When Asked, Patients Tell

Gerbert, Barbara; Bronstone, Amy; Pantilat, Steven Z.; McPhee, Stephen J.; Allerton, Michael; Moe, James

doi:10.1097/00005650-199901000-00014

Cited by 102 publications

(16 citation statements)

References 25 publications

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“…This bias may have been further enhanced by the possible reporting of risky behaviors to providers through Cueing Sheets. We are unable to validate participants' self-reports, but remain convinced that computerized questionnaires yield more disclosure of sensitive topics than do other, traditional methods, such as face-to-face interviews or paper questionnaires [33], [34]. Although our previous research found that sharing risk information with providers did not inhibit patients' disclosure of sensitive behaviors [33], we have no evidence to deny this occurring in the present study.…”

Section: Discussioncontrasting

confidence: 69%

Interactive “Video Doctor” Counseling Reduces Drug and Sexual Risk Behaviors among HIV-Positive Patients in Diverse Outpatient Settings

et al. 2008

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BackgroundReducing substance use and unprotected sex by HIV-positive persons improves individual health status while decreasing the risk of HIV transmission. Despite recommendations that health care providers screen and counsel their HIV-positive patients for ongoing behavioral risks, it is unknown how to best provide “prevention with positives” in clinical settings. Positive Choice, an interactive, patient-tailored computer program, was developed in the United States to improve clinic-based assessment and counseling for risky behaviors.Methodology and FindingsWe conducted a parallel groups randomized controlled trial (December 2003–September 2006) at 5 San Francisco area outpatient HIV clinics. Eligible patients (HIV-positive English-speaking adults) completed an in-depth computerized risk assessment. Participants reporting substance use or sexual risks (n = 476) were randomized in stratified blocks. The intervention group received tailored risk-reduction counseling from a “Video Doctor” via laptop computer and a printed Educational Worksheet; providers received a Cueing Sheet on reported risks. Compared with control, fewer intervention participants reported continuing illicit drug use (RR 0.81, 95% CI: 0.689, 0.957, p = 0.014 at 3 months; and RR 0.65, 95% CI: 0.540, 0.785, p<0.001 at 6 months) and unprotected sex (RR 0.88, 95% CI: 0.773, 0.993, p = 0.039 at 3 months; and RR 0.80, 95% CI: 0.686, 0.941, p = 0.007 at 6 months). Intervention participants reported fewer mean days of ongoing illicit drug use (-4.0 days vs. -1.3 days, p = 0.346, at 3 months; and -4.7 days vs. -0.7 days, p = 0.130, at 6 months) than did controls, and had fewer casual sex partners at (−2.3 vs. −1.4, p = 0.461, at 3 months; and −2.7 vs. −0.6, p = 0.042, at 6 months).ConclusionsThe Positive Choice intervention achieved significant cessation of illicit drug use and unprotected sex at the group-level, and modest individual-level reductions in days of ongoing drug use and number of casual sex partners compared with the control group. Positive Choice, including Video Doctor counseling, is an efficacious and appropriate adjunct to risk-reduction efforts in outpatient settings, and holds promise as a public health HIV intervention.Trial RegistrationClinicaltrials.gov NCT00447707

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Section: Discussioncontrasting

confidence: 69%

Interactive “Video Doctor” Counseling Reduces Drug and Sexual Risk Behaviors among HIV-Positive Patients in Diverse Outpatient Settings

et al. 2008

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“…39,51–53 A variety of methods are effective for eliciting sensitive health risks such as IPV. 54 In our study parents may have left the IPV screening questions blank for a number of reasons. Mothers may fear for their own safety and the safety of their children should disclosure of IPV become known to the perpetrator.…”

Section: Commentmentioning

confidence: 99%

Associations of Early Exposure to Intimate Partner Violence and Parental Depression With Subsequent Mental Health Outcomes

Bauer¹,

Gilbert²,

Carroll³

et al. 2013

JAMA Pediatr

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Objective To examine the association between parent reports of intimate partner violence (IPV) and depressive symptoms within the first 3 years of a child’s life with subsequent mental health conditions and psychotropic drug treatment. Design Prospective cohort study linking parental IPV and depression with subsequent billing and pharmacy data. Setting 4 pediatric clinics between November 2004 and June 2012 Patients/Participants 2,422 children Main Exposure Any report of IPV and/or parental depressive symptoms from birth to 3 years of age. Main Outcome Measures ICD-9 mental health diagnoses and any psychotropic drug treatment between 3 and 6 years of age. Results 2.4% of caregivers (n=58) reported both IPV and depressive symptoms before their children were 3 years of age, 3% (n=69) of caregivers reported IPV only, 29% (n=704) reported depressive symptoms only, and 65.7% (n=1,591) reported neither exposure. Children of parents reporting both IPV and depressive symptoms were more likely to have a diagnosis of attention-deficit hyperactivity disorder (ADHD) (AOR 4.0; 95% CI: 1.5–10.9), even after adjusting for child gender, race/ethnicity, and insurance type. Children whose parents reported depressive symptoms were more likely to have been prescribed psychotropic medication (AOR 1.9; 95% CI: 1.0–3.4). Conclusions Exposure to both IPV and depression before 3 years is associated with preschool-onset ADHD; and early exposure to parental depression is associated with being prescribed psychotropic medication.

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“…They can also be tailored to individual users through the use of integrated risk assessments. This tailoring, plus enhanced anonymity, allows participants to feel more comfortable with computer-based assessments of sensitive information, like high-risk sex or drug use [19], leading to greater disclosure of stigmatized behaviors [20, 21]. CBIs are also delivered with very high fidelity across time and location, increasing their probability of success [16, 22].…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women

et al. 2015

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The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women.

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When Asked, Patients Tell

Cited by 102 publications

References 25 publications

Interactive “Video Doctor” Counseling Reduces Drug and Sexual Risk Behaviors among HIV-Positive Patients in Diverse Outpatient Settings

Interactive “Video Doctor” Counseling Reduces Drug and Sexual Risk Behaviors among HIV-Positive Patients in Diverse Outpatient Settings

Associations of Early Exposure to Intimate Partner Violence and Parental Depression With Subsequent Mental Health Outcomes

A Randomized Trial to Evaluate the Efficacy of a Web-Based HIV Behavioral Intervention for High-Risk African American Women

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