Culturally Tailored Materials for Smoking Cessation and HIV Care Adherence Among Hispanic Adults: Protocol for Content Development and Formative Evaluation.

Background: Hispanic people with HIV who smoke cigarettes experience unique stressors (eg, stigma), which contribute to health disparities. Anxiety sensitivity (AS) may worsen mood management problems, which are a leading barrier to smoking cessation. Interventions targeting AS can improve HIV-specific outcomes and smoking cessation. However, no prior research has culturally tailored an AS reduction program to improve quality of life among Hispanic people with HIV who smoke. The research team previously developed a mobile health (mHealth) intervention addressing AS reduction, smoking cessation, and HIV care management for Black people with HIV who smoke. Building on this work, this study represents a formative, exploratory phase to develop culturally tailored mHealth content for Hispanic people with HIV across 3 distinct regions (Mexico, Central America, and South America), which share many similarities but differ in some cultural and linguistic respects. This work will inform the refinement of materials for these groups and the future development of an integrated mHealth app for smoking, AS, and HIV among this population (ie, VITAL). Objective: This study aimed to culturally tailor evidence-based smoking cessation content targeting AS reduction and HIV management among Hispanic adults to inform the development of the VITAL mHealth program. Methods: Intervention content was culturally adapted using a theory-informed intervention adaptation framework that integrated a cultural considerations document derived from existing literature on smoking cessation and HIV care among the Hispanic population, along with iterative consultation with a Community Research Advisory Board. This resulted in linguistically tailored content in English and Spanish. The pilot study consisted of Hispanic people with HIV who smoke (N=80), divided into 3 subgroups: Mexican/Mexican American, Central American, and South American. Participants completed self-report assessments and a semistructured interview assessing the treatment videos for content relevance, appropriateness, and ease of understanding. Interviews were conducted online in Spanish or English by trained interviewers. Interview transcripts will be coded by a multidisciplinary qualitative team using a 2-pass approach: initial coding of the interview question followed by higher-level concepts. Themes will be reviewed by another member of the team to assess trustworthiness, saturation, and triangulated with quantitative data, then analyzed by geographic subgroup. Results: Three linguistically tailored versions of the intervention materials were developed. Data collection began August 19, 2024, and finished June 26, 2025. Data cleaning is ongoing, and analyses will begin in April 2026. Content refinement and app integration are anticipated to be completed by September 2026. Upon completion of analysis, data will be used to further refine culturally tailored intervention content for Hispanic adult subgroups. Conclusions: This formative pilot study will inform the cultural adaptation and refinement of an mHealth app, VITAL, which will be tested in a subsequent randomized controlled trial to improve health disparities and assist Hispanic people with HIV in quitting smoking.