Increasing Health Equity Through In-The-Moment Reading Assistance for Adults with Diabetes Served at Community Health Centers

通过在社区健康中心为成人糖尿病患者提供即时阅读帮助来提高健康公平

• 批准号: 10325472
• 负责人: Nathan D Shippee
• 金额: $ 20万
• 依托单位: GOGYUP, INC.
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-20 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10325472
• 关键词: Adherence; Adoption; Adult; Affect; Aftercare; American; Back; Benchmarking; Caring; Chronic Disease; Clinic; Communities; Comprehension; Data; Decision Making; Diabetes Mellitus; Disease; Education; Educational Materials; Effectiveness; Ensure; Event; Federally Qualified Health Center; Grant; Health; Health Status; Health education; Healthcare; Home; Immigrant; Individual; Institutes; Instruction; Knowledge; Label; Language; Learning; Limited English Proficiency; Measures; Medicine; Midwestern United States; Minnesota; Modeling; Multicenter Trials; Multimedia; Native-Born; Neighborhood Health Center; Non-Insulin-Dependent Diabetes Mellitus; Outcome; Patient Education; Patients; Phase; Population; Process; Protocols documentation; Randomized; Randomized Controlled Trials; Reader; Readiness; Reading; Research; Rural; Self Care; Self Management; Self-Help Devices; Small Business Innovation Research Grant; System; Techniques; Technology; Testing; Training; Translations; Visit; Vocabulary; base; commercialization; cost; design; diabetes self-management; digital; experience; falls; feasibility testing; follow-up; functional health literacy; health disparity; health equity; health literacy; improved; literacy; minority health; pilot trial; randomized trial; reading difficulties; real world application; recruit; safety net; second grade; skills; suburb; tool; tutoring; uptake; urban setting; volunteer

This SBIR Phase I project will demonstrate GogyUp’s in-the-moment assistive reading technology to increase patients’ ability to understand, manage and communicate about a chronic disease, a National Institute of Minority Health Disparities strategic priority. SIGNIFICANCE: Type two diabetes mellitus (T2DM) affects over 30 million Americans and requires patients to competently manage their conditions at home. However, patient educational print materials for after-visit care are overly complicated, with excessively high reading difficulty and fall short in supporting functional readiness for self-management. Compounding this inaccessibility are several barriers that limit patients’ capacity to learn and build knowledge and health literacy (the ability to process health information to make health decisions), including low print literacy (18% of U.S. adults are unable to read basic sentences), and limited English proficiency. HYPOTHESIS: The research team will determine the feasibility for implementing the GogyUp Reader app (in-the-moment assistive reading technology) in adult health care and whether the app facilitates patient understanding for managing T2DM when compared to the established standard for after-visit care (print materials alone). Aim 1 is to determine the feasibility for using GogyUp Reader as an aid for using disease self-management education materials. The research team will recruit eligible patients with T2DM in safety net clinics within diverse Minnesota communities experiencing higher levels of health disparities and employ engagement and usage measures from internal app data to assess feasibility for this use case. Aim 2 is to conduct a pilot trial of GogyUp’s embedded in-the-moment assistive reading technology for functional health literacy. We will assess the potential effectiveness of GogyUp and the feasibility of conducting a larger, multicenter trial by conducting a pilot randomized trial with a randomized, pre-post design. Outcomes will include functional health literacy, or the ability to read and understand written health materials in the moment as a proximal outcome (primary) and communicative and critical health literacy, or the ability to communicate about and critically appraise self-management activities (secondary), from baseline to three months. PRELIMINARY DATA: End-user data from individual app users and adult education pilots indicate broad uptake among an all-volunteer user base. A randomized trial is needed to assess the technology’s potential impact on health literacy and its applicability for reducing health disparities. LONG TERM GOAL: This real-world application and assessment of the GogyUp Reader app for T2DM will inform system improvements and provide initial data for a Phase II project as a fully powered, multi-year randomized controlled trial to evaluate GogyUp’s assistive reading technology on patient health literacy, commercialization strategy, and reveal best practices for culturally responsive implementation and support.

这个SBIR第一阶段项目将展示GogyUp的即时辅助阅读技术，以增加患者的 了解、管理和沟通慢性病的能力，国家少数民族健康研究所 差异战略优先。意义：2型糖尿病(T2 DM)影响3000多万美国人和 要求患者在家中熟练地管理自己的病情。然而，患者教育印刷材料 访后护理过于复杂，阅读难度过高，缺乏功能支持 准备好自我管理。使这种难以接近的情况变得更加复杂的是几个限制患者能力的障碍 学习和建立知识和健康素养(处理健康信息以作出健康决策的能力)， 包括印刷识字能力低(18%的美国成年人不能阅读基本句子)，以及有限的英语熟练程度。 假设：研究团队将确定实施GogyUp Reader应用程序(即时)的可行性 辅助阅读技术)在成人保健中的应用以及该应用程序是否有助于患者理解管理 与探视后护理(仅限于印刷材料)的既定标准相比，2型糖尿病的风险更大。目标1是确定 使用GogyUp Reader作为使用疾病自我管理教育材料的辅助工具的可行性。这项研究 团队将在明尼苏达州不同社区的安全网诊所招募符合条件的T2 DM患者 更高水平的健康差距，并采用来自内部应用程序数据的参与度和使用率衡量标准来评估 此用例的可行性。目标2是对GogyUp的嵌入式即时辅助阅读进行试点试验 促进功能性健康素养的技术。我们将评估GogyUp的潜在有效性和 进行一项更大规模的多中心试验，采用随机、事前设计的先导性随机试验。 结果将包括功能性健康素养，或阅读和理解书面健康材料的能力 作为近期结果的时刻(主要)和沟通能力和关键的健康素养，或沟通能力 关于并批判性地评估自我管理活动(次级)，从基线到三个月。初步准备 数据：来自个人应用程序用户和成人教育试点的最终用户数据表明，在全志愿者中广泛使用 用户群。需要一项随机试验来评估这项技术对健康素养的潜在影响及其 对缩小健康差距的适用性。长期目标：这一现实世界的应用和评估 适用于T2 DM的GogyUp Reader应用程序将通知系统改进并为第二阶段项目提供完整的 评估GogyUp辅助阅读技术对患者健康影响的有功多年随机对照试验 扫盲、商业化战略，并揭示响应文化的实施和支持的最佳做法。