Development of a culturally appropriate computer-delivered tailored internet-based health literacy intervention for spanish-dominant hispanics living with HIV

BMC Medical Informatics and Decision Making

Research Article

Robin J Jacobs¹  Michael N Kane²  Joshua Caballero³  Raymond L Ownby⁴ 

[1]Biomedical Informatics/Psychiatry and Behavioral Medicine College of Osteopathic Medicine Nova Southeastern University 3200 S, University Drive Terry Building HPD/OST, 33328, Fort Lauderdale, FL, USA

[2]College for Design & Social Inquiry School of Social Work Florida, Atlantic University, Glades road, 33431 777, Boca Raton, FL, USA

[3]College of Pharmacy, Nova Southeastern University, 33328, Fort Lauderdale, FL, USA

[4]Psychiatry and Behavioral, Medicine College of Osteopathic Medicine Nova Southeastern University, 33328, Fort Lauderdale, FL, USA

关键词: eHealth;    Consumer health informatics;    Health literacy;    HIV/AIDS;    Internet;    Hispanics/Latinos;    Tailored intervention;    Medication adherence;    Health technology;    Ethnic minority;    Health disparities;   

DOI  :  10.1186/s12911-014-0103-9

 received in 2013-12-08, accepted in 2014-10-30,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundLow health literacy is associated with poor medication adherence in persons with human immunodeficiency virus (HIV), which can lead to poor health outcomes. As linguistic minorities, Spanish-dominant Hispanics (SDH) face challenges such as difficulties in obtaining and understanding accurate information about HIV and its treatment. Traditional health educational methods (e.g., pamphlets, talking) may not be as effective as delivering through alternate venues. Technology-based health information interventions have the potential for being readily available on desktop computers or over the Internet. The purpose of this research was to adapt a theoretically-based computer application (initially developed for English-speaking HIV-positive persons) that will provide linguistically and culturally appropriate tailored health education to Spanish-dominant Hispanics with HIV (HIV + SDH).MethodsA mixed methods approach using quantitative and qualitative interviews with 25 HIV + SDH and 5 key informants guided by the Information-Motivation-Behavioral (IMB) Skills model was used to investigate cultural factors influencing medication adherence in HIV + SDH. We used a triangulation approach to identify major themes within cultural contexts relevant to understanding factors related to motivation to adhere to treatment. From this data we adapted an automated computer-based health literacy intervention to be delivered in Spanish.ResultsCulture-specific motivational factors for treatment adherence in HIV + SDH persons that emerged from the data were stigma, familismo (family), mood, and social support. Using this data, we developed a culturally and linguistically adapted a tailored intervention that provides information about HIV infection, treatment, and medication related problem solving skills (proven effective in English-speaking populations) that can be delivered using touch-screen computers, tablets, and smartphones to be tested in a future study.ConclusionUsing a theoretically-grounded Internet-based eHealth education intervention that builds on knowledge and also targets core cultural determinants of adherence may prove a highly effective approach to improve health literacy and medication decision-making in this group.

【 授权许可】

CC BY   
© Jacobs et al.; licensee BioMed Central Ltd. 2014