Enhancing Lay Counselor Capacity to Improve Patient Outcomes with Multimedia Technology
Robbins, R.N.; Mellins, C.A.; Leu, C.-S.; Rowe, J.; Warne, P.; Abrams, E.J.; Witte, S.; Stein, D.J.; Remien, R.H.
Aids and Behavior 19(Suppl 2): 163-176
2015
ISSN/ISBN: 1573-3254 PMID: 25566763 DOI: 10.1007/s10461-014-0988-4Document Number: 640815
Multimedia technologies offer powerful tools to increase capacity of health workers to deliver standardized, effective, and engaging antiretroviral medication adherence counseling. Masivukeni-is an innovative multimedia-based, computer-driven, lay counselor-delivered intervention designed to help people living with HIV in resource-limited settings achieve optimal adherence. This pilot study examined medication adherence and key psychosocial outcomes among 55 non-adherent South African HIV+ patients, on antiretroviral therapy (ART) for at least 6 months, who were randomized to receive either Masivukeni or standard of care (SOC) counseling for ART non-adherence. At baseline, there were no significant differences between the SOC and Masivukeni groups on any outcome variables. At post-intervention (approximately 5-6 weeks after baseline), -clinic-based pill count adherence data available for 20 participants (10 per intervention arm) showed a 10 % improvement for-participants and a decrease of 8 % for SOC participants. Masivukeni participants reported significantly more positive attitudes towards disclosure and medication social support, less social rejection, and better clinic-patient relationships than did SOC participants. Masivukeni shows promise to promote optimal adherence and provides preliminary evidence that multimedia, computer-based technology can help lay counselors offer better adherence counseling than standard approaches.
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