Increasing HIV Testing in Urban Emergency Departments via Mobile Technology

Funding Source: National Institute on Drug Abuse (NIDA)

Project Period: 07/01/2014 – 06/30/2017

Principal Investigator: Ian David Aronson, PHD

Project Summary:

Our proposed intervention builds upon initial findings from a trial our research team conducted with patients who declined HIV testing. The brief intervention had a potent effect: a third accepted HIV testing post-intervention. While this preliminary study is highly encouraging, it revealed a number of other critical research questions. First, it remains unclear what intervention component most strongly contributed to patients’ decisions to test. Second, consistent with the literature, participants indicated that depicting a community member onscreen would increase the proportion of patients who test. Third, results suggest there is individual variation in the extent to which behavior is more strongly influenced by onscreen community members or experts (e.g. physicians). Therefore, the goal of the present study is to determine how we can refine mobile computer-based interventions to maximize HIV testing rates among patients who initially decline to test in the ED. The present study will use a pilot four-arm randomized controlled design. All participants will use mobile computers to complete a pre-test assessment. One arm will see video of a physician explaining the importance of HIV testing and modeling rapid testing (similar to the original video). The second arm will view video of a community member who explains testing importance and models testing. A third will have a choice of which of the two videos to watch. A fourth group (control) will not see any video. At the end of the computerized intervention (pre-test/video or pre-test only), onscreen text will ask patients if they would agree to an HIV test. Those who agree will be tested by ED staff. The trial will recruit patients (N=300) aged 18-64 in a high volume, urban hospital center. The study’s endpoint will be post-intervention HIV test rates. Our study will inform scalable interventions for underserved populations nationwide.

Public Health Relevance:

When hospital emergency departments (EDs) offer routine HIV testing to reach substance users and other high-risk patients, those who could benefit most frequently decline. Thus, an important health priority remains not only offering HIV testing to more patients, but developing strategies to increase test rates by working with patients who are reluctant to learn their HIV status. The proposed research will develop and evaluate the acceptability, feasibility, and preliminary efficacy of a mobile computer-based video intervention designed to increase HIV test rates among vulnerable patients in EDs and other high volume clinical settings nationwide.

April 4, 2014

Implementation strategies and outcomes: advancing the science

Enola K. Proctor, PhD
Shanti K. Khinduka Distinguished Professor of Social Work
Associate Dean for Faculty
George Warren Brown School of Social Work
Washington University, in St. Louis, MO

About the Presentation:

How do we move evidence-based practices into real-world care, and how do we sustain them once they are adopted?  How do we capture the challenges and successes in implementation?  What are some of the cutting edge research questions in implementation science? What are the methodological advances and challenges in implementation science? These issues will be the focus of Dr. Proctor’s talk.

About the Presenter:

Dr. Enola Proctor is the Shanti K. Khinduka Distinguished Professor of Social Work and Associate Dean for Faculty at the George Warren Brown School of Social Work, Washington University, in St. Louis, MO.

Her teaching and research are motivated by the question, how do we ensure that people receive the very best possible care?  She has studied this question in a variety of social work, public health, and health care settings, ranging from hospitals to community agencies.  Her most current work focuses on how organizations and individual providers can adopt and deliver evidence based programs and interventions. Her research has been funded by the NIMH, the NIA, and AHRQ.  She directs the Implementation Research Institute, an NIMH supported training program in implementation science. She also leads the Center for Dissemination and Implementation for the Washington University Institute for Public Health, the Dissemination and Implementation Research Core for Washington University’s CTSA program, and dissemination and implementation research cores for research centers in the areas of cancer and diabetes.   She also directs the Center for Mental Health Services Research at Washington University, launched and supported for 20 years with NIMH support. 

Her books include Dissemination and Implementation Research in Health: Translating Science to Practice, published in 2012 with Oxford University Press.  She was a member of the National Advisory Council for the National Institute of Mental Health, and served as Editor in Chief for Social Work Research.  She has received a number of awards, including the Lifetime Achievement Award from the Society for Social Work and Research (2002); the Knee-Wittman Award for lifetime Achievement in Health and Mental Health Practice (2011) from the National Association of Social Workers; and the Mental Health Professional of the Year award from the St. Louis Alliance for the Mentally Ill (1997).  She has received several teaching and mentoring awards and Washington University’s highest faculty honor, the Compton Award (2009).  In 2010, she was elected to the inaugural class of the American Academy of Social Work and Social Welfare and its Board of Directors (2010-11). 

Benjamin S. Crosier, PhD

Postdoctoral Fellow, Dartmouth Psychiatric Research Center

Social Network Analysis, Mobile Sensing, Web Tools for Data Collection

crosierBenjamin Crosier, PhD, is a postdoctoral fellow at the CTBH. Dr. Crosier received his PhD in social psychology at the University of Florida where he minored in research methodology.  He also holds an MS in social psychology from the University of Florida and a MA in Psychology from SUNY New Paltz.  Dr. Crosier’s primary research focuses on the factors shape the structure of social networks, both in online social networks and in terms of face-to-face contact as captured by mobile sensors. He also explores the health outcomes of network structure. Knowing the forces that sculpt networks and the consequences of structural variability can not only give an aerial perspective of a particular problem, it can help practitioners build better interventions that seek to promote healthy behavior.

