Design and Feasibility of Pictographic Medication Reminders for Delivery via Cell

描述(由申请人提供)：健康知识有限的患者承受着不成比例的疾病负担；许多人难以理解和记住药物剂量计划。一些研究评估了使用短信(短消息服务)通过短信传递药物提示的情况；然而，这些消息对于向识字有问题的患者传递药物提示的价值有限，因为它们只能包含文本。解决方案：可以使用一种名为MMS(多媒体消息传递服务)的新消息传递服务将象形文字用药说明发送到手机，该服务允许将图像、文本和音频‘推送’给接收者。这些消息可能有助于作为行动的提示，对于健康素养较低和英语水平有限的人来说，这种格式可能比简单的文本消息更有用。目的：该项目的近期目标是开发一套有效和可靠的与药物相关的象形文字，可以通过手机向健康素养有限的患者提供，使用一种支持图像的新短信模式。我们将在实验室环境中对目标人群中的患者样本测试这些象形文字。方法：我们将使用焦点小组来帮助指导最初的象形文字库的发展。我们第二个目标的实验室测试将减少象形文字的竞争变体，建立内容的有效性和可靠性，并允许探索其他增强功能，如语音辅助象形文字。在我们的第三个目标中，我们将进行可用性测试，模拟象形文字药物提醒的交付，以确定我们干预的总体可行性和安全性。分析：焦点小组数据将由两名研究人员转录并独立编码，用于主题内容。有多种变体的象形文字将使用弗里德曼的按等级进行的双向方差分析来识别。个别可用性测试将采用定性和定量相结合的方法进行分析。结论：我们期望这些结果将建立在随机、对照、临床试验中展示结果所需的结构和过程。 与公共健康相关：我们将与健康素养较低的参与者合作，开发一个与药物相关的初始象形图库，这些象形文字经过优化后可以在手机上作为药物提醒发送。然后，我们将在实验室环境中对这些进行测试，以确定其有效性和可靠性。我们还将与参与者和各种移动手机进行可用性测试。结果将建立随机对照临床试验所需的结构和过程。

DESCRIPTION (provided by applicant): Patients with limited health literacy carry a disproportionate burden of disease; many have difficulty understanding and remembering medication dosing schedules. A number of studies have evaluated the delivery of medication prompts via text messaging using SMS (Short Message Service); however these messages are of limited value for delivering medication prompts to patients with literacy issues as they can only contain text. Solution: Pictographic medication instructions may be sent to cell phones using a new messaging service called MMS (Multimedia Messaging Service) that allows images, text, and audio to be 'pushed' to the recipient. These messages may help serve as cues to action and the format may be more usable for people with low health literacy and limited English proficiency than simple text messages. Purpose: The immediate goal of this project is to develop a set of valid and reliable medication-related pictographs that can be delivered via cell phones to patients with limited health literacy using a new mode of text messages that supports images. We will test these pictographs in a laboratory setting with a sample of patients from the target population. Methods: We will use focus groups to help guide the development of an initial bank of pictographs. Laboratory testing in our second aim will reduce competing variants of pictographs, establish content validity and reliability, and allow for exploration of additional enhancements such as voice assisted pictographs. Within our third aim we will conduct usability tests as we simulate the delivery of pictographic medication reminders to determine the overall feasibility and safety of our intervention. Analysis: Focus group data will be transcribed and independently coded by two researchers for thematic content. Pictographs with multiple variants will be discerned using the Friedman's two-way analysis of variance by ranks. Individual usability tests will be analyzed with a combination of qualitative and quantitative approaches. Conclusion: We expect that these results will establish the structures and processes necessary for demonstrating outcomes in a randomized, controlled, clinical trial. PUBLIC HEALTH RELEVANCE: Working with participants with low health literacy, we will develop an initial bank of medication related pictographs that are optimized to be delivered on cell phones as medication reminders. We will then test these in a laboratory setting to establish validity and reliability. We will also conduct usability testing with participants and a diverse range of mobile handsets. The results will establish the structures and processes necessary for a randomized controlled clinical trial.