Implementing a low-literacy, multimedia IT system to enhance patient-centered can

弱势群体的疾病负担更重，对诊断的了解更少， 治疗，并且不太可能对与医疗保健提供者的沟通感到满意。患者 由于经济资源有限，识字能力低或种族/族裔少数地位， 接受次优护理的风险。这些患者可能会经历更差的健康结果， 护理方面的差异、特殊需求或护理障碍。改善医疗保健环境中的沟通可能 导致更好地坚持推荐的治疗，更高的护理质量，更高的护理满意度 和更好的健康结果。使用新的保健信息技术是一项建议的战略， 改善卫生信息的获取，提高卫生保健沟通质量 交付.拟议的示范项目的总体目标是测试一个对低识字率、 在日常临床实践中使用多媒体信息和评估系统， 护理和改善患者的结果。干预措施将结合联合收割机现有的两项评估， 提供多媒体信息技术（IT）资源的教育系统：癌症帮助-谈话 触摸屏（TT）。这种用户友好的IT资源将为患者提供全面、科学的 教育信息，让患者？个性化？每次会议的信息， 患者自我管理患者报告的结局问卷，允许患者创建一个单独的 定制的需求和问题清单，与他们的医疗保健提供者分享，并帮助患者准备 积极的癌症治疗和后续护理之间的过渡。200例前瞻性随机试验 乳腺癌或结直肠癌患者将在三个流动癌症护理中心进行， 芝加哥。患者将被随机分配至CancerHelp-TT或对照/标准教育组， 最长为9个月（治疗3 - 6个月，随访3个月）。拟议 研究将：1）测试使用CancerHelp-TT是否提高了对医疗保健沟通的满意度， 癌症和治疗的知识，自我效能，坚持推荐的治疗和健康相关的 癌症治疗期间的生活质量（HRQL）; 2）评估患者特征之间的关系， 资源、需求、健康行为和健康结果，使用弱势群体行为模型 人群;和3）评估使用CancerHelp-TT是否改善了对推荐随访的依从性 治疗后早期监测期间的护理和HRQL。CancerHelp-TT干预是一种 完全可导出的独立IT系统，可在任何癌症护理中心实施， 额外资源。它也可以适用于其他健康状况。这个新颖的多媒体IT系统 可能特别有助于解决弱势群体癌症护理方面的差距。

Vulnerable populations experience a greater burden of disease, are less informed about diagnosis and treatment, and are less likely to be satisfied with communication with their healthcare providers. Patients with limited economic resources, low literacy skills or racial/ethnic minority status are particularly vulnerable to receiving sub-optimal care over time. These patients may experience poorer health outcomes due to disparities in care, special needs or barriers to care. Improving communication in healthcare settings may lead to better adherence to recommended treatment, higher quality of care, higher satisfaction with care and better health outcomes. The use of new health information technologies is a recommended strategy for improving access to health information and for enhancing the quality of communication in healthcare delivery. The overall objective of the proposed demonstration project is to test whether a low-literacy friendly, multimedia information and assessment system used in daily clinical practice enhances patient-centered care and improves patient outcomes. The intervention will combine two existing assessment and education systems to provide a multimedia information technology (IT) resource: CancerHelp-Talking Touchscreen (TT). This user-friendly IT resource will deliver comprehensive, state-of-the-science patient education information, allow patients to ?personalize? the information at each session, enable low literacy patients to self-administer patient-reported outcomes questionnaires, allow patients to create an individually tailored list of needs and concerns to share with their healthcare providers, and assist patients in preparing for the transition between active cancer treatment and follow-up care. A prospective randomized trial of 200 patients with breast or colorectal cancer will be conducted at three ambulatory cancer care centers in Chicago. Patients will be randomized to CancerHelp-TT or control/standard education and followed for a maximum of nine months (three to six months of treatment and three months of follow-up). The proposed study will: 1) test whether use of CancerHelp-TT improves satisfaction with healthcare communication, knowledge of cancer and treatment, self-efficacy, adherence to recommended treatment and health-related quality of life (HRQL) during cancer treatment; 2) evaluate the relationships between patient characteristics, resources, needs, health behaviors and health outcomes using the Behavioral Model for Vulnerable Populations; and 3) assess whether use of CancerHelp-TT improves adherence to recommended follow-up care and HRQL during the early post-treatment surveillance period. The CancerHelp-TT intervention is a fully exportable, self-contained IT system that can be implemented in any cancer care center with minimal additional resources. It can also be adapted for other health conditions. This novel multimedia IT system may be especially helpful in addressing disparities in cancer care for vulnerable populations.