Development and Feasibility of “Towards the Sun”: A Digital Salutogenic Intervention to Enhance Sense of Coherence and Health Outcomes Among Newly Diagnosed HIV-Positive MSM

Mimi Zhai,1,2 Yamin Li,1 Jianhai Long,3 Yunxia Li,2,4 Xianyang Lei5 1Nursing Department, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, Hunan Province, People’s Republic of China; 2The Xiangya School of Nursing, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, People’s Republic of China; 4School of Nursing, Lanzhou University, Lanzhou, Gansu, 730000, People’s Republic of China; 5Xiangya School of Public Health, Central South University, Changsha, Hunan, 410013, People’s Republic of ChinaCorrespondence: Xianyang Lei, Xiangya School of Public Health, Central South University, No. 172 Tongzipo Road, Yuelu District, Changsha, Hunan Province, People’s Republic of China, Email [email protected]: To develop and conduct a preliminary evaluation of a digital salutogenic intervention—“Towards the Sun”—aimed at enhancing sense of coherence (SOC) and improving health outcomes among newly diagnosed HIV-positive men who have sex with men (MSM).Methods: The initial intervention draft was developed using the systematic Intervention Mapping (IM) process, informed by preliminary research, literature review, and evidence-based needs assessment. Two rounds of expert panel review were then conducted to refine the draft, followed by a feasibility assessment among newly diagnosed HIV-positive MSM.Results: The final digital intervention consisted of a five-stage, eight-week program, focusing on stress management, resource activation, and meaning exploration to strengthen the three dimensions of SOC. After review by 8 experts, the mean importance ratings of the intervention items were all above 4 and the coefficients of variation (CV) were less than 0.20, indicating consensus. A pilot study involving 7 newly diagnosed MSM demonstrated feasibility: SOC-13 scores increased, levels of stress and depression decreased, and participants reported high satisfaction with the overall content, especially the modules on self-acceptance and resource orientation.Conclusion: This digital salutogenic intervention demonstrated good feasibility, user acceptance, and preliminary effectiveness among newly diagnosed HIV-positive MSM. As a strengths-based and innovative digital solution, it warrants further validation and dissemination in larger samples and randomized controlled designs.Reporting Guidelines: The study followed the TIDieR (Template for Intervention Description and Replication) Checklist.Keywords: digital salutogenic intervention, sense of coherence, HIV, men who have sex with men