Design and Feasibility of Pictographic Medication Reminders for Delivery via Cell

描述（由申请人提供）：卫生知识有限的患者承担着不成比例的疾病负担；许多人难以理解和记住药物剂量表。一些研究评估了使用SMS（短信息服务）通过短信发送药物提示；然而，这些信息对于向有读写能力问题的患者提供药物提示的价值有限，因为它们只能包含文本。解决方案：可以使用一种名为MMS（多媒体信息服务）的新信息服务将象形文字的药物说明发送到手机上，该服务允许将图像、文本和音频“推送”给接收者。这些信息可能有助于作为行动线索，其格式可能比简单的短信更适用于卫生知识水平低和英语水平有限的人。目的：该项目的近期目标是开发一套有效和可靠的与药物有关的象形文字，这些象形文字可以通过手机发送给卫生知识有限的患者，使用一种支持图像的新短信模式。我们将从目标人群中抽取患者样本，在实验室环境中测试这些象形文字。方法：我们将使用焦点小组来帮助指导象形文字初始库的开发。我们第二个目标中的实验室测试将减少象形文字的竞争变体，建立内容的有效性和可靠性，并允许探索额外的增强功能，如语音辅助象形文字。在我们的第三个目标中，我们将进行可用性测试，模拟象形文字药物提醒的传递，以确定我们干预的总体可行性和安全性。分析：焦点小组数据将由两名研究人员转录并独立编码为专题内容。具有多种变体的象形文字将使用弗里德曼的双向方差分析来区分。个人可用性测试将结合定性和定量方法进行分析。结论：我们期望这些结果将建立必要的结构和过程，以证明随机、对照、临床试验的结果。

DESCRIPTION (provided by applicant): Patients with limited health literacy carry a disproportionate burden of disease; many have difficulty understanding and remembering medication dosing schedules. A number of studies have evaluated the delivery of medication prompts via text messaging using SMS (Short Message Service); however these messages are of limited value for delivering medication prompts to patients with literacy issues as they can only contain text. Solution: Pictographic medication instructions may be sent to cell phones using a new messaging service called MMS (Multimedia Messaging Service) that allows images, text, and audio to be 'pushed' to the recipient. These messages may help serve as cues to action and the format may be more usable for people with low health literacy and limited English proficiency than simple text messages. Purpose: The immediate goal of this project is to develop a set of valid and reliable medication-related pictographs that can be delivered via cell phones to patients with limited health literacy using a new mode of text messages that supports images. We will test these pictographs in a laboratory setting with a sample of patients from the target population. Methods: We will use focus groups to help guide the development of an initial bank of pictographs. Laboratory testing in our second aim will reduce competing variants of pictographs, establish content validity and reliability, and allow for exploration of additional enhancements such as voice assisted pictographs. Within our third aim we will conduct usability tests as we simulate the delivery of pictographic medication reminders to determine the overall feasibility and safety of our intervention. Analysis: Focus group data will be transcribed and independently coded by two researchers for thematic content. Pictographs with multiple variants will be discerned using the Friedman's two-way analysis of variance by ranks. Individual usability tests will be analyzed with a combination of qualitative and quantitative approaches. Conclusion: We expect that these results will establish the structures and processes necessary for demonstrating outcomes in a randomized, controlled, clinical trial.