Clinical trial NCT04102540: Information Visualizations to Facilitate HIV-related Patient-provider Communication in New York City (Info Viz: HIV-NYC)
Official title: Information Visualizations to Facilitate HIV-related Patient-provider Communication in New York City (Info Viz: HIV-NYC)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Health Communication
Keywords: Information Visualization
Lead sponsor: Columbia University
Sponsor class: OTHER
Collaborators: name: National Institute of Nursing Research (NINR)
First posted: 2019-09-25
Enrollment: 32
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: This study will use a single pretest-posttest design to evaluate if using infographics for patient education can lead to improved patient outcomes.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: To complete the study aims, a mixed methods study that includes a single group pretest-posttest study design will be used to pilot test the infographic intervention. In-depth interviews will be completed with a selection of participants to explore participant perceptions of HIV-related communication using infographics. Data will be collected from participants through baseline (at enrollment) and follow up assessments at 3- and 6-month follow up visits). Follow up interviews will be conducted with members of the clinical team to ascertain their perspectives on the clinical utility of infographics.

Detailed description: Latinos are the largest and fastest growing minority group in the US, and they are disproportionately affected by HIV. In 2014, almost 25% of new cases of HIV infections were among Latinos although they only represent 17% of the US population. Additionally, Latinos have a faster rate of progression from HIV to AIDS, higher rates of HIV-related deaths, and marked delay in the diagnosis of infections. Approximately 42% of HIV diagnoses among Latinos in the US are in persons born abroad. In absolute numbers, new HIV diagnoses among foreign-born individuals in the US were the highest among Caribbean-born persons, which may partially be attributed to high rates of bidirectional travel. It is, therefore, critical that HIV prevention and treatment activities incorporate factors associated with Latino immigrant and transnational groups. In Washington Heights, New York City, understanding these factors related with bi-directional travel to the Dominican Republic (DR) is warranted, as the Latino population of Washington Heights is largely comprised of Dominicans.

Many factors contribute to the health disparities experienced by Latinos, of which low health literacy and literacy in general are potential contributors. Health literacy, or "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," is an established concern affecting vulnerable communities globally. Not surprisingly, Spanish-speaking, less educated, and/or foreign-born Latinos have lower health literacy than those born in the US. Low health literacy can lead to worse health outcomes, less use of services, and poorer knowledge of illness. Also, patients with limited health literacy are likely to have low numeracy which affects interpretations of medication quantities, time between doses, and time between appointments, among other quantitative knowledge relating to effective management of HIV.

Infographics are emerging technologies to help teach complex health concepts to patients with low health literacy. When effectively designed, infographics (information visualizations) contain a depth and breadth of information and lead to improved understanding of concepts. By carefully selecting the design and included content, simple images can convey large amounts of information in a visually appealing and comprehensible way. Methodically constructed infographics have been shown to improve communication about health behaviors and health risks and minimize comprehension differences between individuals with high and low health literacy. They can also help improve information exchange amidst culture and language differences by using images familiar to patients to explain complicated processes as well as augment attention span and recall of learned material. Furthermore, rigorously designed and evaluated infographics can help mitigate health disparities by helping clinicians provide the information that people need for effective health management in an understandable way.

During preliminary studies, the investigators developed a set of infographics designed to facilitate HIV-related clinician-patient communication during clinic visits. Initial infographics were designed by persons living with HIV (PLWH) in the Dominican Republic and are now being tested for feasibility and usability among a cohort in the DR. In this study, the investigators propose to assess the feasibility of using the infographic intervention in a clinic that specializes in HIV care in Washington Heights to improve clinical communication and subsequently, patient outcomes. Additionally, the investigators will collect information about acculturation and bi-directional travel to more thoroughly assess how these factors relate to HIV infection among Hispanic/Latino populations living in the US.

Eligibility criteria: Inclusion Criteria:

* Adult ≥ 18 years of age
* Living with HIV and has a detectable viral load
* Self-identifies as Hispanic/Latino
* Plan to receive care at the same clinic for the next 6 months

Exclusion Criteria:

* Does not meet inclusion criteria
* Not able to understand study procedures or provide informed consent

Primary outcomes:
measure: Mean CD4 Count
timeFrame: Baseline, 3-, and 6-months
measure: Mean Viral Load
timeFrame: Baseline, 3-, and 6-months
Secondary outcomes:
measure: Mean Score on HIV-related Knowledge Assessment
timeFrame: Baseline, 3-, and 6-months
measure: Mean Score on Satisfaction With Care Scale
timeFrame: Baseline, 3-, and 6-months
measure: Mean Score on the SEMCD Scale
timeFrame: Baseline, 3-, and 6-months
measure: Number of Participants Who Are Adherent to Their Medications
timeFrame: Baseline, 3-, and 6-months
measure: Number of Participants Who Reported Each of the 5 General Health Categories
timeFrame: Baseline, 3-, and 6-months
measure: Mean Score on Current Health Status
timeFrame: Baseline, 3-, and 6-months
measure: Number of Participants With Likely Low vs. Adequate Health Literacy According to SAHL-S&E Measurement
timeFrame: Baseline visit only
measure: Number of Participants With Likely Limited, Possibly Limited, or Adequate Health Literacy According to NVS Measurement
timeFrame: Baseline visit only
measure: Number of Participants in Each Acculturation Category Presented in the Brief ARSMA
timeFrame: Baseline visit only
measure: Percent of Participants Who Complete an In-depth Qualitative Interview
timeFrame: 6 months after baseline
Other outcomes:
Locations:
city: New York
country: United States
facility: Comprehensive HIV Program of NewYork-Presbyterian Hospital
state: New York
Study officials:
affiliation: Columbia University
name: Rebecca Schnall, PhD, MPH, RN
role: PRINCIPAL_INVESTIGATOR
affiliation: Columbia University
name: Samantha B Stonbraker, PhD, MPH, RN
role: STUDY_DIRECTOR
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