Observed reactions among patients attending HIV treatment facilities to a brief video intervention on treatment initiation and adherence

ABSTRACT

Entertainment-education can affect positive behavior change. Taking Care of Me is an effective, video-based intervention designed to improve patients’ continuum of HIV care outcomes. The study’s aim was to refine the pre-final video at points where patients stopped watching and missed embedded health messages. We evaluated the video using systematic unobtrusive observations triangulated with electronic medical record (EMR) data. We conducted observations in three HIV treatment facilities’ waiting rooms in the southern US in 2016. Using a web-based data collection instrument, one observer spent 8 h at each facility observing patients’ engagement with the video. We mapped the embedded messages in each scene and identified the messages that patients missed when they stopped watching. We compared missed messages to treatment initiation, medication adherence, and retention in care data abstracted from each clinic’s EMR system. We were able to identify specific scenes where low levels of engagement corresponded to lower than expected retention in care outcomes and edit these scenes to improve engagement. Identifying and editing video scenes to increase viewership potentially could enhance intervention efficacy. Our methods could be used to assess and refine other video-based interventions being developed in resource limited settings.

KEYWORDS:

• HIV prevention
• entertainment-education
• video intervention
• intervention exposure
• engagement
• qualitative research

Acknowledgements

The study group thanks Sentient Research and Education Development Center for their collaboration on the project, the researchers on the project’s medical results study (Craig B. Borkowf, Marjan Javanbakht, Jeffrey D. Klausner, Kevin C. Malotte, Jorge A. Montoya, Athi Myint-U, Lydia O’Donnell, Cornelis A. Rietmeijer, Susan Robilotto), the project technical consultants who provided input and review of the video storylines and scripts, the videographer (Jesse Moss of Mile End Films West, http://www.mileendfilms.com), the HIV treatment facilities (Thrive Alabama, Huntsville, AL; Borinquen Medical Center, Miami, FL; and HIV Primary Care Clinic, Atlanta, GA) and their staff which implemented the intervention and shared their data, and the patients of these facilities who saw the video.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The data collected and used for this study were funded by the Health and Human Services Secretary’s Minority AIDS Initiative and by the Centers for Disease Control and Prevention through contract number 200-2013-57577 awarded to Sentient Research. The Secretary’s Minority AIDS Initiative provided direct funding. The Centers for Disease Control and Prevention provided direct funding and support in the form of salaries for authors MSN, ADM, and SAF but did not have any additional role in the study design, data collection and analysis, decision to publish or preparation of the manuscript. The three authors who were or are employees of the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, had roles in study design, data collection and analyses, decision to publish, and preparation of the manuscript. One author is an employee of the commercial company, Sentient Research (AP), and had a role in study design, data collection, and preparation of the manuscript. The specific roles of study authors are articulated in the “author contribution” section.