HealthCall for the smartphone: technology enhancement of brief intervention in HIV alcohol dependent patients

Deborah S Hasin, Efrat Aharonovich, Eliana Greenstein, Deborah S Hasin, Efrat Aharonovich, Eliana Greenstein

Abstract

Background: Heavy drinking jeopardizes the health of patients in HIV primary care. In alcohol dependent patients in HIV primary care, a technological enhancement of brief intervention, HealthCall administered via interactive voice response (HealthCall-IVR) was effective at reducing heavy drinking. The smartphone offered a technology platform to improve HealthCall.

Methods: Working with input from patients, technology experts, and HIV clinic personnel, we further developed HealthCall, harnessing smartphone technological capacities (HealthCall-S). In a pilot study, we compared rates of HealthCall-S daily use and drinking outcomes in 41 alcohol dependent HIV-infected patients with the 43 alcohol dependent HIV-infected patients who used HealthCall-IVR in our previous efficacy study. Procedures, clinic, personnel, and measures were largely the same in the two studies, and the two groups of patients were demographically similar (~90% minority).

Results: Pilot patients used HealthCall-S a median of 85.0% of the 60 days of treatment, significantly greater than the corresponding rate (63.8%) among comparison patients using HealthCall-IVR (p < .001). Mean end-of-treatment drinks per drinking day was similar in the two groups. Patients were highly satisfied with HealthCall-S (i.e., 92% reported that they liked using HealthCall-S).

Conclusions: Among alcohol dependent patients in HIV primary care, HealthCall delivered via smartphone is feasible, obtains better patient engagement than HealthCall-IVR, and is associated with decreased drinking. In HIV primary care settings, HealthCall-S may offer a way to improve drinking outcomes after brief intervention by extending patient engagement with little additional demands on staff time.

Figures

Figure 1
Figure 1
The two components of HealthCall.
Figure 2
Figure 2
Flowchart of pilot study participants a. aStudy of HealthCall-Smartphone (HealthCall-S) enhancement of Motivational Interviewing for drinking reduction: New York City HIV primary care alcohol dependent patients at baseline; patients enrolled June 2012-July 2012. bDrinking eligibility (≥4 drinks, ≥1 day, past 30 days) identical to the previous 3-arm MI + Healthcall-IVR randomized trial [35]; alcohol dependence an additional eligibility requirement. c Other eligibility requirements included absence of psychosis, being actively suicidal or homicidal, severely cognitive impaired using Halstead-Reitan Trails A. These requirements were identical to the previous 3-arm MI + Healthcall-IVR randomized trial [35].

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