Testing a video to improve provider-patient interaction

说明(申请人提供)：为了控制不断上升的保健费用，慢性病患者必须能够与其医生合作制定个性化的保健计划，针对威胁其健康的特定风险因素提供保健。为了在预防性保健、避免昂贵的程序和长期护理管理方面发挥更积极的作用，患者必须更好地了解他们的保健需求，并接受培训，以便与护理提供者就制定护理计划以改善他们的健康进行有意义的对话。因此，必须制定提高健康素养的干预措施。这项研究的具体目的是：制定和测试一项措施，在多文化、低识字率人群中评估与风险相关的健康素养；并测试为患者设计的旨在提高其与风险相关的健康素养的视频的有效性。健康素养衡量工具将在理论上以行为改变和传播理论为基础，将包括评估健康素养所需的各种技能和知识，包括听和说，并将处理影响健康素养的特定背景的文化和观念因素。它将具有质量工具的8个特征：概念性建模、可靠和有效、反应灵敏、目标答复者可解释、答复者负担低、能够以适用于可能使用它的不同人群的替代形式开发，并根据文化和语言考虑进行适当调整。我们将利用一个迭代的工具开发过程，在设计过程中整合定性、认知和心理测量学方法。评估将计算机化，并将利用“会说话的触摸屏”编程来提高低识字率人群的利用率。这段视频将在新墨西哥大学的一个多文化患者群体中使用随机对照设计进行测试。这项研究解决了PAR-04-117“了解和促进健康素养”公告的优先事项。

DESCRIPTION (provided by applicant): In order to control the spiraling costs of health care, persons with chronic diseases must be able to develop, in collaboration with their physicians, personalized health plans that direct care to the specific risk factors that threaten their health. To take a more active role in preventive health care, avoidance of costly procedures and management of long-term care, patients must be better informed about their health care needs and trained to engage in meaningful dialogue with care providers about the development of care plans to improve their health. Therefore, interventions to improve health literacy must be developed. The Specific Aims of the research are: to develop and test a measure to assess risk-related health literacy in a multicultural, low literacy population; and to test the efficacy of a video for patients designed to increase their risk-related health literacy. The health literacy measurement tool will be theoretically grounded in behavior change arid communication theory, and will include assessment of the full range of skills and knowledge needed for health literacy, including listening and speaking, and will address the context-specific cultural and conceptual factors that affect health literacy. It will have the 8 attributes of a quality instrument: conceptually modeled, reliable and valid, responsive, interpretable by the intended respondents, of low respondent burden, able to be developed in alternative forms appropriate for different populations in which it might be used, and appropriately adapted for cultural and language considerations. We will utilize an iterative instrument development process integrating qualitative, cognitive and psychometric methods in the design process. The assessment will be computerized and will utilize "Talking Touch Screen" programming to enhance utilization among low-literate populations. The video will be tested using a randomized control design among a multi-cultural patient population at the University of New Mexico. This research addresses the priorities of announcement PAR-04-117 "Understanding and Promoting Health Literacy."