Proof of concept of a self-administered digital health screener (Stopped Enrollment)

The objective of this study is to develop and pilot a brief (3-5 minute) self-administered digital health screener (SASH) to increase the reporting of unhealthy alcohol consumption among those in HIV care in Uganda. The central hypothesis is that a SASH can increase reporting of unhealthy alcohol use. The rationale is that digital technologies such as Audio Computer-Assisted Self Interviewing (ACASI) have increased the rate of reporting of sensitive behaviors in several settings. Developed countries increasingly use tablets for the self-completion of clinic entry forms, and a few clinics have examined the use of digital screening for risk behaviors with promising results(?). The rise of mobile device use worldwide makes digital screening technology feasible in resource poor settings, and the simplicity of touch-screen computers (tablets or smartphones) allow for use by low-literacy populations. Thus, SASH may provide an acceptable conduit to ABI, delivered in-person or electronically.

Specific Aims:

Aim 1. To develop a brief touch-screen tablet based SASH, to be administered in an HIV clinic waiting room, to increase reporting of unhealthy alcohol use for persons with HIV in Uganda.

1. We will conduct focus group discussions (FGDs) with clinic staff and clinicians, and patients who have previously under-reported their drinking and patients with low/no literacy (4 FGDs, 4-6 persons each). These groups will provide input into the format and content of the SASH as well as facilitators and barriers to eventual implementation.
2. We will undergo an iterative process to develop the SASH, demonstrating and testing the SASH prototype and modifying after each round according to feedback. This will be conducted iteratively with 4-6 patients and clinic staff who emerge from the FGDs as opinion leaders.

Aim 2. To pilot the SASH developed in Aim 1 to examine acceptability, ease of use, comfort with reporting, and to discuss how the results of such screening might be used.

1. We will pilot the SASH with 10 clinic patients who have previously under-reported their drinking, and 10 patients with low/no literacy. After piloting the SASH we will conduct qualitative interviews with these patients to examine their experience using the SASH and discuss the above issues.

Principal Investigators: Judy Hahn (UCSF) and   Dr. Winnie Muyindike