An Automated, Tailored Information Application for Medication Health Literacy

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DESCRIPTION (provided by applicant): Health literacy is a critically important problem in improving the health outcomes in patients with HIV infection. Patient behaviors essential to the successful treatment of HIV infection, such as high levels of medication adherence, may depend on patients' understanding how to take medication, how to solve medication-related problems, and how to cope with medication side effects. Addressing the problem of low health literacy in individuals affected by HIV infection may thus be an important way of improving their health status. It is unclear, however, exactly how to improve health literacy in persons with HIV infection and the extent to which improving it might affect important variables such as medication adherence and health outcomes. A related problem in developing interventions to improve health literacy in any patient group is how to provide the intervention in a cost effective manner. Medical care for individuals with low levels of health literacy is often provided in clinics in limited-resource settings or in the offices of busy private practitioners who have little opportunity to provide or support for additional interventions. A promising strategy for providing health literacy interventions in busy or limited-resource setting is to provide them through automated computer-based applications. Information technology-based interventions to promote health literacy have the potential for being readily available on desktop computers or over the Internet. E-health applications may be an important strategy for addressing health disparities (Office of Disease Prevention and Health Promotion, 2006). Once created, costs for their continued maintenance and deployment can be low. They could thus be a cost-effective strategy for addressing health literacy issues in persons with HIV infection (Brown, Vanable, & Eriksen, 2008), but have not been widely developed or validated. As one group (Wolf et al., 2007a) has suggested, "New advances in multimedia technology could be used to better disseminate patient education . . ." (p. 259). The purpose of the study proposed in this application is to create a computer-based and automated application that will provide individually-tailored health literacy education to persons with HIV infection. After development this application will be tested with 100 persons currently on antiretroviral treatment who will be recruited from a local clinic. They will participate in three sessions at four week intervals during the study. The effectiveness of the intervention will be assessed by examining participants' medication and disease-related knowledge and awareness of problem solving skills before and after the training intervention and four weeks later. Self-report and electronically-monitored adherence in the four weeks before and after the intervention will also be assessed. The outcome of this study will be an automated tailored information application to improve health literacy in those coping with HIV infection. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page PUBLIC HEALTH RELEVANCE: Health literacy is a critically important public health problem related to treatment success in HIV+ persons. The application proposed in this application will address this problem by creating a computer-based health literacy teaching application that can readily be deployed on the Internet. PHS 398/2590 (Rev. 11/07) Page Continuation Format Page