Innovative Computer Prototype for HIV Screening and Brief Intervention

描述（由申请人提供）：艾滋病毒仍然是美国的一个主要公共卫生问题，但在许多医疗机构中，艾滋病毒预防服务的渗透率有限。需要将艾滋病毒预防无缝整合到医疗实践中的新方法。拟议的第1阶段STTR项目旨在确定设计创新的计算机化艾滋病毒风险筛查和简短干预软件程序的关键组成部分的可行性，该软件程序适用于各种医疗保健环境。设想中的艾滋病毒风险筛查和简要干预软件将设计用于配备耳机的触摸屏平板电脑，这是一项目前可用的技术，在未来十年内只会变得更加负担得起和无处不在。拟议的简短干预将由既定的社会行为理论提供信息，并将使用个性化规范反馈，规范误解纠正和有针对性的风险降低教育的有前途的策略。干预内容将根据患者对风险行为筛查问题的回答专门针对每位患者。设想的产品最终可能具有成功商业化的高潜力。此外，它可以通过促进在医疗保健环境中更快地传播艾滋病毒预防服务而产生重大的公共卫生影响。拟议项目将有两个总体目标，每个目标都有具体的里程碑。这些目标包括（1）核心组件设计和（2）可行性测试和改进。本I期STTR中的形成性研究将提供关键信息，以指导软件应用程序的设计，该软件应用程序可在未来的随机试验中进行严格测试。原型开发将由一个由有关专家和服务提供者组成的项目咨询小组指导。原型开发完成后，将对软件进行用户测试、反馈和改进。参与者将从一个社区卫生诊所招募，以测试原型，并讨论他们的经验和建议，以改进半结构化的定性访谈。 公共卫生相关性：拟议的第一阶段STTR项目将完成必要的基础工作，以进一步开发可用于各种医疗环境的计算机化艾滋病毒筛查和简短干预软件程序。使用研究驱动的过程，该项目将最终在开发和用户测试的原型软件程序，然后可以进一步完善和测试，在严格的随机试验作为第二阶段STTR项目的一部分。拟议的项目在应用新兴技术预防我们这个时代最具破坏性的疾病之一方面具有高度创新性。它也代表了一种新的应用规范反馈和误解纠正策略，以减少艾滋病毒的危险行为。最后，它在利用现有流行病学数据提供精确的、按人口统计量身定制的规范性比较信息方面具有创新性。该方法还具有巨大的公共卫生潜力，特别是考虑到前端设计考虑因素，以确保最终产品适用于各种医疗保健环境。一种内置简短干预的计算机化筛查产品可以改善患者对风险行为的披露，并大大提高医疗保健系统向广泛患者提供艾滋病毒预防的能力。设想中的软件将绕过许多长期存在的障碍，这些障碍阻碍了将艾滋病毒预防作为日常护理的一部分。这样做不会显著增加医护人员的时间负担。因此，设想的软件可以大大加快艾滋病毒预防服务在各种医疗保健环境中的吸收。

DESCRIPTION (provided by applicant): HIV continues to be a major public health problem in the United States, but there has been limited penetration of HIV prevention services in many healthcare settings. Novel methods for seamlessly integrating HIV prevention into medical practice are needed. The proposed Phase 1 STTR project seeks to establish the feasibility of designing key components of an innovative computerized HIV risk screening and brief intervention software program that would be appropriate for use in a variety of healthcare settings. The envisioned HIV risk screening and brief intervention software will be designed for use on headphone-equipped touch screen tablet computers, a technology that is currently available and will only become more affordable and ubiquitous in the next decade. The proposed brief intervention will be informed by established social-behavioral theories and will use the promising strategies of personalized normative feedback, norms misperception correction, and targeted risk reduction education. Intervention content will be targeted specifically to each patient based on their responses to risk behavior screening questions. The envisioned product could ultimately have high potential for successful commercialization. Moreover, it could have significant public health impact by facilitating faster diffusion of HIV prevention services in healthcare settings. The proposed project will has two overarching aims, each with specified milestones. These aims include (1) Core Components Design and (2) Feasibility Testing and Refinement. The formative research in this Phase I STTR will provide critical information to guide the design of a software application that can be rigorously tested in future randomized trials. Prototype development will be guided by a Project Advisory Panel of relevant experts and service providers. Following development of a prototype, the software will be subjected to user testing, feedback, and refinement. Participants will be recruited from a community-based health clinic to test the prototype and discuss their experiences and suggestions for improvement in semi-structured qualitative interviews. PUBLIC HEALTH RELEVANCE: The proposed Phase I STTR project will complete necessary groundwork to further the development of a computerized HIV screening and brief intervention software program that can be used in a variety of medical contexts. Using a research-driven process, the project will culminate in the development and user testing of a prototype software program which can then be further refined and tested in a rigorous randomized trial as part of a Phase II STTR project. The proposed project is highly innovative in its application of emerging technology to prevent one of the most devastating diseases of our time. It also represents a novel application of normative feedback and misperception correction strategies to reduce HIV risk behaviors. Finally, it is innovative in its use of existing epidemiological data to deliver precise, demographically-tailored normative comparison information. The approach also has substantial public health potential, particularly given the front-end design considerations to ensure suitability of the ultimate product for a variety of healthcare environments. A computerized screening product with a built-in brief intervention could improve patient disclosure of risk behaviors and dramatically enhance the healthcare system's capacity to deliver HIV prevention to a broad spectrum of patients. The envisioned software would circumvent many of the persistent barriers that stymie the adoption of HIV prevention as part of routine care. It would do so without adding significantly to the time burden for healthcare staff. Hence, the envisioned software could dramatically accelerate uptake of HIV preventive services in various healthcare settings.