3.12. Component B: TMQQs
In the present study, TM reminders were paired with QQ each week to assess knowledge gained and to generate points for which participants earned compensation. Participants reported TMQQs were appreciated, it was generally enjoyable to answer the QQ and receive correct answers, and the TMQQ component served a number of functions. First, those currently taking HIV medication experienced the TMQQs as a reminder to take HIV medication. Although HIV knowledge was relatively high for the majority of respondents, particularly those who had lived with HIV for a decade or more, TMQQs served a function of keeping HIV medication adherence in the foreground of their daily activities and decisions, even though the TMs did not focus on medication or adherence. (“Yeah, it's just a constant reminder, the constant influx of information flying in someone's phone…I think it's a great reminder.”). Second, the information provided about HIV was found to be interesting and useful for the most part. Third, the TMQQs were commonly experienced as a form of positive connection with the study. Overall, TMQQs were seen as fostering study engagement.Participants noted TMQQs could be improved in two main ways: they could be more challenging (as they were too easy in most cases, since participants were generally expert on HIV) and should be sent more frequently than once a week. Nonetheless, one of the aims of the TMQQ component were to support continued engagement, and as such they were not intended to be difficult to answer. In most cases, TMQQs were not associated in participants' minds with Would [TMQQs] get people to take their medicine? No. No, I think—I'm not sure it would get people to take their meds. I just think it would be a little bit more challenging. For someone like me, when I saw those questions, I wasn't learning anything. You've got to think about the people that have been sick for a little bit and know the knowledge. So I didn't learn anything new on the questions. It was just a reminder to take my meds. So asking the questions became reminders. I guess that's the first thing I—and that really, I could say that that's cool. The questions did become reminders. […] The fact that the questions were coming to me and things, it keep the HIV medication thing in my head all the time.Participants reported that receiving HIV-related information, such as in medical settings, was not typically associated with positive emotions, and was commonly avoided. However, the TMQQs were a positive experience for most. This was largely related to the fact that information was brief and limited, received by text message, compensation was provided for correct responses on the TMQQs, and TMQQs were associated with the larger generally positive experience of engaging in the S-CAP2 study.