Case Study: Custom Elearning Helps Reduce Perinatal HIV Rates

Client: Texas Department of State Health Services
Industry: Health/Medical, Government
Project Life: 2011 to Present
Website: Perinatal HIV Prevention page on tx.train.org

Background

With an expansive mandate, 12,000 employees and a budget of $3.2 billion, the Texas Department of State Health Services (DSHS) is responsible for the health and well-being of 27 million Texans. DSHS’s Division for Disease Control and Prevention Services has many tasks, including HIV/AIDS prevention. As effective drug therapies and regimens for combating human immunodeficiency virus (HIV) in adults became available in the 1990s, DSHS was at the forefront of putting them into practice.

The Issue

While its programs helped slow the growth of the epidemic among adults and allowed them to live longer lives, perinatal HIV transmission rates were still quite high. Without any drug therapies or behavioral guidelines, the rate of virus transmission from an HIV-­positive woman to her unborn child can reach as high as 25%.

To counteract a serious public health threat, the State of Texas began opt-­out HIV testing for pregnant women in 1997. Aggressive testing, antiviral drug therapies, and efforts to rally clinicians statewide drove the rate of perinatal HIV transmission to just 1% in 2005. However, the rate of perinatal infection bounced back, reaching 4% in just two years.

Through interviews with clinicians and patients, state experts found that there were some procedural obstacles to HIV testing: oral-based rapid testing kits were labor-intensive for hospital staff, for example. But they discovered emotional and communication barriers as well. Some clinicians were uncomfortable administering HIV tests for fear of possibly having to convey bad news to the patient. Commonly used phrasing inadvertently focused on opting out rather than test benefits. Without a consistently applied, strategic approach, pregnant women at risk for carrying the human immunodeficiency virus (HIV) were missing a crucial fact: transmitting HIV to their baby can be prevented. As a result, at-­risk pregnant women were choosing not to undergo HIV testing.

That’s where Microassist came in.

The Solution

DSHS recognized the vital importance of communication: doctors, nurses, and other medical professionals needed training on how to present the advantages of perinatal HIV testing compassionately and clearly. They also needed support for discussing positive test results, as well resources for themselves and their patients.

A custom learning system was an important part of successful public outreach from the medical community to pregnant women. Microassist’s interdisciplinary team created an engaging elearning course that offered caregivers case studies, scientific data, and strategies for communicating with their patients.

The course covers HIV testing:

• During routine medical visits
• During pregnancy
• While in labor and after delivery when the HIV status is unknown

The lessons are interactive and have extensive voiceover narration, improving the “stickiness” of the information. To meet state accessibility standards, subtitles are available as well.

The Results

Microassist succeeded in reaching a notoriously difficult audience: busy doctors and nurses. The Perinatal HIV Prevention course won praise for the team’s engaging and interactive design while also meeting tough, state-mandated accessibility standards.

To date, several hundred Texas doctors, nurses, and other clinicians have completed the online course. By 2013, the rate of perinatal HIV transmission had fallen to less than 1%.
Thanks to better caregiver-patient communication and other DSHS-sponsored programs, hundreds of young Texans have a chance to live normal, healthy lives.

For More Information

For more than 25 years, Microassist has provided broad-­spectrum learning services for enterprise and government clients seeking to share important knowledge and skills with their employees, constituents, and customers. Our Applications Development team offers world-­class mobile app, database, user experience, and accessibility expertise.