Health Literacy Assessment and Intervention to Reduce Disparities: FLIGHT/VIDAS II

健康素养评估和减少差异的干预措施：FLIGHT/VIDAS II

• 批准号: 9015024
• 负责人: RAYMOND L OWNBY
• 金额: $ 56.65万
• 依托单位: NOVA SOUTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-05 至 2020-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9015024
• 关键词: Academic skills; Adherence; Adult; Affect; African American; Age; Age-Years; American; Asthma; Behavioral; Characteristics; Cholesterol; Chronic; Chronic Disease; Clinical; Cognition; Computers; Diabetes Mellitus; Disease; Disease Management; Elderly; Ethnic Origin; Fatigue; HIV Infections; Health; Health Status; Health behavior; Healthcare; Hepatitis; Hepatitis C; Hispanics; Human Resources; Hypertension; Individual; Internet; Intervention; Knowledge; Link; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental disorders; Minority; Minority Groups; Myocardial Infarction; Not Hispanic or Latino; Outcome; Pain; Participant; Patient Self-Report; Patients; Persons; Qualifying; Race; Self Efficacy; Self Management; Sleep; Sleep disturbances; Socioeconomic Status; Sorting - Cell Movement; Stress; Stroke; Tablet Computer; Twin Multiple Birth; Work; coping; cost; cost effective; disparity reduction; effective intervention; ethnic minority population; experience; falls; follow-up; health care service utilization; health disparity; health literacy; improved; information kiosk; interactive multimedia; intervention effect; literacy; mathematical ability; meetings; member; racial minority; response; skills; treatment adherence

 DESCRIPTION (provided by applicant): Health literacy is a critically important skill that helps people to become active participants in their health care. The 2003 National Assessment of Adult Literacy showed that more than 75 million Americans had basic health literacy skills, indicating that as many as 1 in 4 Americans can have difficulty understanding information about their healthcare. Persons in racial and ethnic minorities are likely to have even lower levels of health literacy. Twenty-four percent of blacks (9.5 million persons) and 41% of Hispanics (21 million persons) have below basic levels of health literacy. These persons have lower levels of health literacy and compelling evidence, including our own findings (see below), link race and ethnicity to disparities in health via health literacy. Members of minority groups and older adults are more frequently affected by chronic diseases such as cancer, high blood pressure, heart attack, stroke, diabetes, elevated cholesterol, asthma, hepatitis C, HIV infection, mental health disorders and many others. The twin burdens of chronic disease and low levels of health literacy thus fall disproportionately on those most in need - members of minorities and older adults, all of whom likely to experience one or more chronic conditions while often not having the health literacy skills to help them cope. Chronic disease self-management (CDSM) is a logical target for a general health literacy intervention. In an approach that cuts across specific diseases. CDSM targets problems and skills needed to cope with issues such as fatigue, pain, stress, depression, sleep disturbance and treatment adherence. Studies show that in- person CDSM classes improve patients' functioning and reduce healthcare utilization, but their availability is limited due to the lack of qualified personnel and cost. Similarly, while interventions have been developed to improve health literacy, they are difficult to scale to levels needed to meet the challenge of low health literacy (for more than 40 million persons) due to their cost. Effective interventions with the potential for wider dissemination at reasonable costs are urgently needed. In a previous study, we showed that a computer-delivered tailored information intervention targeting health literacy that can deployed either as an information kiosk in a clinical office or n the Internet could be cost- effective in improving patients' health literacy and adherence. It is nt clear, however, whether the same sort of computer-delivered, multimedia and interactive approach will be effective in improving CDSM skills in persons with low baseline levels of health literacy, and if it is, whether its effects will extend beyond health literacy to general health, slf-efficacy, activation, and treatment adherence. In this follow-up study we will evaluate this possibility by creating a personally relevant computer-delivered intervention targeting CDSM and health literacy among African-Americans, Hispanics, and white non-Hispanics:

 描述（由申请人提供）：健康素养是一项至关重要的技能，可以帮助人们积极参与医疗保健。 2003 年全国成人素养评估显示，超过 7500 万美国人具备基本的健康素养技能，这表明多达四分之一的美国人难以理解有关其医疗保健的信息。少数种族和民族的人的健康素养水平可能更低。 24% 的黑人（950 万人）和 41% 的西班牙裔（2100 万人）的健康素养低于基本水平。这些人的健康素养水平较低，但有令人信服的证据，包括我们自己的研究结果（见下文），通过健康素养将种族和民族与健康差异联系起来。少数群体成员和老年人 更容易受到癌症、高血压、心脏病、中风、糖尿病、胆固醇升高、哮喘、丙型肝炎、艾滋病毒感染、精神健康障碍等慢性疾病的影响。因此，慢性病和健康素养水平低下的双重负担不成比例地落在了那些最需要帮助的人身上——少数族裔和老年人，他们都可能患有一种或多种慢性病，但往往不具备帮助他们应对的健康素养技能。慢性病自我管理（CDSM）是一般健康素养干预的合理目标。以一种跨越特定疾病的方法。 CDSM 针对的是应对疲劳、疼痛、压力、抑郁、睡眠障碍和治疗依从性等问题所需的问题和技能。研究表明，面对面的 CDSM 课程可以改善患者的功能并减少医疗保健利用率，但由于缺乏合格的人员和成本，其可用性受到限制。同样，虽然已经制定了干预措施来提高健康素养，但由于成本原因，它们很难扩大到应对低健康素养挑战（超过 4000 万人）所需的水平。迫切需要采取有效的干预措施，并以合理的成本进行更广泛的传播。在之前的一项研究中，我们表明，计算机提供的针对健康素养的定制信息干预措施可以部署为临床办公室的信息亭或互联网上的信息亭，可以在提高患者的健康素养和依从性方面具有成本效益。然而，尚不清楚同样类型的计算机传输、多媒体和交互方法是否能有效提高健康素养基线水平较低的人的 CDSM 技能，如果有效，其影响是否会超越健康素养，扩展到一般健康、自我效能、激活和治疗依从性。在这项后续研究中，我们将通过针对非裔美国人、西班牙裔和非西班牙裔白人的 CDSM 和健康素养创建个人相关的计算机交付干预措施来评估这种可能性：