Computer-Based Video to Increase HIV Testing Among Emergency Department Patients Who Decline

Aronson, Ian David; Marsch, Lisa A.; Rajan, Sonali; Koken, Juline A.; Bania, Theodore C.

doi:10.1007/s10461-014-0853-5

Cited by 19 publications

(31 citation statements)

References 12 publications

(14 reference statements)

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“…HIV tests can be administered without drawing blood, and results can be delivered in 20 minutes). 11 …”

Section: Methodsmentioning

confidence: 99%

“…18,19 Like the video, text messages were also designed to emphasize details of the test process that participants in prior studies said contributed to their decisions to test. 11 Prior to the pilot, content of the text messages was refined through an iterative process of qualitative interviews with ED patients (n=6) aged 18 – 24. During the development phase of the study, the PI individually interviewed a sample of patients in the ED, showing them draft text messages and asking for feedback about each message, as well as their response to the overall study protocol.…”

Section: Methodsmentioning

confidence: 99%

“…Still, young ED patients frequently decline testing and are less likely to accept a test offered by hospital staff compared to older patients in the same setting. 11 Furthermore, routine testing programs are not designed to identify and provide prevention services to youth who test HIV negative but continue to engage in behaviors that greatly increase their HIV risk.…”

mentioning

confidence: 99%

“…13,14 Studies have also shown computer-based interventions can increase HIV test rates among patients in high volume clinical settings, including testing by patients who declined tests offered by hospital staff. 11 Research with a sample of ED patients who declined HIV testing offered by a triage nurse also indicates an apparent association between reporting problematic substance use via a computer-based intervention and then accepting an HIV test offered by computer. 15 …”

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confidence: 99%

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Mobile screening to identify and follow-up with high Risk, HIV negative youth

Aronson¹,

Cleland²,

Perlman³

et al. 2016

JournalMTM

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Background HIV prevalence remains disproportionately high among youth, especially among young men who have sex with men, young people with substance use disorders, and recently incarcerated youth. However, youth may not report behavioral risks because they fear stigma or legal consequences. While routine HIV screening programs have increased testing, current programs are not designed to identify, or provide prevention services to, high-risk patients who test HIV negative. Aims To examine the feasibility and preliminary efficacy of: a tablet-based screening designed to facilitate HIV risk reporting and testing among a sample of young urban emergency department (ED) patients; and a text message-based follow up protocol for patients who test HIV-negative and report increased behavioral risk. Methods 100 ED patients aged 18 – 24, who declined HIV tests offered at triage, completed a tablet-based intervention that included a risk screening, an educational video, and offered participants HIV tests. If patients accepted testing and reported increased risk, the tablets offered follow-up text messages. Results 30 participants accepted HIV tests following the intervention and 21 participants, identified by custom software as high-risk, agreed to receive text messages. Two thirds (66.7%) of text recipients responded to questions at week 6, more than half (57.1%) responded at week 8, one (4.76%) re-tested after week 12. Conclusion Results indicate our intervention provides a feasible way to facilitate risk reporting, increase HIV testing, and maintain ongoing contact with hard-to-reach youth via tablet computers and text messages.

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“…HIV tests can be administered without drawing blood, and results can be delivered in 20 minutes). 11 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Mobile screening to identify and follow-up with high Risk, HIV negative youth

Aronson¹,

Cleland²,

Perlman³

et al. 2016

JournalMTM

Self Cite

View full text Add to dashboard Cite

show abstract

“…EDs provide important points of contact for youth and other populations with limited or inconsistent access to healthcare, and therefore offer potential opportunities for diagnosis and linkage to care. However, far more ED patients decline HIV testing compared to those who accept, (Aronson, 2015) and young ED patients are especially unlikely to test. Prior research indicates ED patients frequently decline HIV testing due to (possibly incorrect) perceptions of low self-risk, (Christopoulos et al, 2012; Czarnogorski et al, 2011) fear of a positive result, and stigma related to HIV infection and even to HIV testing.…”

mentioning

confidence: 99%

Feasibility of a Computer-Based Intervention Addressing Barriers to HIV Testing Among Young Patients Who Decline Tests at Triage

Aronson

Cleland

Perlman

et al. 2016

Journal of Health Communication

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Young people face greatly increased HIV risk and high rates of undiagnosed HIV, yet are unlikely to test. Many also have limited or inconsistent access to healthcare, including HIV testing and prevention education, and prior research has documented that youth lack knowledge necessary to understand the HIV test process and to interpret test results. Computer-based interventions have been used to increase HIV test rates and knowledge among emergency department (ED) patients, including those who decline tests offered at triage. However, patients aged 18 – 24 years have been less likely to test, even after completing an intervention, compared to older patients in the same ED setting. The current pilot study sought to examine the feasibility and acceptability of a new tablet-based video intervention designed to address established barriers to testing among ED patients aged 18 – 24 years. In particular, we examined whether young ED patients would: agree to receive the intervention; complete it quickly enough to avoid disrupting clinical workflows; accept HIV tests offered by the intervention; demonstrate increased post-intervention knowledge; and report they found the intervention acceptable. Over 4 weeks, we recruited 100 patients in a high volume urban ED aged 18–24, all of whom declined HIV tests offered at triage. Almost all (98%) completed the intervention (mean time <9 mins), 30 percent accepted HIV tests offered by the tablets. Knowledge was significantly higher after than before the intervention (t = −6.67, p < .001) and patients reported generally high acceptability. Additional research appears warranted to increase post-intervention HIV testing.

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Computer-Based Substance Use Reporting and Acceptance of HIV Testing Among Emergency Department Patients

et al. 2019

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More than 10 years after the Centers for Disease Control and Prevention recommended routine HIV testing for patients in emergency departments (ED) and other clinical settings, as many as three out of four patients may not be offered testing, and those who are offered testing frequently decline. The current study examines how participant characteristics, including demographics and reported substance use, influence the efficacy of a video-based intervention designed to increase HIV testing among ED patients who initially declined tests offered by hospital staff. Data from three separate trials in a high volume New York City ED were merged to determine whether patients (N=560) were more likely to test post-intervention if: 1) they resembled people who appeared onscreen in terms of gender or race; or 2) they reported problem substance use. Chi-Square and logistic regression analyses indicated demographic concordance did not significantly increase likelihood of accepting an HIV test. However, participants who reported problem substance use (n = 231) were significantly more likely to test for HIV in comparison to participants who reported either no problem substance use (n = 190) or no substance use at all (n = 125) (x 2 = 6.830, p < .05). Specifically, 36.4% of patients who reported problem substance use tested for HIV post-intervention compared to 30.5% of patients who did not report problem substance use and 28.8% of participants who did not report substance use at all. This may be an important finding because substance use, including heavy alcohol or cannabis use, can lead to behaviors that increase HIV risk, such as sex with multiple partners or decreased condom use.

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Computer-Based Video to Increase HIV Testing Among Emergency Department Patients Who Decline

Cited by 19 publications

References 12 publications

Mobile screening to identify and follow-up with high Risk, HIV negative youth

Mobile screening to identify and follow-up with high Risk, HIV negative youth

Feasibility of a Computer-Based Intervention Addressing Barriers to HIV Testing Among Young Patients Who Decline Tests at Triage

Computer-Based Substance Use Reporting and Acceptance of HIV Testing Among Emergency Department Patients

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