The CDC recommends that routine HIV screening be offered to all adults aged 13 - 64 seen in outpatient medical settings to identify and treat patients with asymptomatic infection. The two greatest barriers to implementing routine HIV screening are patient acceptance and additional workload imposed on healthcare staff. A computer kiosk module can potentially address both of these barriers by automating pre-test education and streamlining informed consent.
Aim 1. Identify provider barriers to routine HIV screening that may be successfully addressed by a kiosk-based module.
Aim 2. Develop a computer kiosk module to minimize attitudinal and operational barriers to HIV screening.
To identify operational barriers to routine HIV screening, we performed structured interviews with eight health care providers experienced in performing rapid oral testing. We performed content analysis of interview field notes to identify 1) knowledge and implementation barriers amenable to a kiosk module intervention, 2) factors that may affect module effectiveness, and 3) potential barriers to kiosk module use. Based on these findings, we developed an educational script for a touch-screen operated module with menu driven video sequences. A beta-version was tested on nine urgent-care patients to identify content and usability problems.
Through structured provider interviews, we identified common patient concerns about routine HIV screening. These were grouped into the following categories: indications for testing; HIV risk factors; test accuracy; test interpretation of test results; and effects on privacy and benefits. The content and form of the module were modified based on structured patient feedback interviews, and we have completed a final production module.
We developed an educational module which may reduce provider burden of providing pre-test counseling and improve patient acceptance of routine HIV screening. We plan to test these hypotheses in future interventional trials.
- Saifu HN, Shamouelian A, Davis LG, Santana-Rios E, Goetz MB, Asch SM, Sun BC. Impact of a kiosk educational module on HIV screening rates and patient knowledge. Journal of telemedicine and telecare. 2012 Mar 1; 17(8):446-50.
- Sun BC, Knapp H, Shamouelian A, Golden J, Goetz MB, Asch SM. Effect of an education kiosk on patient knowledge about rapid HIV screening. Journal of telemedicine and telecare. 2010 Jan 1; 16(3):158-61.