Innovative Computer Prototype for HIV Screening and Brief Intervention

描述（由申请人提供）：艾滋病毒在美国仍然是一个主要的公共卫生问题，但在许多医疗保健机构中，艾滋病毒预防服务的普及率有限。需要将艾滋病毒预防无缝整合到医疗实践中的新方法。拟议的第一阶段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件的可行性，该软件程序将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短干预软件将被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便宜和普遍。建议的简短干预将以已建立的社会行为理论为依据，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等有前途的策略。干预内容将根据每位患者对风险行为筛查问题的回答专门针对每位患者。设想中的产品最终可能具有成功商业化的巨大潜力。此外，它可以通过促进在卫生保健环境中更快地传播艾滋病毒预防服务，对公共卫生产生重大影响。拟议的项目将有两个总体目标，每个目标都有特定的里程碑。这些目标包括(1)核心组件设计和(2)可行性测试和改进。第一阶段STTR中的形成性研究将为指导软件应用程序的设计提供关键信息，这些应用程序可以在未来的随机试验中进行严格的测试。原型开发将由相关专家和服务提供商组成的项目咨询小组指导。在原型开发之后，软件将受到用户测试、反馈和改进的影响。将从一个社区卫生诊所招募参与者来测试原型，并在半结构化定性访谈中讨论他们的经验和改进建议。

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.