Hiv, HIV Testing
Conditions
Keywords
stigma, knowledge, Education, nursing, situated learning
Brief summary
This is a randomized controlled trial design. The investigators plan to recruit about 60 to 70 emergency department nurses from a medical center in Taipei, Taiwan. After completing the paper consent form, these nurses will be randomly assigned to 2 groups, which are a control group and an experimental group. The pre-test includes the demographic data sheet, HIV testing related knowledge and practice scale, and The Health Care Provider HIV/ AIDS Stigma Scale (HPASS). All nurses will receive a learning material when they finish the pre-test. In addition, the experimental group will be provided a real HIV testing and counselling by a researcher. The post-test will be finished one month later of pre-test in the control group, and one month later while the intervention completed in the experimental group. The semi-structural interview will be performed to the experimental group to collect and analyze their opinion toward the experiential HIV testing.
Detailed description
This project aims to develop an intervention of experiential HIV testing and to verify the following effects on emergency nurses: (1) Improve HIV testing related knowledge and practice; (2) Reduce HIV-related stigma; (3) Find out the possible demographic factors that might affect the effectiveness of experiential HIV Testing. During the intervention, nurses can directly participate in the whole process of anonymous HIV testing in the role of who need to be screened, and pre- and post-testing counselling accompanied the education and discussion will also be provided to them by a researcher. Through the above-mentioned measures, the knowledge and practices related to the HIV testing could be improved, and the stigma attitude toward HIV could be reduced through the self-reflection on the testing process.
Interventions
OTHERExperiential HIV Testing
The content of experiential HIV Testing includes HIV testing, counselling, and education and discussion.
Sponsors
National Taiwan University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
\- have registered nurse license and do clinical care in emergency department
Exclusion criteria
* have registered nurse license but doesn't do clinical care, likes head nurse. * do clinical care in emergency department but doesn't have registered nurse license, like volunteers or assistant nurse. * have experienced non-occupational HIV testing. * had been a nurse in HIV/AIDS-focus ward or HIV/AIDS case manager.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| HIV Testing Related Knowledge and Practice | pre-test(Baseline) and post-test (week 4) | A self-development scale, known as the HIV Testing-Related Knowledge and Practice Scale, is employed to assess individuals' knowledge and practices pertaining to HIV testing. The scale consists of twenty-eight questions, encompassing both True-False and multiple-choice formats. Participants earn one point for each correct answer, contributing to a total score that ranges from the minimum scores of 0 to the maximum scores of 28. Higher scores signify a more positive outcome, indicating enhanced HIV testing-related knowledge and practice among the participants. |
| HIV Related Stigma | pre-test (Baseline) and post-test (Week 4) | The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) will be used to assess this outcome. The instrument contains 30 items, each scored on a six-point Likert scale, yielding a minimum total score of 30 and a maximum of 180. Higher scores reflect greater levels of stigma toward people living with HIV, indicating a worse outcome. Validation of the HPASS through factor analysis identified three underlying dimensions. The stereotyping dimension (11 items; score range: 11-66) reflects negative cognitions and beliefs about people living with HIV. The prejudice dimension (13 items; score range: 13-78) captures emotionally driven attitudes. The discrimination dimension (6 items; score range: 6-36) represents behavioral responses stemming from negative attitudes. For all dimensions, higher scores indicate worse outcomes. These 3 dimensions(as sub-scale scores) for stereotyping, prejudice, and discrimination will also be calculated and analyzed. |
Countries
Taiwan
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Get a Learning Material and a Experiential HIV Testing These participants in the experimental group will be provided a learning material about HIV testing, then an experiential HIV Testing, which includes HIV testing and counselling, education and discussion, and a post-test interviews will be provided.
Experiential HIV Testing: The content of experiential HIV Testing includes HIV testing, counselling, and education and discussion. | 36 |
| Get a Learning Material Only These participants in the control group will be provided a learning material about HIV testing only. After the post-test, the experiential HIV Testing will be provided to them. | 36 |
| Total | 72 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 1 | 1 |
Baseline characteristics
| Characteristic | Get a Learning Material and a Experiential HIV Testing | Get a Learning Material Only | Total |
|---|---|---|---|
| Age, Continuous | 28.03 years STANDARD_DEVIATION 4.58 | 29.14 years STANDARD_DEVIATION 5.74 | 28.58 years STANDARD_DEVIATION 5.19 |
| catastrophic illness no | 36 Participants | 35 Participants | 71 Participants |
| catastrophic illness yes | 0 Participants | 1 Participants | 1 Participants |
| education level bachelor's degree | 33 Participants | 33 Participants | 66 Participants |
| education level master's degree | 3 Participants | 3 Participants | 6 Participants |
| ever had HIV occupational exposure or not no | 25 Participants | 25 Participants | 50 Participants |
| ever had HIV occupational exposure or not yes | 11 Participants | 11 Participants | 22 Participants |
| Marital status married | 4 Participants | 6 Participants | 10 Participants |
| Marital status single | 32 Participants | 30 Participants | 62 Participants |
| Nursing practice years | 5.06 years STANDARD_DEVIATION 4.49 | 6.18 years STANDARD_DEVIATION 5.28 | 5.62 years STANDARD_DEVIATION 4.9 |
