Computer Education May Bridge Affordability Gap

Researchers from CDC, the University of Washington-Seattle, California State University-Long Beach, and the Indiana University School of Medicine-Indianapolis, are collaborating with Resources Online, a Seattle computer consulting business, to create a computer-assisted, client-centered, educational CD-ROM product to encourage risk-reduction behaviors and testing for HIV and other STDs.

Studies show that client-centered counseling is more effective than simply providing educational materials. Since many venues have neither the time nor the skilled counselors to provide this service, this product is designed to be an effective replacement for face-to-face counseling.

The program will have a user-friendly interface that asks patients risk assessment questions, followed by individualized counseling messages and negotiation of a realistic prevention plan based on their responses. The CD-ROM is based on well-validated elements, programmed into the computer, incorporating common scenarios and probing techniques used by good counselors.

Although the early versions of the program will be in English, eventually it may be available in a variety of languages. Researchers are building the program so it is appropriate for various at-risk populations and age groups. They are designing the program to be run on a wide variety of computers, reflecting the reality of the type of hardware found in clinics.

When the CD-ROM has been fully developed, the research team intends to distribute it widely, perhaps at no or low cost to health clinics and on a sliding income scale to venues such as emergency rooms and private practices. Users would be able to customize the program by adding phone numbers for local resources and language modules when those become available. The team's goal is for people to use the CD-ROM in medical venues where no human counselors are available, or as an initial interview with follow-up by a counseling staff. The ultimate goal is to test more people for HIV. Development funding began in October 2002 with a plan to begin pilot testing and to design a randomized trial of the intervention in 2003.

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