Optimizing Computer-Based Video to Increase HIV Testing in Emergency Departments

优化基于计算机的视频以增加急诊科的艾滋病毒检测

• 批准号: 8140952
• 负责人: Ian David Aronson
• 金额: $ 15.03万
• 依托单位: NATIONAL DEVELOPMENT AND RESEARCH INSTITUTES, INC.
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-15 至 2013-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8140952
• 关键词: AIDS prevention; Accident and Emergency department; Affect; Centers for Disease Control and Prevention (U.S.); Characteristics; Clinical; Computers; Country; Data; Data Collection; Diagnosis; Dimensions; Drug user; Effectiveness; Environment; Evaluation; Female; Future; Gender; HIV; Handheld Computers; Health Services Accessibility; Healthcare; Hospitals; Hour; Human Resources; Human immunodeficiency virus test; Individual; Infection; Intervention; Knowledge; Law Enforcement; Lead; Learning; Low Literacy Population; Methodology; Modeling; Participant; Patients; Population; Prevalence; Prevention education; Prevention program; Professional counselor; Provider; Public Health; Randomized; Randomized Controlled Trials; Reading; Reporting; Research; Research Personnel; Risk; Services; Solutions; Staging; Stigmata; Testing; Time; Training; Triage; United States; Visit; Work; Workload; base; care seeking; comparative; design; disorder prevention; experience; high risk; high risk behavior; instrument; male; post intervention; public health priorities; social stigma; theories; therapy design; tool; uptake

DESCRIPTION (provided by applicant): In this project, we propose to develop and conduct a preliminary evaluation of a computer-based video intervention designed to increase HIV test acceptance in hospital emergency departments (EDs) across the United States. People most in need of HIV testing and prevention education, including drug users and other HIV-infected individuals who are unaware of their infection status, often have little or no access to healthcare outside the ED. Current efforts to offer routine HIV testing in the ED often miss patients who would benefit most. Due to ED staff limitations, most notably time and an already heavy workload, many EDs are not able to offer all patients a test or adequately provide necessary pre-test information. Further, because HIV testing is voluntary, patients at highest risk may decline. Undiagnosed cases of HIV present a significant public health problem, as people who do not know they are infected cannot receive treatment, and may unknowingly spread HIV to others. The intervention developed in this study can be used not only to offer HIV testing to more patients, but to increase the number of patients who agree to be tested. The proposed intervention will employ computer-based video that communicates standardized public health messages in ways patients understand. A video portraying a skilled provider engagingly explaining the importance of HIV testing can be individually delivered on handheld computers to all patients in an ED, while making only minimal personnel demands. Because viewing a video does not require reading, videos are especially suited to lower-literacy populations that seek care in an ED. The proposed research will involve a randomized controlled trial among ED patients who initially decline an HIV test at ED triage to determine what types of video content lead to increases in HIV test uptake and related knowledge. We will also gather data on patient acceptance and the feasibility of the intervention to inform further research to refine the intervention and expand it for use in an array of clinical environments. This study will also provide a new methodology to comparatively evaluate how video content can be optimized for greatest impact. Participants will be randomized into groups that use handheld computers to view different educational video segments and respond to pre- post-intervention data collection instruments. At the end of the intervention, the computers will ask participants if they would like an HIV test. AIM 1 Develop a computer-based video intervention to increase HIV test acceptance and knowledge among ED patients who initially decline an HIV test offered at triage. AIM 2 Evaluate critical dimensions of video content through an early stage randomized controlled trial examining acceptability, feasibility, and effectiveness. This study will begin a valuable line of research testing how video can be optimized for greatest effectiveness while simultaneously educating high-risk patients who might otherwise not be reached. PUBLIC HEALTH RELEVANCE: The Centers for Disease Control and Prevention recommends routine HIV testing in emergency departments (EDs) because people who visit an ED may lack access to other forms of healthcare, and if they are not tested for HIV, may be infected for years before receiving a diagnosis. Unfortunately, current testing efforts often fail to reach those most at risk. This study will develop and evaluate the acceptability, feasibility and preliminary effectiveness of an automated, computer-based video intervention, which offers considerable promise for increasing HIV test acceptance in EDs across the United States, thus having a marked public health impact.

描述（由申请人提供）：在此项目中，我们建议对旨在增加美国医院急诊室（EDS）的艾滋病毒测试接受的基于计算机的视频干预进行初步评估。最需要艾滋病毒测试和预防教育的人，包括吸毒者和其他不知道其感染状况的人，通常几乎没有或根本无法获得ED外的医疗保健。当前在ED中提供常规艾滋病毒测试的努力经常想念最大受益的患者。由于ED员工的局限性，最著名的时间和已经很重的工作量，许多ED无法为所有患者提供测试或充分提供必要的预测试信息。此外，由于艾滋病毒测试是自愿的，因此风险最高的患者可能会下降。未诊断的艾滋病毒病例提出了一个重大的公共卫生问题，因为那些不知道自己被感染的人无法接受治疗，并且可能在不知不觉中将艾滋病毒传播给他人。这项研究中开发的干预措施不仅可用于向更多患者提供艾滋病毒测试，而且可以增加同意接受测试的患者数量。 拟议的干预措施将采用基于计算机的视频，以患者理解的方式传达标准化的公共卫生信息。一个描绘熟练的提供者诱人的视频可以解释艾滋病毒测试的重要性，可以单独将手持计算机交付给ED中的所有患者，同时只能使人事的需求最少。由于观看视频不需要阅读，因此视频特别适合在ED中寻求护理的低素养人群。 拟议的研究将涉及在ED患者中进行的随机对照试验，这些患者最初拒绝ED Triage的HIV检验，以确定哪种类型的视频内容会导致HIV测试的吸收和相关知识的增加。我们还将收集有关患者接受的数据以及干预措施的可行性，以告知进一步的研究以完善干预措施并将其扩展以在一系列临床环境中使用。这项研究还将提供一种新的方法，以相对评估如何优化视频内容以获得最大的影响。参与者将被随机分为组，这些组使用手持计算机查看不同的教育视频细分并对干预前数据收集工具做出反应。干预结束时，计算机会询问参与者是否想要艾滋病毒测试。 AIM 1开发基于计算机的视频干预措施，以增加最初拒绝Triage提供的HIV测试的ED患者中的HIV测试接受和知识。 AIM 2通过早期阶段随机对照试验评估视频内容的关键维度，检查可接受性，可行性和有效性。 这项研究将开始一项有价值的研究测试，以如何优化视频以获得最大的有效性，同时对可能无法达到的高危患者进行教育。 公共卫生相关性：疾病控制与预防中心建议在急诊科（ED）进行常规的艾滋病毒测试，因为访问ED的人可能无法获得其他形式的医疗保健，如果未对HIV进行测试，可能会在接受诊断之前被感染多年。不幸的是，目前的测试工作通常无法达到最大的风险。这项研究将开发和评估基于计算机的自动化视频干预的可接受性，可行性和初步有效性，该视频干预为增加美国EDS的HIV测试接受提供了巨大的希望，从而产生了明显的公共卫生影响。