Beta Testing of a Network-Based Health Literacy Program Tailored for Older Adults With Hypertension

Abstract

A touch screen–enabled “Personal Education Program” was modified to the “next generation” to capture self-medication behaviors of older adults with hypertension and assess related knowledge and self-efficacy. The program analyzes patient-entered information and delivers interactive educational content tailored to the reported behaviors. Summaries of self-reported symptoms, medication use (including frequency/time), drug interactions, and corrective strategies with an illustration of the drug interaction are printed to inform the provider before the primary care visit and for the patient to take home for self-study. After formative research during development and formal diagnostic and verification usability studies with advanced practice nurses and older adults, a beta test was conducted with older adults with hypertension over a 3-month period. Findings from the beta test suggest that older adult user satisfaction was high. Blood pressure declined over the four visits for 82% of the participants. The next generation of the Personal Education Program had a large effect size in increasing knowledge and self-efficacy for avoiding adverse self-medication behaviors. Behavior risk score did not change significantly but was significantly correlated with systolic blood pressure on the fourth visit. The positive results found in this small sample suggest that the next generation of the Personal Education Program could play a central role in facilitating patient-provider communication and medication adherence.

Effects of Active Learning on Health Literacy and Behavior in Older Adults: A Randomized Controlled Trial

“…It was previously proposed that a multimedia e‐learning module had potential to improve colon cancer literacy in elderly adults, although that was a pilot study . Another study found that a network‐based health literacy program customized for older adults with hypertension improved knowledge and self‐efficacy for avoiding adverse self‐medication behavior . These were not RCTs and addressed disease‐specific health literacy.…”

“…Secondary Outcome older adults with hypertension improved knowledge and self-efficacy for avoiding adverse self-medication behavior. 39 These were not RCTs and addressed disease-specific health literacy. In this education program for health promotion in older age, participants repeatedly experienced the exploration of health promotion, critically appraising the process with colleagues, and application of health promotion in daily life.…”

A qualitative study of older adults and computer use for health education: ‘It opens people's eyes’

“…17 Educational interventions aimed at increasing older (aged 60 and over) patients’ knowledge and self-efficacy for avoiding adverse self-medication behaviors demonstrated positive clinical outcomes. 18,19 …”

Instruments of health literacy used in nursing studies with hypertensive elderly

“…The studies were classifi ed into levels of evidence (12) as follows: fi ve were classifi ed in to level VI (13,17,18,20,22) , which corresponds to the evidence resulting from a single de-scriptive or qualitative study, and three into level II (14,19,21) , concerning the evidence from at least one well-designed randomized controlled trial.…”