Health Literacy Assessment and Intervention to Reduce Disparities: FLIGHT/VIDAS II

健康素养评估和减少差异的干预措施：FLIGHT/VIDAS II

• 批准号: 9217666
• 负责人: RAYMOND L OWNBY
• 金额: $ 56.29万
• 依托单位: NOVA SOUTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-02-05 至 2020-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9217666
• 关键词: Academic skills; Adherence; Adult; Adult Acute Lymphocytic Leukemia; Affect; African American; Age; Age-Years; American; Asthma; Behavioral; Characteristics; Cholesterol; Chronic; Chronic Disease; Clinical; Cognition; Computers; Diabetes Mellitus; Disease; Disease Management; Elderly; Ethnic Origin; Fatigue; Follow-Up Studies; HIV Infections; Health; Health Status; Health behavior; Healthcare; Hepatitis; Hepatitis C; Hispanics; Human Resources; Hypertension; Individual; Internet; Intervention; Knowledge; Link; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental disorders; Minority; Minority Groups; Multimedia; Myocardial Infarction; Not Hispanic or Latino; Outcome; Pain; Participant; Patient Self-Report; Patients; Persons; Race; Self Efficacy; Self Management; Sleep; Sleep disturbances; Socioeconomic Status; Stress; Stroke; Tablet Computer; Twin Multiple Birth; Work; cost; cost effective; disparity reduction; effective intervention; ethnic minority population; experience; falls; follow up assessment; follow-up; health care service utilization; health disparity; health literacy; improved; information kiosk; interactive multimedia; intervention effect; literacy; mathematical ability; member; public health relevance; racial and ethnic; racial minority; response; skills; treatment adherence; Academic skills; Adherence; Adult; Adult Acute Lymphocytic Leukemia; Affect; African American; Age; Age-Years; American; Asthma; Behavioral; Characteristics; Cholesterol; Chronic; Chronic Disease; Clinical; Cognition; Computers; Diabetes Mellitus; Disease; Disease Management; Elderly; Ethnic Origin; Fatigue; Follow-Up Studies; HIV Infections; Health; Health Status; Health behavior; Healthcare; Hepatitis; Hepatitis C; Hispanics; Human Resources; Hypertension; Individual; Internet; Intervention; Knowledge; Link; Malignant Neoplasms; Measures; Mediating; Mediator of activation protein; Mental Depression; Mental disorders; Minority; Minority Groups; Multimedia; Myocardial Infarction; Not Hispanic or Latino; Outcome; Pain; Participant; Patient Self-Report; Patients; Persons; Race; Self Efficacy; Self Management; Sleep; Sleep disturbances; Socioeconomic Status; Stress; Stroke; Tablet Computer; Twin Multiple Birth; Work; cost; cost effective; disparity reduction; effective intervention; ethnic minority population; experience; falls; follow up assessment; follow-up; health care service utilization; health disparity; health literacy; improved; information kiosk; interactive multimedia; intervention effect; literacy; mathematical ability; member; public health relevance; racial and ethnic; racial minority; response; skills; treatment adherence

 DESCRIPTION (provided by applicant): Health literacy is a critically important skill that helps people to become active participants in their health care. The 2003 National Assessment of Adult Literacy showed that more than 75 million Americans had basic health literacy skills, indicating that as many as 1 in 4 Americans can have difficulty understanding information about their healthcare. Persons in racial and ethnic minorities are likely to have even lower levels of health literacy. Twenty-four percent of blacks (9.5 million persons) and 41% of Hispanics (21 million persons) have below basic levels of health literacy. These persons have lower levels of health literacy and compelling evidence, including our own findings (see below), link race and ethnicity to disparities in health via health literacy. Members of minority groups and older adults are more frequently affected by chronic diseases such as cancer, high blood pressure, heart attack, stroke, diabetes, elevated cholesterol, asthma, hepatitis C, HIV infection, mental health disorders and many others. The twin burdens of chronic disease and low levels of health literacy thus fall disproportionately on those most in need - members of minorities and older adults, all of whom likely to experience one or more chronic conditions while often not having the health literacy skills to help them cope. Chronic disease self-management (CDSM) is a logical target for a general health literacy intervention. In an approach that cuts across specific diseases. CDSM targets problems and skills needed to cope with issues such as fatigue, pain, stress, depression, sleep disturbance and treatment adherence. Studies show that in- person CDSM classes improve patients' functioning and reduce healthcare utilization, but their availability is limited due to the lack of qualified personnel and cost. Similarly, while interventions have been developed to improve health literacy, they are difficult to scale to levels needed to meet the challenge of low health literacy (for more than 40 million persons) due to their cost. Effective interventions with the potential for wider dissemination at reasonable costs are urgently needed. In a previous study, we showed that a computer-delivered tailored information intervention targeting health literacy that can deployed either as an information kiosk in a clinical office or n the Internet could be cost- effective in improving patients' health literacy and adherence. It is nt clear, however, whether the same sort of computer-delivered, multimedia and interactive approach will be effective in improving CDSM skills in persons with low baseline levels of health literacy, and if it is, whether its effects will extend beyond health literacy to general health, slf-efficacy, activation, and treatment adherence. In this follow-up study we will evaluate this possibility by creating a personally relevant computer-delivered intervention targeting CDSM and health literacy among African-Americans, Hispanics, and white non-Hispanics:

 描述（由适用提供）：健康素养是一项至关重要的技能，可以帮助人们积极参与其医疗保健。 2003年对成人扫盲的全国评估表明，超过7500万美国人具有基本的健康素养技能，表明多达四分之一的美国人可能很难理解有关其医疗保健的信息。种族和少数民族的人可能具有较低的健康素养。 24％的黑人（950万人）和41％的西班牙裔（2100万人）低于基本健康素养水平。这些人的健康素养水平较低，并具有令人信服的证据，包括我们自己的发现（见下文），通过健康素养将种族和种族与健康差异联系起来。少数群体和老年人的成员 频繁受到慢性疾病的影响，例如癌症，高血压，心脏病发作，糖尿病，胆固醇升高，哮喘，肝炎，HIV感染，心理健康疾病等。因此，慢性病的双胞胎烧伤和健康素养水平较低，因此对大多数有需要的人来说是不成比例的 - 少数民族和老年人的成员，他们所有人都可能经历一种或多种慢性病，而通常没有健康素养技能来帮助他们应对。慢性疾病自我管理（CDSM）是一般健康素养干预的逻辑目标。在切断特定疾病的方法中。 CDSM目标是应对疲劳，疼痛，压力，抑郁，睡眠障碍和治疗依从性等问题所需的问题和技能。研究表明，面对面的CDSM课程可改善患者的功能并降低医疗保健利用，但是由于缺乏合格的人员和成本，他们的可用性受到限制。同样，尽管已经开发出干预措施来提高健康素养，但由于成本，它们很难扩展到应对低健康素养（超过4000万人）所需的水平。有效的干预措施迫切需要以合理的成本进行更广泛的传播。在先前的研究中，我们表明，针对健康素养的计算机量身定制的信息干预措施可以在临床办公室中部署为信息亭，或者互联网在改善患者的健康素养和依从性方面可能具有成本效益。但是，很明显，是否有类型的计算机传递，多媒体和互动方法将有效地提高基准健康素养水平较低的人的CDSM技能，以及它的影响是否会超越健康素养，对一般健康，SLF效能，激活，激活和治疗效果。在这项后续研究中，我们将通过创建针对非裔美国人，西班牙裔和白人非西班牙裔的个人相关计算机提供的个人相关干预措施来评估这种可能性：