| Publication Abstract Display | | Type: Poster | | Title: The Simulated Market Task (SMarT): A pilot study of a novel web-based shopping task in HAND. | | Authors: Woods SP, Iudicello J, Doyle K, Cushman C, Grant I, the HNRP Group | | Date: 07-31-2013 | | Abstract:INTRODUCTION: The relevance and usefulness of everyday functioning assessments in HIV in the modern era demands consideration of technological advances that have transformed the ways in which people navigate their daily world. The Internet plays an increasingly critical role in the daily functioning of persons living with HIV infection, who use the Web to manage their healthcare, access psychosocial support resources, and complete household activities (e.g., shopping). Internet navigation difficulties may represent a serious barrier to optimal daily functioning, but there are no studies regarding the impact of HIV Association Neurocognitive Disorders on this essential component of day-to-day functioning. The current pilot study aimed to examine the sensitivity of a novel, web-based measure of household shopping (i.e., Simulated Market Task; SMarT) to HAND.
METHOD: Participants were 72 individuals with HIV infection and 44 seronegative comparison subjects. The HIV-infected participants were classified into persons with (n=22) and without (n=50) HAND based on the results of a neurocognitive evaluation consistent with Frascati diagnostic criteria. We excluded individuals with histories of severe psychiatric illness, neurological disease, and current substance dependence. The three study groups were comparable for demographics, histories of substance dependence, computer use frequency, and anxiety (ps>.10).
All participants completed a beta version of the SMarT paradigm that was modeled after major Internet shopping sites (e.g., Amazon.com). In brief, participants are asked to independently navigate a simulated online superstore to purchase 8 specific items (e.g., cold/allergy medicine) within a pre-determined budget. Participants must navigate the website to identify the correct items, place them in a virtual shopping cart, and successfully check-out using a mock credit card and associated mock personal information. During the task, participants are also subject to a series of advertising pop-ups and instant messages. Participants are asked to ignore these messages, with the exception of one particular message that prompts them to add an item to their cart while staying within their original budget.
RESULTS: A one-way ANOVA showed significant omnibus group effects on number of correct items purchased (p=.012) and purchasing intrusion errors (p=.017) on SMarT. Planned post-hoc analyses revealed that these effects were driven by deficits in the HAND group relative to the seronegatives (ps<.05; Hedges g = .40 and .48, respectively), who did not differ from the HIV+ noHAND group (ps>.10). There were no significant between-group effects on speed of completion, response to distractors, total money spent, or check-out errors (ps>.10).
DISCUSSION: Results of this pilot study extend prior research by showing that HAND is associated with increased difficulties accurately navigating the Internet to purchase household goods. Findings are commensurate with Goverover and colleagues (2000), who observed deficits naturalistic Internet navigation skills in multiple sclerosis (i.e., purchase an airline ticket). Future studies might examine the neurocognitive (e.g., executive), functional (e.g., adherence,), HIV disease (e.g., nadir CD4), and psychiatric (e.g., depression) correlates of the observed Internet navigation deficits in HAND. We are presently developing online banking and pharmacy tasks that will comprise a multi-domain, interrelated web-based functional assessment battery for HIV and other populations (e.g., schizophrenia). |
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