Dataset Information

A human immunodeficiency virus posttest video to increase condom use among adolescent emergency department patients.

ABSTRACT:

Purpose

To compare the effectiveness of a theory-based HIV educational video tool with in-person HIV counseling in promoting safer sex behaviors among adolescent patients of an urban Emergency Department (ED).

Methods

This was a randomized controlled trial taking place in the Emergency Department of Jacobi Medical Center in the Bronx, New York. A total of 203 stable, sexually active patients aged 15-21 years completed pre-intervention and postintervention measures. Participants were randomized to the intervention video series (102 participants), a theory-based, youth-friendly human immunodeficiency virus (HIV) educational video, or an in-person HIV counseling session with a trained HIV counselor (101 participants). Participants completed pre-intervention and postintervention measures on the primary outcomes: condom intention, outcome expectancy, and self-efficacy.

Results

Participants in the video group improved condom use intention (adjusted differential mean improvement [ADMI] = .98 units; confidence interval [CI], .20-1.77; Holm adjusted p = .028), condom self-efficacy outcome (ADMI = .26 units; CI, .04-.48; Holm adjusted p = .019), and condom outcome expectancy scores (ADMI = .15 units; CI, .07-.23; Holm adjusted p < .001) significantly more than those in the counselor group, adjusting for stage of change. The intervention helped participants progress to the next level of readiness or maintain their positive behavior, and did not differ by age, gender, or race.

Conclusions

A theory-based, youth-friendly video can be a valid means to provide posttest HIV education and prevention messages within an urban emergency department. The theory-based prevention messages can improve teenagers' condom intentions, condom self-efficacy, and condom outcome expectancies immediately after the intervention.

SUBMITTER: Calderon Y

PROVIDER: S-EPMC3745017 | biostudies-literature | 2013 Jul

REPOSITORIES: biostudies-literature

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Publications

A human immunodeficiency virus posttest video to increase condom use among adolescent emergency department patients.

Calderon Yvette Y Cowan Ethan E Leu Cheng-Shiun CS Brusalis Christopher C Rhee John Y JY Nickerson Jillian J Leider Jason J Bauman Laurie J LJ

The Journal of adolescent health : official publication of the Society for Adolescent Medicine 20130409 1

<h4>Purpose</h4>To compare the effectiveness of a theory-based HIV educational video tool with in-person HIV counseling in promoting safer sex behaviors among adolescent patients of an urban Emergency Department (ED).<h4>Methods</h4>This was a randomized controlled trial taking place in the Emergency Department of Jacobi Medical Center in the Bronx, New York. A total of 203 stable, sexually active patients aged 15-21 years completed pre-intervention and postintervention measures. Participants we ...[more]

PMID: 23582525

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Project description:IntroductionAfter discharge from the emergency department (ED), pain management challenges parents, who have been shown to undertreat their children's pain. Our goal was to evaluate the effectiveness of a five-minute instructional video for parents on pain treatment in the home setting to address common misconceptions about home pediatric pain management.MethodsWe conducted a randomized, single-blinded clinical trial of parents of children ages 1-18 years who presented with a painful condition, were evaluated, and were discharged home from a large, tertiary care pediatric ED. Parents were randomized to a pain management intervention video or an injury prevention control video. The primary outcome was the proportion of parents that gave their child pain medication at home after discharge. These data were recorded in a home pain diary and analyzed using the chi square test to determine significant difference. Parents' knowledge about components of at-home pain treatment were tested before, immediately following, and two days after intervention. We used McNemar's test statistic to compare incorrect pretest/correct post-test answers between intervention and control groups.ResultsA total of 100 parents were enrolled: 59 parents watched the pain education video, and 41 the control video. Overall, 75% of parents completed follow-up, providing information about home medication use. Significantly more parents provided pain medication to their children after watching the educational video: 96% vs 80% (difference 16%; 95% CI 7.8-31.3%). Significantly more parents had correct pain treatment knowledge immediately following the educational video about pain scores (P = 0.04); the positive effects of analgesics (P <0.01); and pain medication misconceptions (P = 0.02). Most differences in knowledge remained two days after the video intervention.ConclusionThe five-minute educational video about home pain treatment viewed by parents in the ED prior to discharge significantly increased the proportion of children receiving pain medication at home as well as parents' knowledge about at-home pain management.