Dr. Crosier also works on applying new ways to collect social network data, focusing on web-based snowball sampling methods, wireless sensor networks and Google Glass. These emerging methods in social network analysis can help researchers obtain data that was previously hidden, illuminating relationships that were originally difficult to trace.  In his spare time, Dr. Crosier likes snowboarding and amateur astronomy. 

Selected Publications:

Howell JL, Crosier BS, Shepperd JA. Does lacking threat-management resources increase information avoidance? A multi-sample, multi-method investigation. Journal of Research in Personality. 2014;50(0):102-109.

Webster GD, Graber JA, Gesselman AN, Crosier BS, Schember TO. A life history theory of father absence and menarche: A meta-analysis. Evolutionary Psychology. 2014; 12(2):273-294.

Crosier BS, Webster GD, Dillon HM. Wired to connect: evolutionary psychology and social networks. Review of General Psychology. 2012;16(2):230-239. doi: 10.1037/a0027919.


Justin Tauscher, MS, LADC, LCMHC

Research Associate and Project Director, Center for Technology and Behavioral Health and the Center for Supported Employment Technology

Prevention and Treatment for Co-occurring Disorders; Technology-based Interventions; Implementation Science; Adolescent Care

tauscherJustin Tauscher is a Research Associate and Project Director at the Center for Technology and Behavioral Health and the Center for Supported Employment Technology. He earned a Bachelor’s Degree in Psychology and Sociology from Western Washington University and a Master’s Degree in Mental Health Counseling from the University of Vermont. He is currently the Project Director for the Center for Supported Employment Technology at Dartmouth College and is working to develop new and innovative technology based strategies for enhancing the delivery of IPS supported employment services in community settings. In addition to his role as a Project Director, Justin provides cognitive behavioral interventions to OEF/OIF veterans as part of a research project aimed at enhancing treatment seeking behavior in veteran populations and is aiding in the adaptation of this intervention to a technology based platform. Along with other members of the CTBH research team, Justin is also involved with exploring ways to adapt technology based tools to enhance the process of screening, brief intervention, and referral to treatment (SBIRT) in a variety of settings.

Justin has an extensive clinical background as a dually licensed mental health and addiction counselor. He has developed a range of experiences while serving as a clinical supervisor and clinician specializing in providing co-occurring treatment with adolescents, adults, and families. Justin currently serves as an adjunct faculty member within the graduate counseling program at the University of Vermont with a focus on teaching about addiction issues and co-occurring treatment. Additionally, Justin provides consultation to state and community based agencies in the areas of program development; screening, assessing, and treating co-occurring mental health and substance use issues; and developing treatment approaches for reducing criminality and recidivism in the community.  Research interests include dissemination and implementation of evidence based practice in community settings, technology-based behavioral health care, criminality, PTSD, and supported employment. In his spare time, he enjoys reading, riding his bike, playing soccer, going hiking, and spending time with his friends and family.

February 7, 2014

Creative Communication: Using Innovative Design and Technology to Make Data Meaningful and Motivate Positive Behavior Change

Lorie LoebResearch Professor, Department of Computer Science, Dartmouth College; Director, Digital Arts Minor; Director, DALI Lab

About the Presentation:

The Neukom Digital Arts Leadership and Innovation Lab (DALI) is a new research and development lab in the computer science department at Dartmouth College.  Teams of graduate and undergraduate students, staff and faculty work together to design and develop innovative technology tools that help our partners communicate effectively, make data meaningful and information accessible.  DALI partners with faculty, Centers, non-profits and start-ups.  (

Lorie will present examples and case studies from her work.  There will be an opportunity to discuss your current work and how data visualization might be of value.

The DALI Lab is supported by the Neukom Institute for Computational Science and the Computer Science Department.  

About the Presenter:

Lorie is a Research Professor in the computer science department at Dartmouth College, Director of the Digital Arts Minor, and the Director of DALI Lab. Before coming to Dartmouth, Lorie was Senior Research Scientist in the Computer Science Department at Stanford University and a Professor in New York University’s Tisch School of the Arts.  Lorie’s expertise is in data visualization, user experience design and animation/motion study.

Lorie is an artist as well as a technologist.  She has worked on award winning films (e.g. two Emmy Awards, a Cine Golden Eagle Award) that have been screened internationally (e.g. the Museum of Modern Art NY, the Sundance Film Festival, the NY Film Festival, the London Film Festival the Whitney Biennial).

Lorie’s work has been funded by Intel, Sony, Microsoft, The National Science Foundation, Electronic Arts, The Neukom Institute for Computational Science, the Morgan Family Foundation and the New York Foundation for the Arts. She has two patents (one pending).  She is a Fulbright Specialist Scholar, a Whiting Foundation Fellow and a Donella Meadows Sustainability Leadership Fellow. Lorie is also the President and Co-Founder of TellEmotion, Inc., an energy feedback company with clients around the globe and offices in Vermont and Arizona.