Video-Based Delivery of HIV Test Information for Spanish-Speaking Latinos

描述（由申请人提供）：拉丁美洲人在美国艾滋病毒流行中所占比例不成比例。尽管是艾滋病毒感染的高风险人群，但美国大约一半的拉丁美洲人从未接受过艾滋病毒检测。美国拉丁美洲人中超过一半的新艾滋病毒感染者是讲西班牙语的移民，这表明需要创新，有效，文化敏感和语言适当的方法来进行艾滋病毒筛查和诊断测试。这些方法对那些健康知识技能较低的人也必须有效。 在这项R21研究中，为讲西班牙语的拉丁美洲人提供基于视频的艾滋病毒检测信息，我们将在为讲英语的艾滋病毒检测接受者开发有效信息视频方面取得成功。我们在这个项目中的目标是制作一个视频，使讲西班牙语的拉丁美洲人，特别是那些卫生知识技能较低的人，能够理解有关艾滋病毒和艾滋病毒检测的基本信息。该视频最终将用于帮助简化和鼓励艾滋病毒筛查和诊断检测工作。 这项R21早期形成性研究将分三个连续阶段进行。在第一阶段，我们将从60名讲英语和西班牙语的拉丁裔艾滋病毒检测接受者和15名讲英语和西班牙语的拉丁裔艾滋病毒检测提供者的国家样本中获得有关如何在文化和语言上适应原始英语艾滋病毒和艾滋病毒检测信息视频的输入。在第二阶段，我们将使用这一投入制作西班牙语视频，并在全国范围内对来自医疗保健和社区外展艾滋病毒检测机构的60名讲西班牙语的拉丁裔艾滋病毒检测接受者和15名讲西班牙语的拉丁裔艾滋病毒检测提供者进行基于认知的视频评估。在第一阶段和第二阶段，我们将寻求来自不同拉丁美洲亚文化的人口统计学上多样化的受访者群体的投入，以及那些健康素养技能较低的人。 在第三阶段，我们将进行一项随机、对照、非劣效性试验，评估西班牙语HIV和HIV检测信息视频在医疗保健和社区外展HIV检测环境中讲西班牙语的HIV检测接受者中的有效性。我们的目标是确定观看西班牙语视频的艾滋病毒检测接受者是否与通过艾滋病毒检测顾问的介绍获得相同亲自信息的人具有类似的艾滋病毒和艾滋病毒检测知识水平。我们特别感兴趣的是，视频是否对那些健康知识技能较低的人同样有效甚至更有效。如果视频被证明是有效的，我们将免费提供西班牙语视频，供正在进行艾滋病毒筛查和诊断测试的团体作任何非商业用途。我们计划将该视频用于未来的RO1（s），以改善健康知识技能较低的人的艾滋病毒和艾滋病毒检测信息的提供，简化艾滋病毒检测工作，并增加拉丁美洲人口中艾滋病毒检测的利用率。 公共卫生相关性：拉丁美洲人，特别是母语为西班牙语的人，在美国的艾滋病毒流行中占主导地位，只有一半的美国拉丁美洲人接受过艾滋病毒检测。这项研究制作的视频将提供一种文化敏感和语言适当的手段，促进讲西班牙语的拉丁美洲人的艾滋病毒筛查和诊断测试。该项目的最终目标是通过简化但有效的艾滋病毒检测方法，帮助减少艾滋病毒的传播。

DESCRIPTION (provided by applicant): Latinos are disproportionately represented in the US HIV epidemic. Despite being a population at high risk for an HIV infection, approximately half of Latinos in the US have never been tested for HIV. Over half of new HIV infections among US Latinos are among Spanish-speaking immigrants, which indicates a need for innovative, effective, culturally-sensitive, and linguistically-appropriate approaches to conduct HIV screening and diagnostic testing. Such approaches also must be effective for those with lower health literacy skills. In this R21 study, Video-based delivery of HIV test information for Spanish-speaking Latinos, we will build upon our prior success in developing an effective informational video for English-speaking HIV test recipients. Our goal in this project is to produce a video that enables Spanish-speaking Latinos, particularly those with lower health literacy skills, to comprehend fundamental information about HIV and HIV testing. The video will ultimately be employed to help streamline and encourage HIV screening and diagnostic testing efforts. This R21 early-stage, formative research will proceed in three successive stages. In Stage I, we will obtain input about how to culturally and linguistically adapt the original English-language HIV and HIV test information video from a national sample of 60 English- and Spanish-speaking Latino HIV test recipients and 15 English- and Spanish-speaking Latino HIV test providers from the healthcare and the community outreach HIV testing settings. In Stage II, we will produce the Spanish-language video using this input and conduct cognitive-based assessments of the video among a national sample of 60 Spanish-speaking Latino HIV test recipients and 15 Spanish-speaking Latino HIV test providers from the healthcare and the community outreach HIV testing settings. During Stage I and II, we will seek input from a demographically diverse group of respondents from various Latino sub-cultures, as well as those who have lower health literacy skills. In Stage III, we will conduct a randomized, controlled, non-inferiority trial evaluating the effectiveness of the Spanish-language HIV and HIV test information video among Spanish-speaking HIV test recipients in the healthcare and the community outreach HIV testing settings. We aim to determine if HIV test recipients who watch the Spanish-language video have a similar level of knowledge about HIV and HIV testing as those who receive identical in-person information through a presentation from an HIV test counselor. We are specifically interested in whether the video is as or even more effective for those with lower health literacy skills. If the video is shown to be effective, we will make the Spanish-language video freely available for any non- commercial use to groups that are conducting HIV screening and diagnostic testing. We plan to use the video for a future RO1(s) on improving delivery of HIV and HIV test information for those with lower health literacy skills, streamlining HIV test efforts, and increasing utilization of HIV testing among Latino populations. PUBLIC HEALTH RELEVANCE: Latinos, particularly native Spanish-speakers, are overrepresented in the HIV epidemic in the US, and only half of US Latinos have ever been tested for HIV. The video produced from this research will provide a culturally-sensitive and linguistically-appropriate means of facilitating HIV screening and diagnostic testing for Spanish-speaking Latinos. The ultimate aim of this project is to help reduce the transmission of HIV through streamlined yet effective HIV testing approaches.