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Comparison of a video to a pictorial brochure in improving HIV/AIDS and HIV testing knowledge and increasing HIV testing motivation and behavioral skills among adult emergency department patients.

ABSTRACT: Objectives:We sought to determine if a pictorial brochure improves HIV/AIDS and HIV testing knowledge and increases HIV testing motivation and behavioral skills as well as a video among adult emergency department patients, regardless of language spoken and health literacy level. Methods:ED patients were stratified by primary language spoken (English or Spanish) and health literacy level (lower or higher) and randomly assigned to watch the study video or review the content-matched pictorial brochure. HIV/AIDS and HIV testing knowledge, motivation for HIV testing, and behavioral skills for HIV testing were assessed using study instruments before and after watching the video or reviewing the pictorial brochure. Results:Of the 712 English- and 655 Spanish-speaking ED patients, HIV/AIDS and HIV testing knowledge improved more among participants in the video than the pictorial brochure arm (? 0.43; 95% confidence interval [CI]: 0.07, 0.79). This improvement was more pronounced among those with lower (? 0.60; 95% CI: 0.06, 1.13) than higher health literacy (? 0.27; 95% CI: -0.22, 0.76). HIV testing motivation was high before the intervention and did not increase differentially between arms. Confidence in recognizing when to be tested for HIV was slightly greater in the video than pictorial brochure arm (? 0.15; 95% CI: 0.01, 0.28), but did not differ by language spoken or health literacy level. Conclusions:A video improved HIV/AIDS and HIV testing knowledge slightly more than a pictorial brochure. Other considerations (eg, patient volume, staffing, space, and video access) should guide EDs on how best to provide information about HIV testing to ED patients.

SUBMITTER: Merchant RC

PROVIDER: S-EPMC7493585 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Comparison of a video to a pictorial brochure in improving HIV/AIDS and HIV testing knowledge and increasing HIV testing motivation and behavioral skills among adult emergency department patients.

Merchant Roland C RC Marks Sarah J SJ Clark Melissa A MA Carey Michael P MP Liu Tao T

Journal of the American College of Emergency Physicians open 20200320 3

<h4>Objectives</h4>We sought to determine if a pictorial brochure improves HIV/AIDS and HIV testing knowledge and increases HIV testing motivation and behavioral skills as well as a video among adult emergency department patients, regardless of language spoken and health literacy level.<h4>Methods</h4>ED patients were stratified by primary language spoken (English or Spanish) and health literacy level (lower or higher) and randomly assigned to watch the study video or review the content-matched ...[more]

PMID: 33000035

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Project description:BACKGROUND:Although this has not been fully studied, videos and pictorial brochures might be equivalent methods of delivering HIV/AIDS and HIV testing information to emergency departments (ED) patients. It also is not known how well or for how long such knowledge is retained, if this information should be tailored according to patient health literacy, and if retention of this knowledge impacts future HIV testing behavior. METHODS:We will conduct a multi-site, randomized, controlled, longitudinal trial among 600 English- and 600 Spanish-speaking 18-64-year-old ED patients to investigate these questions. We will stratify our sample within language (English vs. Spanish) by health literacy level (lower vs. higher) and randomly assign patients to receive HIV/AIDS and HIV testing information by video or pictorial brochure. All patients will be tested for HIV in the ED. At 12-months post-enrollment, we will invite participants to be tested again for HIV. As primary aims, we will compare the efficacy of pictorial brochures and videos in improving short-term (in ED) HIV/AIDS and HIV testing knowledge and retaining this knowledge over 12 months. We will determine if and how short-term improvement and longer-term retention of knowledge interacts with information delivery mode (pictorial brochure or video), patient health literacy level (lower or higher), and language (English or Spanish). As secondary aims, using the Information-Motivation-Behavioral Skills (IMB) model as a heuristic framework, we will measure constructs from the IMB model relevant to our study, and assess their impact on HIV re-testing behavior; we will also examine the moderating influences of information delivery mode, language, and health literacy level. In addition, we will explore simplified screening strategies to identify ED patients with lower health literacy as ways to implement a tailored approach to HIV/AIDS and HIV testing information delivery in EDs. DISCUSSION:Study findings will guide ED-based delivery of HIV/AIDS and HIV testing information; that is, whether delivery modes (video or pictorial brochure) should be selected for patients by language and/or health literacy level. The results also will inform EDs when, how, and for whom information needs to be provided for those undergoing testing again for HIV within a one-year period. TRIAL REGISTRATION:ClinicalTrials.gov Identifier: NCT02284451 . Posted November 6, 2014.

Project description:IntroductionHIV prevalence is declining in key populations in Armenia including in people who inject drugs (PWID), men who have sex with men, prison inmates, and female sex workers (FSWs); however, prevalence is increasing among Armenians who seasonally migrate to work in countries with higher HIV prevalence, primarily to the Russian Federation.MethodsWe conducted a modelling study using the Optima model to assess the optimal resource allocation to meet targets from the 2013 to 2016 national strategic plan to minimize HIV incidence and AIDS-related deaths by 2020. Demographic, epidemiological, behavioural, and programme cost data from 2000 through 2014 were used to inform the model. The levels of coverage that could be attained among targeted populations with different investments, as well as their expected outcomes, were determined. In the absence of evidence of the efficacy of HIV programmes targeted at seasonal labour migrants, we conducted a sensitivity analysis to determine the cost-effective funding threshold for the seasonal labour migrant programme.ResultsThe optimization analysis revealed that shifts in funding allocations could further minimize incidence and deaths by 2020 within the available resource envelope. The largest emphasis should be on antiretroviral therapy (ART), with the optimal investment to increase treatment coverage by 40%. Optimal investments also involve increases in opiate substitution therapy and FSW programmes, as well as maintenance of other prevention programmes for PWID and prevention of mother-to-child transmission. Additional funding for these increases should come from budgets for general population programmes. This is projected to avert 17% of new infections and 29% of AIDS-related deaths by 2020 compared to a baseline scenario of maintaining 2013 spending. Our sensitivity analysis demonstrated that, at current spending, coverage of annual testing among migrants of at least 43% should be achieved to warrant continuation of funding for this programme.ConclusionsOptimization of HIV/AIDS investment in Armenia, with a main priority for scaling-up ART, and less emphasis on primary prevention in the general non-key population could significantly reduce incidence and deaths by 2020.

Dataset Information

Comparison of a video to a pictorial brochure in improving HIV/AIDS and HIV testing knowledge and increasing HIV testing motivation and behavioral skills among adult emergency department patients.

Publications

Comparison of a video to a pictorial brochure in improving HIV/AIDS and HIV testing knowledge and increasing HIV testing motivation and behavioral skills among adult emergency department patients.

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