About this Video

"What do you know about HIV and HIV testing?" is approximately a 15.5-minute video that contains information about conventional and rapid HIV testing in comparable English-language and Spanish-language formats. The animated and live-action video contains US Centers for Disease Control and Prevention (CDC)-recommended elements of HIV/AIDS and HIV testing information1, as well as information about acute HIV infection and current methods of HIV testing (rapid and conventional; oral, fingerstick and phlebotomy sampling; and antibody, antigen, and ribonucleic acid testing) without mention of any type of testing product. The narrated video follows two protagonists (male and female; purposely racially/ethnically ambiguous and not named to appeal to a wider audience and avoid social labels) as they receive information about HIV/AIDS and HIV testing and proceed through the HIV testing process. Animation, graphics, images, still shots, text, and live-action segments are used to emphasize the topics presented.

Video Development

The video was produced through a partnership of clinicians and researchers at Brown University, Rhode Island Hospital, and Northeastern University. It was developed through a multi-phase process with the assistance and feedback of clients, patients, and staff from clinical and non-clinical settings from six cities throughout the United States.

The study authors first created an English-language draft of the video based upon prior English-language videos by the study authors on the same topic. Next, sixty bilingual (English- and Spanish-speaking) 18-64-year-old Latino patients/clients were recruited to review the video and provide feedback through qualitative, semi-scripted interviews at three healthcare sites (an ambulatory medicine clinic in Providence, Rhode Island, an emergency department in Los Angeles, California, and a sexually transmitted disease clinic in San Juan, Puerto Rico) and three non-healthcare sites (community-based organizations that provide HIV testing chiefly for Latinos in Chicago, Illinois; Miami, Florida; and San Antonio, Texas). Fifteen bilingual HIV test counselors at the non-healthcare sites were also recruited to review video and provide feedback. The English-language video was then adapted and revised for primarily Spanish-language speakers based upon the results of the interviews. Translation accuracy was verified by the bilingual members of the research team and through recommended translation/back-translation techniques.2-4

Following creation of the Spanish-language video draft, standard cognitive-based assessments5-8 were conducted at the three healthcare and three non-healthcare sites to evaluate the Spanish-language video draft among 60 18-64-year-old primarily Spanish-speaking Latino patients or clients and 15 bilingual HIV test counselors. The video was revised based upon the results of these assessments. The Fernandez-Huerta Readability Score9 for the final script for the Spanish-language version of the video was 85, which indicated an “easy” level of reading difficulty. A comparable English-language version of the video was created. The final English-language version of the video script has a Flesch reading ease of 72.9, indicating a low reading ability level.

Video Efficacy Assessment

The Spanish-language version of the video's effectiveness in comparison to orally-delivered information from an HIV test counselor was demonstrated through a randomized, controlled, non-inferiority trial among 150 primarily Spanish-speaking clients and patients at three clinical and non-clinical settings in Providence, Rhode Island. [citation to https://www.ncbi.nlm.nih.gov/pubmed/25179540 ] After the video or orally-delivered information, HIV/AIDS and HIV testing knowledge applicable to CDC recommendations was assessed through a 25-item questionnaire. The mean scores on the questionnaire for the video (20.4; 95% CI: 19.5~21.3) and orally-delivered information (20.6; 95% CI: 19.7~21.5) groups (Δ = -0.15; 95% CI: -1.4~1.1) were similar, which indicated that those who watched the video and received information orally demonstrated a similar level of knowledge. Of those who watched the video, 93% stated that they were well or very well informed, and of those who received information orally, 96% stated that they were well or very well informed.

A study was also performed to determine if a video improved HIV/AIDS and HIV testing knowledge among a global sample of Internet users, to discern if this improvement was the same for English and Spanish speakers, and to ascertain if the video was efficacious for those with lower health literacy. [citation tohttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012116/ ] A worldwide sample of English- or Spanish-speaking Internet users was solicited. Participants completed a 25-item questionnaire to assess their HIV/AIDS and HIV testing knowledge before and after watching the video. Mean scores on the questionnaire improved after watching the video for both English speakers (after: 19.6 versus before: 16.4; Δ = 3.2; 95% confidence interval [CI]: 2.8-3.5) and Spanish speakers (20.7 versus 17.3; Δ = 3.4; 95% CI: 3.0-3.8). There was no difference in improvement of scores between English and Spanish speakers (Δ = −0.24; 95% CI: −0.79 to 0.31), and this video was equally efficacious for those with lower and higher health literacy skills.

Funding for Video

The development of the video's content and the subsequent evaluation of the video were made possible through a grant from the National Institute of Nursing Research (R21NR011997). The collaborators at Brown University, Rhode Island Hospital and Northeastern University, but not the National Institute of Nursing Research were responsible for the educational, substantive, and scientific content of the video.

Additional Information and Contact

For more information about this video and its previous versions, visit the Brown University AIDS Program website.

If you have any additional inquires, please contact:
Roland C. Merchant, MD, MPH, ScD
Associate Professor
Emergency Medicine and Epidemiology
Alpert Medical School of Brown University
Rhode Island Hospital
Roland_Merchant@brown.edu

Citations

  1. Centers for Disease Control and Prevention. Revised guidelines for HIV counseling, testing, and referral. MMWR Recomm Rep. 2001;50(RR-19):1-57.
  2. Brislin RW. Back-translation for cross-cultural research. Cross-Cultural Psychology. 1970;1(3):185-216.
  3. Brislin RW. The wording and translation of research instruments. In: Lonner WJ, Berry J, eds. Field methods in cross-cultural research. Beverly Hills: Sage Publications; 1986:137-164.
  4. Jones PS, Lee JW, Phillips LR, Zhang XE, Jaceldo KB. An adaptation of Brislin's translation model for cross-cultural research. Nurs Res. Sep-Oct 2001;50(5):300-304.
  5. Jobe JB, Mingay DJ. Cognitive research improves questionnaires. Am J Public Health. Aug 1989;79(8):1053-1055.
  6. Sudman S, Bradburn NM, Schwarz N. Thinking about answers : the application of cognitive processes to survey methodology. San Francisco: Jossey-Bass Publishers; 1995.
  7. Willis GB, Royston, Patricia, Bercini, Deborah. The use of verbal report methods in the development and testing of survey questionnaires. Applied Cognitive Psychology. 1991;5(3):251-267.
  8. Willis GB. Cognitive interviewing: a tool for improving questionnaire design. Thousand Oaks, CA: SAGE Publications, Inc.; 2005.
  9. Fernandez-Huerta JM. Medidas sencillas de lecturabilidad (Simple readability measures). Consigna. 1959;214:29-32.