Selective Exposure in HIV Prevention
| Status: | Completed |
|---|---|
| Conditions: | HIV / AIDS |
| Therapuetic Areas: | Immunology / Infectious Diseases |
| Healthy: | No |
| Age Range: | 18 - 35 |
| Updated: | 1/19/2018 |
| Start Date: | May 2010 |
| End Date: | April 30, 2017 |
Study to Test Meta-intervention to Increase Retention in HIV Prevention Counseling
Unfortunately, people most at risk for HIV are the least likely to enroll and remain in
prevention programs. In our past work, we have learned how to increase enrollment in such
programs among this group. We have identified and addressed previously ignored
gender-specific and client self-validation issues that conventional interventions often leave
not only uncontrolled, but often biased against participation. The present work will extend
these methods from enrollment to retention.
We intend to recruit a sample of 656 at-risk participants through our collaboration with the
Duval County, FL Health Department for our randomized, double-blind trial. Our study will
investigate if a meta-intervention video designed for empowering participants as agents of
their own change can increase the number of attended sessions relative to a control condition
without such a video. This trial will also determine if a meta-intervention video addressing
various emotional/social and instrumental benefits of an HIV-prevention-counseling
intervention can also increase the number of attended sessions. These two factors will be
crossed, and their effects on retention will be estimated for different genders and
ethnicities. Effects on clients' attention to the return sessions as reported by the
counselor will also be explored among participants who return.
We will also conduct mediator analyses for investigating if the meta-intervention has
mediating influences on corresponding expectations about the return counseling session. As
the inclusion of meta-cognitive measures can alter the efficacy of the intervention, half of
the sample will receive measures immediately (0-10 minutes) after exposure to the
meta-intervention, before attendance to the next session is registered. The other half will
not complete these measures.
prevention programs. In our past work, we have learned how to increase enrollment in such
programs among this group. We have identified and addressed previously ignored
gender-specific and client self-validation issues that conventional interventions often leave
not only uncontrolled, but often biased against participation. The present work will extend
these methods from enrollment to retention.
We intend to recruit a sample of 656 at-risk participants through our collaboration with the
Duval County, FL Health Department for our randomized, double-blind trial. Our study will
investigate if a meta-intervention video designed for empowering participants as agents of
their own change can increase the number of attended sessions relative to a control condition
without such a video. This trial will also determine if a meta-intervention video addressing
various emotional/social and instrumental benefits of an HIV-prevention-counseling
intervention can also increase the number of attended sessions. These two factors will be
crossed, and their effects on retention will be estimated for different genders and
ethnicities. Effects on clients' attention to the return sessions as reported by the
counselor will also be explored among participants who return.
We will also conduct mediator analyses for investigating if the meta-intervention has
mediating influences on corresponding expectations about the return counseling session. As
the inclusion of meta-cognitive measures can alter the efficacy of the intervention, half of
the sample will receive measures immediately (0-10 minutes) after exposure to the
meta-intervention, before attendance to the next session is registered. The other half will
not complete these measures.
1. After the Informed Consent is signed, the research assistant supervises administration
of the baseline questionnaire via ACASI. In ACASI, the questions are seen on the
computer screen and heard through earphones simultaneously. This technique has been
shown to enhance the accuracy of any reported non-normative behavior by the relative
privacy and anonymity it affords. It is expected to take about 30 minutes.
2. Participants are seen for one-on-one HIV counseling for approximately 20 minutes by
counselors briefed to the study according to the protocol described in the attached
document "Scripts Florida Study.doc" (hereinafter "the Scripts document").
3. After the counseling session, participants will watch a 20-minute video delivering one
of the experimental or control meta-intervention messages, which are more fully
described in the Scripts document.
4. The self-reporting of expectations and intentions that we need to elicit at this point
may have a confounding effect on the retention that the study hopes to measure.
Therefore, half of the participants will skip the next step and half will complete it,
to allow us to assess the actual effect of this self-report measure on retention while
studying if these measures mediate retention.
5. The half of the participants reporting expectations will report their expectations and
intentions for further counseling, via a 10-minute ACASI questionnaire. The
questionnaire is designed to distinguish the dimensions of social/emotional,
instrumental and empowering expectations.
6. At the end of the first 70-80 minute session, the counselor schedules the follow-up
appointments.
7. Customary phone reminders are issued two days before each 20-minute follow-up session,
as is routine for medical and counseling appointments.
8. The study counselor does the following at each follow-up session:
- Records the participant's attendance or absence on the Counselor's Questionnaire.
- For attending participants, the study counselor rates their attention to the
counseling on the Counselor's Questionnaire.
- The RA in charge of video presentation rates attention to the videos.
- At the end of the second session, the study counselor double-checks the third
appointment with the participant, and reschedules if necessary.
9. A detailed description of the two follow-up sessions is found in the attached document
titled "Counselor Guidelines (2nd and 3rd sessions). The questions and statements
therein will be delivered and answered verbally.
10. At the end of the third session, participants who did not answer the questionnaire in
Step 5 will answer a similar questionnaire about their reactions to the
meta-intervention video.
11. All participants will be fully debriefed. Non-attendees will be called and debriefed
either by phone or in person based on their preferences.
of the baseline questionnaire via ACASI. In ACASI, the questions are seen on the
computer screen and heard through earphones simultaneously. This technique has been
shown to enhance the accuracy of any reported non-normative behavior by the relative
privacy and anonymity it affords. It is expected to take about 30 minutes.
2. Participants are seen for one-on-one HIV counseling for approximately 20 minutes by
counselors briefed to the study according to the protocol described in the attached
document "Scripts Florida Study.doc" (hereinafter "the Scripts document").
3. After the counseling session, participants will watch a 20-minute video delivering one
of the experimental or control meta-intervention messages, which are more fully
described in the Scripts document.
4. The self-reporting of expectations and intentions that we need to elicit at this point
may have a confounding effect on the retention that the study hopes to measure.
Therefore, half of the participants will skip the next step and half will complete it,
to allow us to assess the actual effect of this self-report measure on retention while
studying if these measures mediate retention.
5. The half of the participants reporting expectations will report their expectations and
intentions for further counseling, via a 10-minute ACASI questionnaire. The
questionnaire is designed to distinguish the dimensions of social/emotional,
instrumental and empowering expectations.
6. At the end of the first 70-80 minute session, the counselor schedules the follow-up
appointments.
7. Customary phone reminders are issued two days before each 20-minute follow-up session,
as is routine for medical and counseling appointments.
8. The study counselor does the following at each follow-up session:
- Records the participant's attendance or absence on the Counselor's Questionnaire.
- For attending participants, the study counselor rates their attention to the
counseling on the Counselor's Questionnaire.
- The RA in charge of video presentation rates attention to the videos.
- At the end of the second session, the study counselor double-checks the third
appointment with the participant, and reschedules if necessary.
9. A detailed description of the two follow-up sessions is found in the attached document
titled "Counselor Guidelines (2nd and 3rd sessions). The questions and statements
therein will be delivered and answered verbally.
10. At the end of the third session, participants who did not answer the questionnaire in
Step 5 will answer a similar questionnaire about their reactions to the
meta-intervention video.
11. All participants will be fully debriefed. Non-attendees will be called and debriefed
either by phone or in person based on their preferences.
Inclusion Criteria:
- Sexually active,
- Low condom use,
- Low intention to use condom
Exclusion Criteria:
- Trying to get pregnant
- HIV positive
- with contaminant knowledge about the study
- planning to leave the area
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