| Nursing practice years in the ED | 3.6 years STANDARD_DEVIATION 3.64 | 4.77 years STANDARD_DEVIATION 4.32 | 4.18 years STANDARD_DEVIATION 4.01 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 36 Participants | 36 Participants | 72 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| receiving HIV-related lecture in recent 12 months no | 25 Participants | 26 Participants | 51 Participants |
| receiving HIV-related lecture in recent 12 months yes | 11 Participants | 10 Participants | 21 Participants |
| Region of Enrollment Taiwan | 36 participants | 36 participants | 72 participants |
| religion Buddhism | 3 Participants | 7 Participants | 10 Participants |
| religion Buddhism and Taoism | 1 Participants | 2 Participants | 3 Participants |
| religion Catholicism | 1 Participants | 0 Participants | 1 Participants |
| religion Christianity | 2 Participants | 2 Participants | 4 Participants |
| religion None | 23 Participants | 19 Participants | 42 Participants |
| religion Taoism | 6 Participants | 6 Participants | 12 Participants |
| Sex: Female, Male Female | 28 Participants | 28 Participants | 56 Participants |
| Sex: Female, Male Male | 8 Participants | 8 Participants | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 72 | 0 / 72 |
| other Total, other adverse events | 0 / 72 | 0 / 72 |
| serious Total, serious adverse events | 0 / 72 | 0 / 72 |
Outcome results
Primary
HIV Related Stigma
The Healthcare Provider HIV/AIDS Stigma Scale (HPASS) will be used to assess this outcome. The instrument contains 30 items, each scored on a six-point Likert scale, yielding a minimum total score of 30 and a maximum of 180. Higher scores reflect greater levels of stigma toward people living with HIV, indicating a worse outcome. Validation of the HPASS through factor analysis identified three underlying dimensions. The stereotyping dimension (11 items; score range: 11-66) reflects negative cognitions and beliefs about people living with HIV. The prejudice dimension (13 items; score range: 13-78) captures emotionally driven attitudes. The discrimination dimension (6 items; score range: 6-36) represents behavioral responses stemming from negative attitudes. For all dimensions, higher scores indicate worse outcomes. These 3 dimensions(as sub-scale scores) for stereotyping, prejudice, and discrimination will also be calculated and analyzed.
Time frame: pre-test (Baseline) and post-test (Week 4)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (pre-test)HPASS in total | 89.39 score on a scale | Standard Deviation 16.14 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (post-test)HPASS in total | 85.94 score on a scale | Standard Deviation 20.1 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (pre-test)stereotyping | 36.36 score on a scale | Standard Deviation 6.85 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (post-test)stereotyping | 36.31 score on a scale | Standard Deviation 7.66 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (pre-test)prejudice | 35.78 score on a scale | Standard Deviation 8.51 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (post-test)prejudice | 33.14 score on a scale | Standard Deviation 10.73 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (pre-test)discrimination | 17.25 score on a scale | Standard Deviation 5.61 |
| Get a Learning Material and a Experiential HIV Testing | HIV Related Stigma | (post-test)discrimination | 16.50 score on a scale | Standard Deviation 5.59 |
| Get a Learning Material Only | HIV Related Stigma | (post-test)discrimination | 15.28 score on a scale | Standard Deviation 5.32 |
| Get a Learning Material Only | HIV Related Stigma | (pre-test)HPASS in total | 86.75 score on a scale | Standard Deviation 22.06 |
| Get a Learning Material Only | HIV Related Stigma | (pre-test)prejudice | 34.44 score on a scale | Standard Deviation 12.11 |
| Get a Learning Material Only | HIV Related Stigma | (post-test)HPASS in total | 88.03 score on a scale | Standard Deviation 20.44 |
| Get a Learning Material Only | HIV Related Stigma | (pre-test)discrimination | 13.94 score on a scale | Standard Deviation 5.68 |
| Get a Learning Material Only | HIV Related Stigma | (pre-test)stereotyping | 38.36 score on a scale | Standard Deviation 8.43 |
| Get a Learning Material Only | HIV Related Stigma | (post-test)prejudice | 34.72 score on a scale | Standard Deviation 10.31 |
| Get a Learning Material Only | HIV Related Stigma | (post-test)stereotyping | 38.03 score on a scale | Standard Deviation 9.2 |
p-value: 0.15ANCOVA
p-value: 0.02t-test, 2 sided
Primary
HIV Testing Related Knowledge and Practice
A self-development scale, known as the HIV Testing-Related Knowledge and Practice Scale, is employed to assess individuals' knowledge and practices pertaining to HIV testing. The scale consists of twenty-eight questions, encompassing both True-False and multiple-choice formats. Participants earn one point for each correct answer, contributing to a total score that ranges from the minimum scores of 0 to the maximum scores of 28. Higher scores signify a more positive outcome, indicating enhanced HIV testing-related knowledge and practice among the participants.
Time frame: pre-test(Baseline) and post-test (week 4)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Get a Learning Material and a Experiential HIV Testing | HIV Testing Related Knowledge and Practice | post-test | 19.44 score on a scale | Standard Deviation 2.21 |
| Get a Learning Material and a Experiential HIV Testing | HIV Testing Related Knowledge and Practice | pre-test | 17.17 score on a scale | Standard Deviation 1.88 |
| Get a Learning Material Only | HIV Testing Related Knowledge and Practice | pre-test | 17.22 score on a scale | Standard Deviation 2.14 |
| Get a Learning Material Only | HIV Testing Related Knowledge and Practice | post-test | 17.36 score on a scale | Standard Deviation 2.69 |
Comparison: Using G\*Power 3.1, the required sample size for ANCOVA with two groups was estimated with a significance level of 0.05, statistical power of 0.80, and an effect size of 0.35, based on Cohen's guidelines for a medium-to-large effect commonly applied in behavioral research (Cohen, 1988). Assuming up to two covariates, a minimum of 67 participants was required. Accounting for a 10% attrition rate, the final target was set at 74 participants.p-value: <0.001ANCOVA