Professor Teams With New Media Center to Better Inform Couples About HIV
A five-year study led by Susan Witte, associate professor at Columbia’s School of Social Work, is testing the effectiveness of disseminating an Internet-based program to prevent HIV among couples across New York State. The study seeks to close the gap between research and program delivery to achieve increased HIV-risk reduction in the U.S. The program was developed in collaboration with the Columbia Center for New Media Teaching and Learning (CCNMTL) using games, videos and other interactive features to create an updated version of Project Connect, a successful program that aims to prevent HIV transmission among couples.
Multimedia Connect includes original videos with actors modeling communications skills that couples learn and practice in each of the program’s six sessions.
With assistance from Witte, Project Connect was originally designed and tested by Nabila El-Bassel and Louisa Gilbert, senior researchers at the School of Social Work’s Social Intervention Group. With funding from the National Institute of Mental Health (NIMH), a clinical trial of Connect demonstrated significant decreases in the number of unprotected sexual acts, as well as significant increases in the rates of condom use, among the 217 participating couples. Previous intervention programs designed to prevent HIV encouraged participants—usually women—to protect themselves as individuals from disease, whereas the emphasis in Connect is for both members of a couple to keep each other safe.
Once Witte and her colleagues had demonstrated that Connect was effective at reducing unprotected sex, they realized two major obstacles were keeping the program from being put to widespread use. First, the materials used to implement the program—a lengthy, bound script with ancillary materials and posters—were bulky and hard to transport easily. Second, effective use of the materials demanded the skills of trained social workers, who are not always available at community health and service organizations.
The goal of the Internet-based version, therefore, is to improve the teaching and learning experience for both HIV service providers and couples, expand the range of providers who can implement the program, and ensure that the program is executed more consistently and effectively. If the study, now in its third year, finds that community-based organizations are more likely to use the Internet-based version of the program, known as Multimedia Connect, it may become a prototype for the prevention and treatment of other health and human services-related issues.
“It’s one thing to demonstrate that a program works,” said Witte. “But until providers can implement programs in their day to day service delivery, it is completely useless and does not have impact.”
Health educators use Multimedia Connect as a road map for completing a series of exercises, including videos that support communication and listening skills among heterosexual couples, and other computer-based interactive features that serve as conversation starters. For instance, in one activity couples are asked to work with an interactive diagram of the human body to determine the risk level of specific kinds of sexual contact.
“The visual images break the ice because the couple sees his and her bodies and, together, they can explore levels of risk,” said Witte. “So the discussion and the experience of learning about risk becomes less didactic, less abstract and much more interactive and fun for the couple.”
To compare the effectiveness of the new Multimedia Connect to the original version of Connect, Witte has devised a study in which the original paper-based version and the new Internet-based version are randomly distributed to 80 agencies across New York State. Forty agencies are receiving the traditional version of Connect and 40 are receiving the multimedia version. Eleven of the programs participating in the study are located in Harlem. An additional 50 participating organizations are located in the five boroughs of New York City.
In addition to designing the interface and building the Connect web application, CCNMTL was also responsible for video production and worked with Witte and Connect facilitators to produce scripts, cast actors and shoot and edit the videos. CCNMTL provides free training in the use of Multimedia Connect plus technical assistance to each agency that received the Internet version of the program. Reports of participating staff at each agency are collected pre-training and post-training.
“Connect was our first intervention and the flagship project for the Triangle Initiative,” said Jessica Rowe, manager of CCNMTL’s Triangle Initiative, which creates digital tools designed for professionals in education and research and the larger community. “We spent a lot of time brainstorming and working on it, and the lessons that we learned are helping us improve our other projects. So our collaboration with Dr. Witte and SIG has been very valuable to us.”