A low literacy multimedia approach to disseminate bilingual diabetes CERSGs

Hahn, Elizabeth

Abstract

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.