Reducing Assessment Barriers for Patients with Low Literacy

减少识字率低的患者的评估障碍

• 批准号: 9238395
• 负责人: James William Griffith
• 金额: $ 82.24万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-03-07 至 2022-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9238395
• 关键词: Academic Medical Centers; Adult; American; Anxiety; Assessment tool; Boston; Characteristics; Clinical; Clinical Research; Collection; Computer Assisted; Country; Data; Data Analyses; Data Collection; Development; Ensure; Evaluation; Fatigue; Guidelines; Health; Health Status; Healthcare; Individual; Information Systems; Language; Logic; Longitudinal Studies; Measurement; Measures; Mental Depression; Methods; Pain intensity; Pain interference; Paper; Participant; Patient Outcomes Assessments; Patients; Physical Function; Primary Health Care; Process; Property; Psychometrics; Questionnaire Designs; Questionnaires; Reading; Recommendation; Recruitment Activity; Research; Role; Sampling; Sleep disturbances; Speech; Survey Methodology; Surveys; Symptoms; Technology; Testing; Time; United States; United States National Institutes of Health; Validation; Voice; Work; Writing; base; clinical care; clinical decision-making; design; experience; functional health literacy; health literacy; improved; instrument; literacy; response; skills; social stigma; statistics; syntax; tool; touchscreen

Background: This R01 is in response to PAR-13-130: Understanding and Promoting Health Literacy (R01). Health literacy is the degree to which an individual can obtain, process, and understand basic health information, which includes the ability to understand written questionnaires. Almost none of the survey instruments being used across the country has been validated for use with people who have low health literacy. This fundamental cross-cutting weakness in survey methods undermines the accuracy of a broad swath of data collected in research and clinical care. Written questionnaires are omnipresent in healthcare, including patient demographic forms, symptom assessment tools, and patient-reported outcome questionnaires. The NIH has invested heavily in the creation of the NIH Patient-Reported Outcomes Measurement Information System (PROMIS), which has significantly advanced health measurement. But PROMIS, like almost all survey instruments, has not been validated for use by people with low health literacy and it exists in a written format that may be inaccessible to individuals with low literacy. Aims: We will remove health literacy barriers to accurate survey research by: 1) evaluating differences in psychometric properties by health literacy of PROMIS questionnaires as well as other commonly used surveys; 2) identifying and characterizing survey items that do not work properly for people with low health literacy; and, 3) creating a guide for survey item development and evaluation for different modes of test administration that are most appropriate for people who have low health literacy. Methods: We will recruit a large sample of participants across two primary care networks at Northwestern Universtiy and Boston University Medical Center. The sample will be evenly balanced across English versus Spanish language and adequate versus low health literacy. These assessments will be given at multiple time points as part of a longitudinal study. We will use state-of-the-art psychometric methods to determine differences among participants with low versus adequate health literacy, and whether these differences can be overcome by alternative modes of survey administration. Impact: We will identify survey item characteristics that are associated with differential item functioning by health literacy for different modes of test administration. Based on our analyses, we will create a guide for survey item development and evaluation. This will lead to assessments in healthcare that are more accessible for people with low health literacy and more accurate. This project has broad relevance insofar as many widely-used health questionnaires have not been validated for use with people who have low health literacy. We will present a generalizable approach that can rapidly influence the mode of data collection from patients. We will also present modes of data analyses oriented toward understanding health-literacy, which is a critical component of survey validation activities.

背景：本 R01 是对 PAR-13-130：理解和促进健康素养 (R01) 的回应。 健康素养是个体获得、处理和理解基本健康知识的程度 信息，包括理解书面调查问卷的能力。调查中几乎没有 全国范围内使用的仪器已经过验证，可用于健康素养较低的人群。 调查方法中这一根本性的跨领域弱点损害了大量数据的准确性 在研究和临床护理中收集。书面调查问卷在医疗保健领域无处不在，包括患者 人口统计表格、症状评估工具和患者报告的结果调查问卷。美国国立卫生研究院有 投入巨资创建 NIH 患者报告结果测量信息系统 （PROMIS），它显着先进了健康测量。但 PROMIS 与几乎所有调查一样 工具尚未经过验证，可供健康素养较低的人使用，并且以书面形式存在 识字率低的人可能无法接触到这一点。 目标：我们将通过以下方式消除健康素养障碍，以进行准确的调查研究：1）评估 PROMIS 问卷以及其他常用调查的健康素养的心理测量特性； 2) 识别和描述对健康素养较低的人不起作用的调查项目； 3) 为不同测试管理模式的调查项目开发和评估创建指南 最适合健康素养较低的人。 方法：我们将在西北大学的两个初级保健网络中招募大量参与者样本 大学和波士顿大学医学中心。该样本将在英语和英语之间均衡平衡 西班牙语和健康素养充足与低下。这些评估将多次进行 点作为纵向研究的一部分。我们将使用最先进的心理测量方法来确定 健康素养较低与足够的参与者之间的差异，以及这些差异是否可以被 通过替代调查管理模式来克服。 影响：我们将通过以下方式确定与差异项目功能相关的调查项目特征： 不同测试管理模式的健康素养。根据我们的分析，我们将创建调查指南 项目开发和评估。这将使人们更容易获得医疗保健评估 健康素养低，更准确。就许多广泛使用的健康领域而言，该项目具有广泛的相关性 尚未验证问卷是否适用于健康素养较低的人群。我们将呈现一个 可以快速影响患者数据收集模式的通用方法。我们还将呈现 旨在了解健康素养的数据分析模式，这是调查的重要组成部分 验证活动。