Testing a video to improve provider-patient interaction

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DESCRIPTION (provided by applicant): In order to control the spiraling costs of health care, persons with chronic diseases must be able to develop, in collaboration with their physicians, personalized health plans that direct care to the specific risk factors that threaten their health. To take a more active role in preventive health care, avoidance of costly procedures and management of long-term care, patients must be better informed about their health care needs and trained to engage in meaningful dialogue with care providers about the development of care plans to improve their health. Therefore, interventions to improve health literacy must be developed. The Specific Aims of the research are: to develop and test a measure to assess risk-related health literacy in a multicultural, low literacy population; and to test the efficacy of a video for patients designed to increase their risk-related health literacy. The health literacy measurement tool will be theoretically grounded in behavior change arid communication theory, and will include assessment of the full range of skills and knowledge needed for health literacy, including listening and speaking, and will address the context-specific cultural and conceptual factors that affect health literacy. It will have the 8 attributes of a quality instrument: conceptually modeled, reliable and valid, responsive, interpretable by the intended respondents, of low respondent burden, able to be developed in alternative forms appropriate for different populations in which it might be used, and appropriately adapted for cultural and language considerations. We will utilize an iterative instrument development process integrating qualitative, cognitive and psychometric methods in the design process. The assessment will be computerized and will utilize "Talking Touch Screen" programming to enhance utilization among low-literate populations. The video will be tested using a randomized control design among a multi-cultural patient population at the University of New Mexico. This research addresses the priorities of announcement PAR-04-117 "Understanding and Promoting Health Literacy."