Addressing Intersectional Stigma: Testing THRIVE 365 for Black Sexual Minority Men (On The Daily)
Phase: NA
Conditions: Medication Adherence, Depressive Symptoms, Anxiety Symptoms, Emotion Regulation
Sponsor: Rutgers, The State University of New Jersey

Cover Page 
 
 
Title: Brief Protocol Summary-- Addressing Intersectional Stigma: Testing THRIVE 365 
for Black Sexual Minority Men (On The Daily)   
 
 
NCT Number: NCT05376397 
 
 
Document Date: 12/18/2023 

Brief Protocol Summary 
 
The sample consisted of Black sexual minority men (SMM) living with HIV and 
connected with the community-based organization, THRIVE SS. THRIVE SS is an 
Atlanta, GA based CBO that focuses on health equity for Black SMM, most of whom are 
living with HIV, through cultivating peer support, advocacy, and community building. The 
study team recruited a nonrandom purposive sample through advertisements on 
THRIVE SS’s social media and email blasts. Eligibility criteria for this analysis were: 16 
years old or older, identifying as masculine, identifying as Black/African American, 
reporting being attracted to and/or sexually active with men, able to complete all 
procedures in English, mobile access to the internet in order to complete the once-daily 
survey procedures.  After the screening eligible for the study, participants received an 
invitation to participate in a HIPPA compliant WebEx informed consent meeting and 
baseline assessment with a trained research assistant. After baseline was a 14-day 
daily diary study with surveys administered on an Internet-based Qualtrics platform. 
Across all days, participants received 8 PM text-messages with links to their daily 
surveys. For those who had not completed the survey by 9:30 PM, they received an 
automatic reminder message. Surveys included measures of psychological and 
behavioral variables. We used simple randomization to vary the order of administration 
of all instruments. In line with a pre-post, one-arm trial, participants did not have access 
to the iTHRIVE 365 intervention for days 1–7 then received access to register and use 
the invention for days 8–14. The follow-up assessment occurred at the end of the 2-
week daily diary period. We collected summary paradata (i.e., process data detailing 
app usage) on intervention page access. Participants received $30 for baseline and 
follow-up and $1.50 per survey for the first 7 daily surveys and $2.50 for the next 7 
surveys, with a $5 bonus for completing all surveys (total maximum: $93). The Rutgers 
University institutional review board approved all study procedures. 
 
iTHRIVE 365 is a multicomponent intervention that uses mHealth features in 
alignment with 4 community priorities identified in our formative CBPR research: (1) 
Support HIV and psychological health knowledge and motivation; (2) Foster a sense of 
community and positive social connections among Black SMM; (3) Connect users to 
Black SMM-affirming health care, including HIV treatment and mental health care; (4) 
Provide resources for housing, transportation, and other economic empowerment. In 
line with best-practices for administering and testing interventions with mHealth 
components with trials of intervention principles (TIPs), iTHRIVE 365 deploys 
intervention elements that contain content that may be updated to maintain user 
engagement, but ultimately serve to accomplish delineated intervention strategies that 
match the community priorities. iTHRIVE 365 uses these intervention elements: (1) 
Weekly HIV and psychological health information and motivation content and daily 
health notifications; (2) Online moderated forums, interpersonal chats, and community 
calendars; (3) Linkage to biopsychosocial health care via THRIVE SS’s network of Black 
SMM-affirming providers; and (4) Housing and economic resources through THRIVE 
SS’s direct support and referral network. The health knowledge and motivation content 
includes a health maintenance notification system and content covering HIV and 
psychological health content that are evidence-based and culturally-tailored by the 

Rutgers School of Public Health and THRIVE SS team for Black SMM. The health 
maintenance notification system allows users to input the timing and dosage of 
medications or health practices (e.g., mindfulness meditation) to receive personalized 
reminders. Similar notification systems, such as automated pill reminders, have been 
shown to improve ART adherence. The HIV health content includes educational and 
motivational material developed by THRIVE SS that is supported by evidence-based 
HIV treatment approaches. The psychological health content includes psychoeducation 
and exercises from cognitive behavioral therapy (CBT), positive psychology (PPI), and 
dialectic behavioral therapies (DBT) aimed at promoting individual education and 
motivation and facilitating users to identify and replace negative thought and behavioral 
patterns consistent with a transtheoretical approach. In the pilot version of iTHRIVE 365 
tested here, the health knowledge and motivation content was housed in the 
home/landing and pill reminder pages. The social support content includes a community 
calendar that provides up-to-date information on THRIVE SS-led and other Black SMM 
community events in the Atlanta, GA area and gives users the option to receive 
reminder notifications about them. It also includes evidence-based features such as a 
moderated forum with discussions on topics generated by THRIVE SS staff or proposed 
by users and approved by staff. These forums have supported discussions on topics 
such as confronting stigma, medication side effects, and shared interests in popular 
culture. In line with guidance from formative focus groups, the forums are meant to 
support community around more than just HIV (e.g., finances, music) and include 
community guidelines that require users to refrain from personal attacks, hateful 
language, and other forms of communication that may cause forums to be unsafe for 
users. Forum moderators are THRIVE SS staff who identify violations of community 
guidelines. The interpersonal chat is a private chat between users that is only restricted 
if a user reports a violation of community guidelines. In the pilot version of iTHRIVE 365 
tested here, the social support content was housed in the community, calendar, and 
chat pages. The access to affirming health care feature allows users to request THRIVE 
SS institutional support including linkage to psychotherapy, Black SMM support groups, 
HIV care, and COVID care. THRIVE SS draws on a network of Black SMM-affirming 
Atlanta, GA-area health care providers that has been developed and vetted by THRIVE 
SS over 10 years through site visits and qualitative evaluations from staff and members 
that assess aspects of affirming contexts (e.g., ease of access, patient comfort, and 
provider cultural humility). Given the timing of the deployment of this version of iTHRIVE 
365 first in 2021, we included a CDC COVID screener 
(https://www.cdc.gov/screening/index.html) in this section. The housing and economic 
empowerment resources linkage features allow users to request free transportation, 
food assistance, culturally-appropriate clothes, and connection to housing support. 
Transportation costs are covered through paid transit passes and direct cash 
assistance. Clothes and food assistance are provided on-site at THRIVE SS and 
through THRIVE SS partner organizations. Housing assistance is managed by THRIVE 
SS case workers and includes transitional housing at a THRIVE SS-owned transitional 
home that provides housing for up to 5 months for those seeking a permanent 
residence and referrals to housing vouchers and other housing support in THRIVE SS’s 
network. In the pilot version of iTHRIVE 365 tested here, the access to affirming health 
care and economic empowerment features were housed in the linkage page.