Project description:ImportanceTo encourage the appropriate utilization of emergency care, cost-sharing for emergency care was increased from HK$100 (US $12.8) to HK$180 (US $23.1) per visit in June 2017 in all public hospitals in Hong Kong. However, there are concerns that this increase could deter appropriate emergency department (ED) visits and be associated with income-related disparities.ObjectiveTo examine changes in ED visits after the fee increase.Design, setting, and participantsThis retrospective cohort study used administrative data from June 2015 to May 2019 from all public hospitals in Hong Kong. Participants included all Hong Kong residents aged 64 years and younger, categorized into low-income, middle-income, and high-income groups according to the median household income in their district of residence. Data analysis was performed from May to June 2023.Main outcomes and measuresThe primary outcome was the ED visit rate per 100 000 people per month, categorized into 3 severity levels (emergency, urgent, and nonurgent). Secondary outcomes include general outpatient (GOP) visit rate, emergency admission rate, and in-hospital mortality rate per month at public hospitals. Segmented regression analyses were used to estimate changes in the level and slope of outcome variables before and after the fee increase.ResultsThis study included a total of 5 441 679 ED patients (2 606 332 male patients [47.9%]; 2 108 933 patients [38.5%] aged 45-64 years), with 2 930 662 patients (1 407 885 male patients [48.0%]; 1 111 804 patients [37.9%] aged 45-64 years) from the period before the fee increase. The fee increase was associated with an 8.0% (95% CI, 7.1%-9.0%) immediate reduction in ED visits after June 2017, including a 5.9% (95% CI, 3.3%-8.5%) reduction in urgent visits and an 8.9% (95% CI, 8.0%-9.8%) reduction in nonurgent visits. In addition, a 5.7% (95% CI, 4.7%-6.8%) reduction of emergency admissions was found, whereas no significant changes were observed in in-hospital mortality. Specifically, a statistically significant increase in GOP visits (4.1%; 95% CI, 0.9%-7.2%) was found within the low-income group, but this association became insignificant after controlling for the social security group, who were exempted from payment, as a control.Conclusions and relevanceIn this cohort study, the fee increase was not associated with changes in ED visits for emergency conditions, but there was a negative and significant association with both urgent and nonurgent conditions across all income groups. Considering the marginal increase in public GOP services, further study is warranted to examine strategies to protect low-income people from avoiding necessary care.

Project description:ObjectivesIn this study, Increasing Viral Testing in the Emergency Department (InVITED), the authors investigated if a brief intervention about human immunodeficiency virus (HIV) and hepatitis C virus (HCV) risk-taking behaviors and drug use and misuse in addition to a self-administered risk assessment, compared to a self-administered risk assessment alone, increased uptake of combined screening for HIV and HCV, self-perception of HIV/HCV risk, and impacted beliefs and opinions on HIV/HCV screening.MethodsInVITED was a randomized, controlled trial conducted at two urban emergency departments (EDs) from February 2011 to March 2012. ED patients who self-reported drug use within the past 3 months were invited to enroll. Drug misuse severity and need for a brief or more intensive intervention was assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Participants were randomly assigned to one of two study arms: a self-administered HIV/HCV risk assessment alone (control arm) or the assessment plus a brief intervention about their drug misuse and screening for HIV/HCV (intervention arm). Beliefs on the value of combined HIV/HCV screening, self-perception of HIV/HCV risk, and opinions on HIV/HCV screening in the ED were measured in both study arms before the HIV/HCV risk assessment (pre), after the assessment in the control arm, and after the brief intervention in the intervention arm (post). Participants in both study arms were offered free combined rapid HIV/HCV screening. Uptake of screening was compared by study arm. Multivariable logistic regression models were used to evaluate factors related to uptake of screening.ResultsOf the 395 participants in the study, the median age was 28 years (interquartile range [IQR] = 23 to 38 years), 44.8% were female, 82.3% had ever been tested for HIV, and 67.3% had ever been tested for HCV. Uptake of combined rapid HIV/HCV screening was nearly identical by study arm (64.5% vs. 65.2%; Δ = -0.7%; 95% confidence interval [CI] = -10.1% to 8.7%). Of the 256 screened, none had reactive HIV antibody tests, but seven (2.7%) had reactive HCV antibody tests. Multivariable logistic regression analysis results indicated that uptake of screening was not related to study arm assignment, total ASSIST drug scores, need for an intervention for drug misuse, or HIV/HCV sexual risk assessment scores. However, uptake of screening was greater among participants who indicated placing a higher value on combined rapid HIV/HCV screening for themselves and all ED patients and those with higher levels of perceived HIV/HCV risk. Uptake of combined rapid HIV/HCV screening was not related to changes in beliefs regarding the value of combined HIV/HCV screening or self-perceived HIV/HCV risk (post- vs. pre-risk assessment with or without a brief intervention). Opinions regarding the ED as a venue for combined rapid HIV/HCV screening were not related to uptake of screening.ConclusionsUptake of combined rapid HIV/HCV screening is high and considered valuable among drug using and misusing ED patients with little concern about the ED as a screening venue. The brief intervention investigated in this study does not appear to change beliefs regarding screening, self-perceived risk, or uptake of screening for HIV/HCV in this population. Initial beliefs regarding the value of screening and self-perceived risk for these infections predict uptake of screening.

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Dataset Information

A human immunodeficiency virus posttest video to increase condom use among adolescent emergency department patients.

Purpose

Methods

Results

Conclusions

Publications

A human immunodeficiency virus posttest video to increase condom use among adolescent emergency department patients.

Similar Datasets

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