Development and Pilot Testing of a PHCI for Emergency Department Patients Who Decline Rapid HIV/ HCV Screening
Condition: Hiv; Hepatitis C
MeSH terms: Hepatitis C; Emergencies
Study type: Interventional

Summary: 
      The Centers for Disease Control and Prevention (CDC) recommends that emergency departments
      (EDs) and other health care facilities conduct HIV and HCV screening to identify and link to
      care those with undiagnosed infections. Screening for both infections in EDs is preferable
      due to: the shared overlap of some risk behaviors for HIV and HCV acquisition (e.g., drug
      use) the relatively high co-occurrence of these infections in some populations the more
      complex medical needs and worse sequelae for those co-infected, and efficiency. Although some
      EDs have experimented with dual HIV and HCV screening, best practices on how to conduct
      screening so as to maximize patient screening uptake have yet to be identified.

      In this pilot RCT, the investigators will examine the efficacy of the persuasive health
      communication intervention in convincing adult ED patients who decline rapid HIV/HCV
      screening to be tested for these infections. Adult ED patients who decline rapid HIV/HCV
      screening will be randomly assigned to the ED medical staff arm or the HIV/HCV counselor arm.
      Within each arm, participants further will be randomly assigned to receive the persuasive
      health communication intervention or to watch a CDC HIV/HCV testing brochures-based video.
      Following the intervention or control condition, all participants will be offered rapid
      HIV/HCV testing again.
    

Detailed description: 
      The investigators will conduct this R34 project at the Rhode Island Hospital ED, the primary
      site for many of the research team's previous HIV (Human Immunodeficiency Virus) and HCV
      (Hepatitis C Virus) testing studies. Dr. Beaudoin (PI) is an attending physician at the Rhode
      Island Hospital ED. Our multi-disciplinary team consists of researchers with extensive
      experience in HIV and HCV testing research, intervention development and testing, and
      qualitative, quantitative and cost-effectiveness research.

      First, the investigators will examine our primary objective in this R34 pilot RCT( Randomized
      Controlled Trial) of comparing the persuasive health communication intervention to the video.
      Second, the investigators can compare WITHIN study arms (HIV/HCV counselor arm, ED medical
      staff arm) and ACROSS these study arms uptake of HIV/HCV testing among participants. Second,
      the design permits the investigators to obtain initial efficacy data of the persuasive health
      communication intervention when used by HIV/HCV counselors vs. ED medical staff (ACROSS study
      arms), as well as compared to the video (WITHIN study arms). Third, the design replicates our
      subsequent R01 RCT when the investigators compare HIV/HCV screening uptake when conducted
      solely by HIV/HCV counselors vs. ED medical staff.
    

Intervention name(s): Persuasive Health Communication Intervention
Intervention type(s): Behavioral
Intervention description(s): A persuasive health communication intervention will be performed
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Adult ED patients who decline rapid HIV/HCV screening will be randomly assigned to the ED medical staff arm or the HIV/HCV counselor arm. Within each arm, participants further will be randomly assigned to receive the persuasive health communication intervention or watch the CDC HIV/HCV testing brochures-based video.
Masking: None (Open Label)
Primary purpose: Other