The talking touchscreen: A new approach to outcomes assessment in low literacy

Hahn, Elizabeth A.; Cella, David; Dobrez, Deborah G.; Shiomoto, Gail; Marcus, Elizabeth A.; Taylor, Samuel G.; Vohra, Mala; Chang, Chih‐Hung; Wright, Benjamin D.; Linacre, John M.; Weiss, Barry D.; Valenzuela, Veronica; Chiang, Hsaio Lin; Webster, Kimberly

doi:10.1002/pon.719

Cited by 80 publications

(76 citation statements)

References 42 publications

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“…We developed a bilingual multimedia Talking Touchscreen (TT) for self-administration of questionnaires to accommodate varying literacy levels and computer skills [4,37,38]. As text appears on the screen, it is automatically read out loud as patients listen via headset.…”

Section: The Talking Touchscreenmentioning

confidence: 99%

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

et al. 2006

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Section: The Talking Touchscreenmentioning

confidence: 99%

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

et al. 2006

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“…The evidence of their effectiveness as a strategy for limited-literacy populations, however, is mixed. 6,46,47 These methods often present information in a complex manner or are used as a substitute rather than a complement to discussions with clinicians or health educators. 48 Furthermore, they often presume English proficiency or a level of technological sophistication (eg, having a DVD player at home) that does not exist in some cultures.…”

Section: Technologymentioning

confidence: 99%

Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

Andrulis¹,

Brach²

2007

am j health behav

217

159

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Objective-To understand the interrelationship of literacy, culture, and language and the importance of addressing their intersection.Methods-Health literacy, cultural competence, and linguistic competence strategies to quality improvement were analyzed.Results-Strategies to improve health literacy for low-literate individuals are distinct from strategies for culturally diverse and individuals with limited English proficiency (LEP). The lack of integration results in health care that is unresponsive to some vulnerable groups' needs. A vision for integrated care is presented.Conclusion-Clinicians, the health care team, and health care organizations have important roles to play in addressing challenges related to literacy, culture, and language. Keywords communication; cultural competence; health literacy; language barriers; literacy; linguistic competence; minority health; quality improvement Many patients face great difficulties in understanding health information and navigating the health care system. Nearly 2 decades of research have linked limited literacy with challenges in health care, including lower health knowledge, misinterpretation of prescriptions, and lower receipt of preventive services. [1][2][3] Only in the last 5 years has health literacy-defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions," 4 -received national attention.

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“…The developed multimedia addresses many of the needs and preferences of low-income and underserved Americans concerning content: information provided on a basic health literacy level, content for nonEnglish speakers, and culturally defined content (40). Furthermore, the implementation of touch-screen monitors offers an alternative to keyboard and mouse for computer input, which may hold value for individuals who are older, have lower health literacy, or have less computer experience (41,42).…”

Section: Subject Feedback On Computer Usementioning

confidence: 99%

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

et al. 2005

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OBJECTIVE -To evaluate a clinic-based multimedia intervention for diabetes education targeting individuals with low health literacy levels in a diverse population.RESEARCH DESIGN AND METHODS -Five public clinics in Chicago, Illinois, participated in the study with computer kiosks installed in waiting room areas. Two hundred forty-four subjects with diabetes were randomized to receive either supplemental computer multimedia use (intervention) or standard of care only (control). The intervention includes audio/video sequences to communicate information, provide psychological support, and promote diabetes self-management skills without extensive text or complex navigation. HbA 1c (A1C), BMI, blood pressure, diabetes knowledge, self-efficacy, self-reported medical care, and perceived susceptibility of complications were evaluated at baseline and 1 year. Computer usage patterns and implementation barriers were also examined.RESULTS -Complete 1-year data were available for 183 subjects (75%). Overall, there were no significant differences in change in A1C, weight, blood pressure, knowledge, self-efficacy, or self-reported medical care between intervention and control groups. However, there was an increase in perceived susceptibility to diabetes complications in the intervention group. This effect was greatest among subjects with lower health literacy. Within the intervention group, time spent on the computer was greater for subjects with higher health literacy.CONCLUSIONS -Access to multimedia lessons resulted in an increase in perceived susceptibility to diabetes complications, particularly in subjects with lower health literacy. Despite measures to improve informational access for individuals with lower health literacy, there was relatively less use of the computer among these participants. Diabetes Care 28:1574 -1580, 2005T here is a growing awareness of the impact of low health literacy on diabetes (1,2). Low health literacy poses a major barrier to education and self-management (3). Health literacy directly impacts health outcomes, such as hospitalization risk, particularly in those with chronic diseases (4,5). In one crosssectional study (5) measuring the health literacy level of type 2 diabetic patients, patients with inadequate health literacy were less likely than those with adequate health literacy to achieve tight glycemic control. However, there is limited data from longitudinal studies regarding the impact of health literacy on changes in clinical outcomes over time (2).Despite increasing concern about the impact of low health literacy on diabetes care, there are few proven interventions available that address low health literacy (6). Recent evidence (6,7) suggests that diabetes education improves selfmanagement and glycemic control in those with limited health literacy. Simultaneously, clinicians are faced with less time and resources for disseminating information. Regular attendance in diabetes education classes is disappointingly low, particularly for those with lower socioeconomic status and those who...

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The talking touchscreen: A new approach to outcomes assessment in low literacy

Abstract: The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills.

Cited by 80 publications

References 42 publications

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

The impact of literacy on health-related quality of life measurement and outcomes in cancer outpatients

Integrating Literacy, Culture, and Language to Improve Health Care Quality for Diverse Populations

Implementation and Evaluation of a Low-Literacy Diabetes Education Computer Multimedia Application

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