How Patient Interactions With a Computer-Based Video Intervention Affect Decisions to Test for HIV

Abstract

The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational videos about HIV testing and respond to pre-postintervention data collection instruments. After the intervention, computers asked participants if they would like an HIV test: Approximately 43% (n = 86) accepted. Participants who accepted HIV tests at the end of the intervention took longer to respond to postintervention questions, which included the offer of an HIV test, F(1, 195) = 37.72, p < .001, compared with participants who did not accept testing. Participants who incorrectly answered pretest questions about HIV symptoms were more likely to accept testing F(14, 201) = 4.48, p < . 001. White participants were less likely to accept tests than Black, Latino, or "Other" patients, χ 2 (3, N = 202) = 10.39, p < .05. Time spent responding to postintervention questions emerged as the strongest predictor of HIV testing, suggesting that patients who agreed to test spent more time thinking about their response to the offer of an HIV test. Examining intervention usage data, pretest knowledge deficits, and patient demographics can potentially inform more effective behavioral health interventions for underserved populations in clinical settings. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.Reprints and permissions: sagepub.com/journalsPermissions.nav (CDC, 2012). HHS Public AccessIn light of the above, questions of how to design and deliver interventions that increase HIV test rates take on particular significance in high volume, urban health care settings, including hospital emergency departments (EDs), that often serve vulnerable populations who may have limited access to health care providers and, correspondingly, to health education. Interventions must not only be brief enough to offer while patients are receiving treatment; they must also be effective enough to reach patients who decline voluntary HIV testing because they (sometimes) falsely believe they are not at risk (Swenson, Hadley, Houck, Dance, & Brown, 2011) or because they fear a positive result (CDC, 2003). Content and intervention design must also help learners recognize gaps in their knowledge, including misconceptions (Rotheram-Borus, Ingram, Swendeman, & Flannery, 2009). If participants believe they already know all they need to know about HIV, they may not attend to intervention content and may remain unlikely to test. Much remains unknown as to how these interventions can be optimized for patients who could benefit most and how time to completion, baseline knowledge, and participant race may contribute to postintervention behavior in a given setting. et al. (2007, 2009), delive...

Pharmacy Intervention to Improve HIV Testing Uptake Using a Comprehensive Health Screening Approach

“…Computer-based video interventions have been shown to influence HIV testing knowledge and willingness to receive an HIV test in a hospital emergency room setting. 22,23,34 The video developed for this intervention was created based on social cognitive theory to encourage behavior change through increasing knowledge of HIV transmission, one's ability to make decisions about one's health, and the observation of others' behaviors who did not perceive HIV as a disease that was exceptional from other health outcomes. f HIV shame was defined as an affirmative response to any of the following: "I would be ashamed if I were infected with HIV," "I would be ashamed if someone in my family had HIV/AIDS," or "People with HIV should be ashamed of themselves."…”

Mobile Technology to Increase HIV/HCV Testing and Overdose Prevention/Response among People Who Inject Drugs

“…Our team has previously used technology-based interventions to facilitate HIV testing and related education among emergency department (ED) patients in high volume settings ( 22 – 25 ). EDs and community-based SEPs face a number of similar barriers to patient education and HIV testing, including limitations on staff availability in high volume settings and the challenge of working with high-risk populations who lack access to primary care.…”

“…Employing pre-post knowledge testing designs helped us gain a better understanding of what participants knew and did not know at baseline ( 25 ), and how learning specific details from a video could potentially influence decisions to test ( 23 ). In a 2012 study, we recruited 160 ED patients who had all declined HIV testing at triage, and approximately one-third accepted testing after watching a video ( 23 ).…”