have been used to generate test promotion messaging in both high-income countries and LMICs, including messaging tailored to mainland China. Test promotion materials developed through crowdsourcing contests in China have been shown to effectively promote HIV testing among Chinese MSM, and this strategy could also be used to generate hepatitis testing promotion materials.