The importance of content and choice in a technology-based intervention to increase HIV testing

ABSTRACT

Although the Centers for Disease Control and Prevention recommends routine HIV testing in emergency departments and other facilities, many patients are never offered testing, and those who are offered testing frequently decline. In response, our team developed and evaluated a series of differently configured technology-based interventions to explore how we can most effectively increase HIV testing among reluctant patients. The current study examines how different videos (onscreen physician vs. onscreen community member), and different intervention configurations (enabling some participants to select a video while others are assigned to watch a video or to view bullet-point text), could potentially increase self-efficacy to test for HIV among patients who had never tested. Analyses of data from 285 emergency department patients in New York City who declined HIV testing offered by hospital staff indicated that participants reported highly significant differences in self-efficacy depending on their history of previous testing, whether they were enabled to select a video or were assigned a video, and which video they watched. Participants who reported no previous testing reported significantly lower pre-test self-efficacy compared to those who had tested at least once before. Among those who had not previously tested, the greatest pre-post increases in self-efficacy were reported by participants who were randomly enabled to select an intervention video and chose to watch video depicting a physician. Our findings highlight the importance, not only of intervention content, but how that content is delivered to specific participants. These findings may inform more effective technology-based behavioral health interventions.

KEYWORDS:

• HIV testing
• technology-based intervention
• self-efficacy
• New York City

Acknowledgments

The current study was funded by grants from the National Institutes of Health, including NICHD R42 HD088325; NIDA P30 DA029926; NIDA P30 DA011041. Dr. Aronson is a co-founder of Digital Health Empowerment, which is a small business that creates technology-based behavioral health interventions. No Digital Health Empowerment products were used as part of the current research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [R42HD088325]; National Institute on Drug Abuse [P30DA011041,P30DA029926,R34DA037129].