Positive health check: developing a web-based video counseling tool for HIV primary care clinics

Harshbarger, Camilla; Taylor, Olivia; Uhrig, Jennifer; Lewis, Megan A.

doi:10.1080/17538068.2017.1341189

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…The details of the formative research and technical development of PHC are described elsewhere. 25,26 Those assigned to the intervention arm used PHC at baseline during an initial clinical visit when randomization occurred and could use PHC up to 2 more times over the study period. Participants chose the video doctor they would interact with as part of the PHC intervention experience.…”

Section: Interventionmentioning

confidence: 99%

Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Lewis

Harshbarger

Bann

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Interventionmentioning

confidence: 99%

Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Lewis

Harshbarger

Bann

et al. 2022

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…However, the scope of PHC goes beyond previous HIV video-based interventions in that it covers the above topics and also includes modules on treatment initiation, retention in medical care, safe injection drug use, and preventing mother-to-child transmission. The formative work that guided the development of PHC is described elsewhere [ 29 ].…”

Section: Overview Of Phcmentioning

confidence: 99%

“…Although the original scripts were developed collaboratively with end users and HIV providers [ 29 ], the creative director continued to translate these information-dense scripts into lines the actors could easily convey to PHC users and imbued them with more natural, conversational language. This resulted in a streamlined script to ensure end users would be more engaged and attentive.…”

Section: Challenges and Solutions To Designing And Developing Phcmentioning

confidence: 99%

“…To address the challenge to verify and test the 200 functional requirements, we conducted numerous rapid and iterative feedback sessions or “sprints” in the application of “agile” methodology via collaborative, cross-functional, multidisciplinary teams [ 37 , 38 ]. As noted earlier, we also consulted end users, including patients and clinicians, across all phases of development [ 29 ]. This also entailed user testing of the prototypes and features during development.…”

Section: Challenges and Solutions To Designing And Developing Phcmentioning

confidence: 99%

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Challenges of and Solutions for Developing Tailored Video Interventions That Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: Tutorial

Harshbarger

Burrus

Rangarajan

et al. 2021

JMIR Mhealth Uhealth

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Background Video is a versatile and popular medium for digital health interventions. As mobile device and app technology advances, it is likely that video-based interventions will become increasingly common. Although clinic waiting rooms are complex and busy environments, they offer the opportunity to facilitate engagement with video-based digital interventions as patients wait to see their providers. However, to increase efficiency in public health, leverage the scalability and low cost of implementing digital interventions, and keep up with rapidly advancing technology and user needs, more design and development guidance is needed for video-based tailored interventions. Objective We provide a tutorial for digital intervention researchers and developers to efficiently design and develop video-based tailored digital health interventions. We describe the challenges and solutions encountered with Positive Health Check (PHC), a hybrid app used to deliver a brief, interactive, individually tailored video-based HIV behavioral counseling intervention. PHC uses video clips and multimedia digital assets to deliver intervention content, including interactive tailored messages and graphics, a repurposed animated video, and patient and provider handouts generated in real time by PHC. Methods We chronicle multiple challenges and solutions for the following: (1) using video as a medium to enhance user engagement, (2) navigating the complexity of linking a database of video clips with other digital assets, and (3) identifying the main steps involved in building an app that will seamlessly deliver to users individually tailored messages, graphics, and handouts. Results We leveraged video to enhance user engagement by featuring “video doctors,” full-screen video, storyboards, and streamlined scripts. We developed an approach to link the database of video clips with other digital assets through script coding and flow diagrams of algorithms to deliver a tailored user experience. We identified the steps to app development by using keyframes to design the integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven back-end solution to tailor message delivery to individual users. Conclusions Video-based digital health interventions will continue to play an important role in the future of HIV prevention and treatment, as well as other clinical health practices. However, facilitating the adoption of an HIV video intervention in HIV clinical settings is a work in progress. Our experience in designing and developing PHC presented unique challenges due to the extensive use of a large database of videos tailored individually to each user. Although PHC focuses on promoting the health and well-being of persons with HIV, the challenges and solutions presented in this tutorial are transferable to the design and development of video-based digital health interventions focused on other areas of health.

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“…We engaged a user-centered approach and gathered detailed and iterative feedback on the many steps taken to design, develop, and implement PHC from prospective HIV-patient users and HIV providers, including both implementers and gatekeepers. This process is described in Harshbarger et al [17]. To film, manage, program, use feedback, and fine-tune PHC from the database of 700 video clips, the PHC team employed an agile development process [18].…”

Section: Introductionmentioning

confidence: 99%

Implementing Web-Based Interventions in HIV Primary Care Clinics: Pilot Implementation Evaluation of Positive Health Check

Harshbarger¹,

Burrus²,

Zulkiewicz³

et al. 2019

JMIR Form Res

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Background Web-based interventions can help people living with HIV achieve better clinical outcomes and behaviors, but integrating them into clinical practice remains challenging. There is a gap in understanding the feasibility of implementing these interventions in HIV clinic settings from the clinicians’ perspective. Objective The goal of the research was to determine whether Positive Health Check (PHC)—a Web-based, tailored video counseling tool focused on increasing patient adherence and retention in care and reducing HIV risk among HIV-positive patients—was acceptable, appropriate, and feasible for HIV primary care clinic staff to implement in clinic workflows. Methods A multiple-case study design was used to evaluate the pilot implementation. Four primary care clinics located in the southeastern United States implemented PHC over a 1-month period. Nine clinic staff across the clinics participated in structured interviews before, during, and after the implementation. In total, 54 interviews were conducted. We used a framework analysis approach to code the data and identify themes related to implementation outcomes, including acceptability, appropriateness, and feasibility. We also analyzed patient intervention use metrics (n=104) to quantify patient intervention completion rates (n=68). Results Overall, clinicians viewed PHC as acceptable and appropriate. Themes that emerged related to these implementation outcomes include the ability for PHC to increase provider-patient communication and its ability to engage patients due to the tailored and interactive design. While generally feasible to implement, challenges to the clinic workflow and physical environment were areas that clinics needed to manage to make PHC work in their clinics. Conclusions Findings from this pilot implementation suggest that clinical staff viewed PHC as acceptable and appropriate, especially as more patients used the intervention over the pilot period. Feasibility of implementation was challenging in some cases, and lessons learned from this pilot implementation can provide information for larger scale tests of the intervention that include assessment of both implementation outcomes and clinical outcomes.

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Positive health check: developing a web-based video counseling tool for HIV primary care clinics

Cited by 7 publications

References 16 publications

Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Effectiveness of an Interactive, Highly Tailored “Video Doctor” Intervention to Suppress Viral Load and Retain Patients With HIV in Clinical Care: A Randomized Clinical Trial

Challenges of and Solutions for Developing Tailored Video Interventions That Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: Tutorial

Implementing Web-Based Interventions in HIV Primary Care Clinics: Pilot Implementation Evaluation of Positive Health Check

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