Patient-Tailored Health Literacy Improvement System

描述（由申请人提供）：低健康素养影响了美国9000多万成年人，并破坏了医生和护士提供高质量护理的最佳努力-估计每年花费730亿美元（医学研究所，2003年）。卫生知识普及程度低还导致个人和集体公共卫生状况不佳，更容易感染疾病，以及生物恐怖主义等复杂的紧急情况。针对这一问题，医疗保健技术与方法（HTM）提出开发一个创新和实用的“患者定制的健康素养改善系统”，并在第一阶段测试其可行性。最初，这一新系统的目标是提高健康素养，改善老年人在家庭医疗保健中的自我护理。以后，预计将扩大到其他保健场所和医疗条件。这一为患者量身定制的健康素养改善系统将包括：（1）使用综合生态模型的新的多维健康素养筛查工具，（2）帮助患者确定其首选学习方式的问卷，以及（3）针对每个患者的健康素养水平和首选学习方式量身定制的健康教育材料（例如，纸张、互联网、视像及交互式话音回应）。定制的健康教育材料将有效地自动组合，适用于不同的健康素养水平。在第一阶段的可行性研究中，Inova VNA家庭保健护士将管理筛选工具和学习方式问卷。根据结果，他们将向30名60岁及以上新诊断为II型糖尿病的患者分发量身定制的健康教育材料（主题：饮食自我管理）。HTM将通过研究前和研究后的问卷调查来确定护士和患者对系统的满意度以及建议。HTM还将通过研究前和研究后的知识测试来测量患者对指定健康主题的知识。在第二阶段，健康医疗将根据第一阶段的经验改进筛查工具、模式问卷和自我护理教育材料。此外，HTM还将为糖尿病自我护理的其他方面开发量身定制的材料。配备了改进和扩展的系统，HTM将与适当数量的受试者进行随机对照试验（基于功效分析），以验证筛选工具并衡量患者自我护理知识和健康结果的改善。在第二阶段完成后，HTM设想将一个有效和实用的临床实践系统商业化，并可以不断调整和扩展，供英语和非英语患者使用。HTM估计，该公司可以在五到七年内实现每年1000万到1500万美元的许可收入。 公共卫生相关性：卫生知识普及程度低会导致各种问题，包括个人和集体公共卫生状况不佳、更容易感染疾病和生物恐怖主义等复杂的紧急情况。因为超过一半的美国成年人发现很难理解健康信息-健康计划覆盖范围，阅读药物说明，或理解公共健康警告，我们的国家远没有达到健康或安全的程度。通过提出一个新的系统来促进健康素养，这个研究项目正在解决一个730亿美元的问题，这是我们国家公共卫生系统和国家安全的基础。

DESCRIPTION (provided by applicant): Low health literacy affects more than 90 million adults in the United States and undermines the best efforts of physicians and nurses to provide high quality care - at an estimated cost of $73 billion per year (Institute of Medicine, 2003). Low health literacy also contributes to poor individual and collective public health, greater susceptibility to diseases, and complex emergencies such as bioterrorism. In response to this problem, Healthcare Technologies and Methods (HTM) proposes to develop an innovative and practical "Patient- Tailored Health Literacy Improvement System" and test its feasibility in Phase I. Initially, this novel system will be targeted to advance health literacy and improve self-care for older people in home health care with Type II diabetes. Later, expansion to other health venues and medical conditions is anticipated. This Patient-Tailored Health Literacy Improvement System will be comprised of: (1) A new multidimensional health literacy screening tool using an integrated ecological model, (2) A questionnaire that helps patients identify their preferred learning modality, and (3) Health education materials that are tailored for each patient's health literacy level and preferred learning modality (e.g., paper, Internet, video and interactive voice response [IVR]). The tailored health education materials will be efficiently and automatically assembled for various health literacy levels. In the Phase I feasibility study, Inova VNA Home Health nurses will administer the screening tool and learning modality questionnaire. Based on the results, they will distribute tailored health education materials (topic: dietary self management) to 30 patients ages 60 and over, who are newly diagnosed with Type II diabetes. HTM will determine the nurses' and patients' satisfaction with the system and suggestions with pre- and post-study questionnaires. HTM also will measure patients' knowledge of the specified health subject with pre- and post-study knowledge tests. In Phase II, HTM will refine the screening tool, modality questionnaire and self-care education materials based on Phase I experiences. In addition, HTM will develop tailored materials for additional aspects of diabetes self- care. Equipped with the improved and expanded system, HTM will conduct a randomized controlled trial with an appropriate number of subjects (based on a power analysis) to validate the screening tool and measure improvements in patients' self-care knowledge and health outcomes. After completion of Phase II, HTM envisions commercializing a system that is efficient and practical for clinical practice and can be continuously adapted and expanded for use by English-speaking and non English-speaking patients. HTM estimates that the company can achieve annual licensing revenues of $10 million - $15 million within five to seven years. PUBLIC HEALTH RELEVANCE: Patient-Tailored Health Literacy Improvement System Low health literacy contributes to a variety of problems including poor individual and collective public health, greater susceptibility to diseases and complex emergencies such as bioterrorism. Because more than half of adults in the U.S. find it difficult to understand health information - health plan coverage, read medication instructions, or understand public health warnings, our nation is not nearly as healthy or as safe as it needs to be. By proposing a new system to advance health literacy, this research project is addressing a $73 billion problem which is at the foundation of our nation's public health system and national security.