HSR&D Home » Research » RRP 08-251 – QUERI Project
Email Social Marketing of HIV Testing
Donald K McInnes, ScD MS BA
VA Bedford HealthCare System, Bedford, MA
Funding Period: October 2008 - March 2009
Early detection of HIV disease is a crucial health issue in the VA. In the U.S., up to 25% of persons who are infected with HIV are unaware of their status. Despite frequent opportunities for early diagnosis, only 30-50% of VA patients with documented risk factors for HIV infection have been tested. Earlier detection of HIV helps prevent serious HIV-related health problems, leads to cost-effective early treatment, and helps reduce risky behaviors that spread the virus.
The objectives of this study are to: (a) assess Veteran and provider attitudes/beliefs about the MyHealtheVet (MHV) website and its use to transmit public health messages; (b) develop draft messages that educate patients about the CDC guidelines and encourage them to be tested for HIV (and other health conditions); (c) evaluate patient and provider reactions to these messages; and (d) select one message and refine it, in preparation email broadcasting.
We conducted 2 patient focus groups at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, MA and 2 focus groups with primary care providers at the VA Medical Center in Manchester, NH. Patients were recruited with fliers in the primary care service and in the Veterans' computer center. Providers were recruited through a presentation at the weekly primary care staff meeting. Focus group guides were used to lead the discussions. In addition, at the 2nd patient and 2nd provider focus groups we presented draft text of messages about disease screening to obtain participant perceptions and suggestions for improvement. All focus groups were audio-recorded and later transcribed. We conducted grounded thematic analyses of the focus group audio recordings and transcripts, identifying key concepts linked to both patient and provider perceptions of HIV testing and social marketing strategies.
Patients found the concept of disease screening social marketing unproblematic and wanted these messages to link to additional health and disease-related information. Some expressed concern, however, about receiving a direct email message that included content regarding HIV. Most preferred that any direct emails to Veterans solely be used to link them to content that is on MyHealtheVet. Providers expressed more concerns than patients, however, the concerns were surmountable with appropriate crafting of messages and advance notice to providers before the VA broadcasts electronic messages to patients. Providers felt messages might create undue worry in patients, and would lead to a large increase in call and visit volume that would be unmanageable given the current primary care resources.
Discussions with patients and providers indicate that electronic means of communicating important disease screening education with Veterans is viable, as long as patient and provider concerns are addressed. This method of communication may provide another mode to reach out to Veterans and to increase important disease screening rates.
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MeSH Terms: none