An Educational HIV Pretest Counseling Video Program for Off-Hours Testing in the Emergency Department - 18/08/11

Doi : 10.1016/j.annemergmed.2006.01.003

Yvette Calderon, MD, MS ^a,^⁎ , Marianne Haughey, MD ^a, Polly E. Bijur, PhD ^c, Jason Leider, MD, PhD ^b, Lisa Moreno-Walton, MD ^a, Sandra Torres, MSIV ^e, Paul Gennis, MD ^a, Laurie J. Bauman, PhD ^d
^a Department of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY
^b Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY
^c Department of Emergency Medicine, Albert Einstein College of Medicine, Bronx, NY
^d Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY
^e Albert Einstein College of Medicine, Bronx, NY

Address for correspondence: Yvette Calderon, MD, MS, 1400 Pelham Parkway South, Emergency Medicine Department, Room 1W20, Bronx, NY 10461; 718-918-5820, fax 718-918-7459

Résumé

Study objective

Multiple barriers to traditional pretest HIV counseling make HIV testing difficult to accomplish in the emergency department setting in off hours. This study compares the educational effectiveness of a 10-minute pretest counseling video with the usual practice of a session with an HIV counselor.

Methods

This was a prospective randomized controlled trial of adult patients presenting to the urgent care area of a busy inner-city hospital. Patients either viewed an HIV educational video or spoke with an HIV counselor for pretest counseling. The video was developed by 2 of the investigators (YC, MH) and covered essential educational elements for HIV testing, as required by the New York State Department of Health. All participants completed a measure of HIV knowledge after their intervention. An equivalence analysis was performed to assess whether the video was at least as good as counseling in terms of overall mean knowledge score.

Results

Of 129 patients recruited for the study, 65 patients were randomized to the intervention and 64 patients to the control group. Five patients were unable to complete the study. The final analysis was based on 124 patients. Mean knowledge scores were higher in the intervention (85.3% versus 79.7%; 90% confidence interval for the difference 2.6% to 8.7%).

Conclusion

We conclude that the use of an educational video with an inner-city adult population was at least as effective as in-person pretest counseling in conveying information related to HIV testing.

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Plan

Introduction

Materials and methods

Study Design

Setting

Selection of Participants

Interventions

Outcome Measures

Primary Data Analysis

Results

Limitations

Discussion

Supervising editors: Rita K. Cydulka, MD, MS; Arthur L. Kellermann, MD, MPH
Author contributions: YC, PG, JL, MH, PEB, and LJB conceived the study, designed the trial, and obtained research funding. YC and JL supervised the conduct of the trial and data collection. LMW and ST undertook recruitment of patients and managed the data. PEB and LB provided statistical advice on study design, and YC and PEB analyzed the data. YC, JL, and MH drafted the manuscript, and all authors contributed substantially to its revision. YC takes responsibility for the paper as a whole.
Funding and support: The authors report this study did not receive any outside funding or support.
Reprints not available from the authors.