The purpose of this paper is to present data that show a measurable change in HCV awareness in IDUs immediately after their having been exposed to a multimedia educational intervention. The most important results are that we can measure and document an improvement in HCV knowledge and show that participants gained a better understanding of the severity of and their individual susceptibility to the HCV infection. In addition, a reduction of HCV risk-behavior and an improvement in the subjects' self-confidence regarding their abilities to avoid HCV risk behavior was observed. These findings suggests that multimedia interventions based on the HBM and SCT theoretical frameworks is a viable approach to health related behavior changes for high risk Hispanic populations. These behavioral theories attract the individual attention; thereby improving retention and the ability to reproduce or copy a modeled behavior.15,16
As previously reported by others authors10–12
multimedia intervention has the potential advantage of being capable of addressing a wide range of health-related issues and affecting the knowledge and behaviors of high-risk population. Computer-based strategies offer an opportunity for systematically exposing high-risk individuals to individually relevant, effective health promotion messages.10–13
Advances in computer software and hardware allowed us to create and implement a user-friendly multimedia intervention program that overcame the potential barriers that would have limited the delivery of messages to members of the studied population, with their generally limited formal educations. The use of cartoons, pictures, and audio narration that described in detail the most common risk-behaviors and rituals performed by IDUs when preparing, administering, and sharing drugs facilitated the learning process and the subsequent incorporation of HCV-infection preventive behaviors in this high-risk population. The principal goal of our intervention was to increase the participants' motivation to self-implement behavioral changes based on improved knowledge and risk perception. The multimedia intervention strategy we used was able to capture and maintain the participants' attention, in turn facilitating the educational process. Improved attention skills and a higher interest lead to greater knowledge and an improvement in the preventive practices required. We believe our data suggests that this improvement occurred in the study group. The content of the multimedia presentation attracted the participants' attention and augmented knowledge retention, improving their ability to practice the desired preventive behaviors modeled therein, as postulated by the HBM.14
Our interpretations could explain the significant reduction of active IDU, despite the fact that this outcome was not the principal goal of the educational intervention. However, we have to consider the possibility that this finding could be influenced by an individual ambition to give socially desirable answers.
Our findings verify the potential benefit of multimedia programs for the dissemination of HCV prevention strategies in a Hispanic high-risk population. This type of intervention could easily and inexpensively be disseminated via the internet to a wide number of health care providers and/or health educators for a number of clinical uses.
Our study has the following limitations. 1) Low prevalence of HIV mono-infection in the study sample could have affected the statistical power that evaluates changes in the perception of disease infection susceptibility. 2) Similarly, a low prevalence of active IDU in the study group could have limited the evaluation of the program's goal, i.e., the reduction in HCV infection risk behavior. For the future this multimedia intervention would need to be implemented in a group at an earlier stage of drug addiction and in a group with a higher level of active injecting drug used in order to confirm the preventive trend found in this study.
Our computer-based intervention appears to decrease HCV risk behaviors among HIV-IDUs. The introduction of preventive strategies in this hard-to-reach population may ultimately serve to decrease the hard to control health-care disparity in this group of patients.