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Patient Educ Couns. 2010 Dec;81(3):468-75. doi: 10.1016/j.pec.2010.08.011.

From questionnaire to conversation: a structural intervention to improve HIV test counseling.

Author information

  • 1UCSF Center for AIDS Prevention Studies, San Francisco, CA 94105, USA. Nicolas.Sheon@ucsf.edu

Abstract

OBJECTIVE:

We describe the effects of structural intervention to enhance the quality of HIV test counseling interaction with men who have sex with men (MSM) in San Francisco.

METHODS:

Audio recordings of 28 rapid HIV test sessions by seven counselors were collected in two phases: before and after implementation of a waiting room intervention prior to the session. The sessions were analyzed using sequence maps to visualize and compare the sequence and distribution of four activities: counseling, information delivery, data collection, and sample collection.

RESULTS:

Prior to the intervention, counselors and clients often oriented to data collection about the client's past risk as if it were a survey. In sessions recorded after the intervention, questions about past risk were dispersed throughout the session and embedded within an elaborated discussion of the client's particular life circumstances.

CONCLUSION:

Direct observation with the aid of sequence maps illuminates the ways that counselors and clients collaboratively orient to various tasks.

PRACTICE IMPLICATIONS:

We demonstrated the feasibility of a structural intervention that improved the quality of both counseling and the accuracy of client risk data without requiring additional session time or counselor training.

Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

PMID:
20888723
[PubMed - indexed for MEDLINE]
PMCID:
PMC2997860
Free PMC Article

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