Facilitating HIV/AIDS and HIV Testing Literacy for Emergency Department Patients

促进急诊科患者的艾滋病毒/艾滋病和艾滋病毒检测知识

• 批准号: 8896881
• 负责人: Roland C Merchant
• 金额: $ 69.24万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-07-23 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8896881
• 关键词: AIDS/HIV problem; Accident and Emergency department; Address; Attitude; Behavior; Behavioral; Belief; Centers for Disease Control and Prevention (U.S.); Emergency Department patient; English Language; Enrollment; Equipment; Future; HIV; HIV Infections; HIV risk; Health; Human immunodeficiency virus test; Knowledge; Knowledge acquisition; Language; Measures; Modeling; Motivation; Oral; Pamphlets; Participant; Patients; Persons; Randomized; Resources; Risk; Risk-Taking; Sampling; Self Efficacy; Site; Study models; Test Result; Testing; Text; Time; Variant; Writing; arm; base; behavior test; comparative efficacy; disorder prevention; health literacy; heuristics; improved; literacy; response; satisfaction; skills; uptake

DESCRIPTION (provided by applicant): The Centers for Disease Control and Prevention (CDC) recommends that all patients should receive information about HIV/AIDS and HIV testing orally or in writing at every HIV testing encounter. However, for busy emergency departments (EDs), delivering information orally is a barrier to HIV testing, and written brochures likely are not useful for those with lower health or general literacy. Videos might be as or more efficacious than orally-delivered information in improving HIV/AIDS and HIV testing knowledge, particularly for those with lower health literacy skills. However, the resources required to show videos might limit their use in EDs. Pictorial brochures are a promising alternative, but are of unknown efficacy. Regardless of how patients are informed, we do not know how well or for how long this knowledge is retained, if this information should be delivered according to patient needs and abilities, and if retention of this knowledge impacts future HIV testing behavior. This R01 study will address these gaps in our understanding. 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. Using a valid measure of health literacy, we will stratify our sample within language by health literacy level (lower vs. higher). We will randomly assign patients to receive HIV/AIDS and HIV testing information by video or pictorial brochure. At one year post-enrollment, we will offer participants an opportunity 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. More specifically, 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 examine components of the IMB model relevant to our study and their interrelationships, their impact on HIV re-testing behavior, and the moderating influence of information delivery mode, language and health literacy level through the model. In regards to HIV re-testing behaviors, we will assess: (1) testing uptake at one year post-enrollment when offered as part of the study, (2) testing utilization during the study period but not as part of the study, and (3) change in testing utilization one year pre vs. post study enrollment. 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, or whether either mode could be used. The results also will inform EDs when, how, and for whom information needs to be provided for those testing again for HIV within one year.

描述（由申请人提供）：疾病控制和预防中心（CDC）建议，所有患者都应在每次HIV检测时以口头或书面形式获得有关HIV/AIDS和HIV检测的信息。然而，对于忙碌的急诊科（ED）来说，口头提供信息是艾滋病毒检测的一个障碍，而书面小册子对那些健康状况较低或一般文化水平较低的人可能没有用。在提高艾滋病毒/艾滋病和艾滋病毒检测知识方面，视频可能与口头传播的信息一样有效或更有效，特别是对于那些健康知识技能较低的人。然而，显示视频所需的资源可能会限制其在ED中的使用。图画小册子是一个很有前途的选择，但其功效尚不清楚。 无论患者如何被告知，我们都不知道这些知识被保留了多久，这些信息是否应该根据患者的需求和能力提供，以及这些知识的保留是否会影响未来的HIV检测行为。这项R01研究将解决我们理解中的这些差距。 我们将在600名讲英语和600名讲西班牙语的18 - 64岁艾德患者中进行一项多中心、随机、对照、纵向试验，以调查这些问题。使用有效的健康素养衡量标准，我们将 我们的样本在语言内的健康素养水平（较低与较高）。我们将随机分配病人接受艾滋病毒/艾滋病和艾滋病毒检测信息的视频或图片小册子。注册后一年，我们将为参与者提供再次接受艾滋病毒检测的机会。 作为主要目标，我们将比较图片小册子和视频在提高短期（艾德）艾滋病毒/艾滋病和艾滋病毒检测知识和保留这些知识超过12个月的效果。更具体地说，我们将确定知识的短期改善和长期保留是否以及如何与信息传递模式（图片小册子或视频），患者健康素养水平（较低或较高）和语言（英语或西班牙语）相互作用。 作为第二个目标，使用信息动机行为技能（IMB）模型作为启发式框架，我们将检查IMB模型的组件相关的我们的研究和他们的相互关系，他们对艾滋病毒重新检测行为的影响，并通过该模型的信息传递模式，语言和健康素养水平的调节作用。关于HIV复检行为，我们将评估：（1）作为研究的一部分提供时，入组后1年的检测使用情况，（2）研究期间但不作为研究一部分的检测使用情况，以及（3）研究入组前1年与研究入组后1年检测使用情况的变化。 研究结果将指导基于教育的艾滋病毒/艾滋病和艾滋病毒检测信息的提供;即是否应根据语言和/或健康知识水平为患者选择提供模式（视频或图片小册子），或者是否可以使用任何一种模式。结果还将告知ED何时，如何以及需要为那些在一年内再次进行艾滋病毒检测的人提供信息。