BMC primary care · 2026
Knowledge improvement on premarital HIV counseling with PAUSE© flipchart versus conventional method: a cluster randomised controlled trial.
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Aziz Aznida Firzah Abdul, Chelladorai Magaletchumi, Tan Chai Eng, Muthupalaniappen Leelavathi
Аннотация
INTRODUCTION: Premarital HIV testing was made mandatory for Muslim couples in Malaysia as an effort to curb the transmission of HIV. The PAUSE© flipchart is a Malay language counselling tool to facilitate consistent and effective pre-test counselling for premarital couples. This study evaluates the effectiveness of the PAUSE© flipchart versus conventional methods in enhancing HIV knowledge at public primary healthcare clinics in Johor Bahru.
METHODS: A parallel cluster randomised controlled trial was conducted among adult Malay-literate clients who registered for mandatory premarital HIV testing. Cluster randomisation was used to select 8 public primary healthcare clinics from Johor Bharu District to be allocated into intervention and control groups. Clients in the intervention group (n = 90) received counselling using the PAUSE© flipchart, whereas clients in the control group (n = 90) received routine verbal counselling. HIV knowledge was assessed using the Malay HIV Knowledge Questionnaire before and after counselling. Understandability of the PAUSE© flipchart was evaluated using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) among clients in the intervention group.
RESULTS: Both groups showed significant increases in HIV knowledge post-counselling (p < 0.001). The intervention group had a mean score increase of 6.99 (95% CI [6.01, 7.97]), significantly higher than the control group's 3.99 (95% CI [2.89, 5.09]). Post-counselling scores were higher in the intervention group [mean 19.99 (SD = 1.26) vs. 16.59 (SD = 4.41), p < 0.001]. The PAUSE© flipchart demonstrated high understandability with a mean score of 95.92 (SD:7.15) among clients.
CONCLUSION: The PAUSE© flipchart is a highly acceptable, user-friendly, and more effective alternative to conventional premarital HIV counselling, warranting adoption in primary care to standardize and strengthen client education.
TRIAL REGISTRATION: This trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry on 26 June 2024 (ACTRN12624000788572).
METHODS: A parallel cluster randomised controlled trial was conducted among adult Malay-literate clients who registered for mandatory premarital HIV testing. Cluster randomisation was used to select 8 public primary healthcare clinics from Johor Bharu District to be allocated into intervention and control groups. Clients in the intervention group (n = 90) received counselling using the PAUSE© flipchart, whereas clients in the control group (n = 90) received routine verbal counselling. HIV knowledge was assessed using the Malay HIV Knowledge Questionnaire before and after counselling. Understandability of the PAUSE© flipchart was evaluated using the Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P) among clients in the intervention group.
RESULTS: Both groups showed significant increases in HIV knowledge post-counselling (p < 0.001). The intervention group had a mean score increase of 6.99 (95% CI [6.01, 7.97]), significantly higher than the control group's 3.99 (95% CI [2.89, 5.09]). Post-counselling scores were higher in the intervention group [mean 19.99 (SD = 1.26) vs. 16.59 (SD = 4.41), p < 0.001]. The PAUSE© flipchart demonstrated high understandability with a mean score of 95.92 (SD:7.15) among clients.
CONCLUSION: The PAUSE© flipchart is a highly acceptable, user-friendly, and more effective alternative to conventional premarital HIV counselling, warranting adoption in primary care to standardize and strengthen client education.
TRIAL REGISTRATION: This trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry on 26 June 2024 (ACTRN12624000788572).