A low literacy multimedia approach to disseminate bilingual diabetes CERSGs

描述(由申请人提供)：以低识字率的多媒体方法传播双语糖尿病CERSG改善CER结果的可及性对服务不足的人群尤其重要。拟议示范项目的总体目标是测试日常临床实践中使用的双语、低识字率、多媒体信息和评估系统是否增加了特定于糖尿病的CERSGs的影响，加强了以患者为中心的护理，并改善了患者的结果。干预措施将调整现有的两个评估和教育系统，以提供多媒体信息技术资源：糖尿病帮助说话触摸屏(TT)。这一用户友好的资源将向CERSG提供有关口服糖尿病药物和胰岛素类似物的信息，这些信息适用于讲英语和西班牙语的成人2型糖尿病患者，使识字率低的患者能够自我管理患者报告的结果问卷，并允许患者创建一个单独定制的需求和关注事项清单，与他们的医疗保健提供者分享。一项针对260名2型糖尿病患者的前瞻性随机试验将在芝加哥一家为弱势人群服务的流动初级保健诊所进行。这个拟议的项目建立在一个学术机构和一个以社区为基础的医疗保健中心之前成功合作的基础上。患者将随机通过TT或印刷小册子接受CERSG信息，并进行为期三个月的跟踪调查。拟议的研究将：1)测试使用糖尿病Help-TT是否增加了糖尿病特定CERSGs的影响，增强了以患者为中心的护理，并改善了患者结果；2)使用弱势人群行为模型评估患者特征、资源、需求、健康行为和健康结果之间的关系；以及3)确定TT的短期成本效益，并开发预算影响模型来评估TT的可负担性。DiabetesHelp-TT计划可以在任何医疗保健环境或社区组织中实施，只需最少的额外资源。它还可以适应其他健康状况和治疗。这一新颖的多媒体IT系统可能特别有助于解决弱势人群在糖尿病护理方面的差异。 公共卫生相关性：该项目与两个公共卫生优先事项相关：消除健康差距和改善糖尿病自我管理活动。使用双语、低识字率、多媒体健康信息系统有可能增加讲英语和西班牙语的糖尿病患者获得比较有效性研究结果的机会，增进他们对诊断和治疗的了解，并导致更好地坚持建议的治疗和后续护理。

DESCRIPTION (provided by applicant): A low literacy multimedia approach to disseminate bilingual diabetes CERSGs Improving the accessibility of CER findings is especially important for underserved populations. The overall objective of the proposed demonstration project is to test whether a bilingual, low literacy, multimedia information and assessment system used in daily clinical practice increases the impact of diabetes-specific CERSGs, enhances patient-centered care and improves patient outcomes. The intervention will adapt two existing assessment and education systems to provide a multimedia information technology resource: DiabetesHelp-Talking Touchscreen (TT). This user-friendly resource will deliver CERSG information on oral diabetes medication and insulin analogues for English- and Spanish-speaking adults with type-2 diabetes enable low literacy patients to self-administer patient-reported outcomes questionnaires, and allow patients to create an individually tailored list of needs and concerns to share with their health care providers. A prospective randomized trial of 260 patients with type 2 diabetes will be conducted at an ambulatory primary care clinic serving vulnerable populations in Chicago. This proposed project builds on previous successful collaborations between an academic institution and a community-based health care center. Patients will be randomized to receive the CERSG information via the TT or by print booklets, and followed for three months. The proposed study will: 1) test whether use of DiabetesHelp-TT increases the impact of diabetes-specific CERSGs, enhances patient-centered care and improves patient outcomes; 2) evaluate the relationships between patient characteristics, resources, needs, health behaviors and health outcomes using the Behavioral Model for Vulnerable Populations; and 3) determine the short-term cost-effectiveness of the TT and develop a budget impact model to assess the affordability of the TT. The DiabetesHelp-TT program can be implemented in any health care setting or community-based organization with minimal additional resources. It can also be adapted for other health conditions and treatments. This novel multimedia IT system may be especially helpful in addressing disparities in diabetes care for vulnerable populations. PUBLIC HEALTH RELEVANCE: This project is relevant to two public health priorities: eliminating health disparities and improving diabetes self-management activities. Use of a bilingual, low literacy, multimedia health information system has the potential to increase English- and Spanish-speaking diabetes patients' access to comparative effectiveness research findings, to improve their understanding of their diagnosis and treatment, and to lead to better adherence to recommended treatment and follow-up care.