Vulnerable populations experience a greater burden of disease, are less informed about diagnosis and treatment, and are less likely to be satisfied with communication with their healthcare providers. Patients with limited economic resources, low literacy skills or racial/ethnic minority status are particularly vulnerable to receiving sub-optimal care over time. These patients may experience poorer health outcomes due to disparities in care, special needs or barriers to care. Improving communication in healthcare settings may lead to better adherence to recommended treatment, higher quality of care, higher satisfaction with care and better health outcomes. The use of new health information technologies is a recommended strategy for improving access to health information and for enhancing the quality of communication in healthcare delivery. The overall objective of the proposed demonstration project is to test whether a low-literacy friendly, multimedia information and assessment system used in daily clinical practice enhances patient-centered care and improves patient outcomes. The intervention will combine two existing assessment and education systems to provide a multimedia information technology (IT) resource: CancerHelp-Talking Touchscreen (TT). This user-friendly IT resource will deliver comprehensive, state-of-the-science patient education information, allow patients to ?personalize? the information at each session, enable low literacy patients to self-administer patient-reported outcomes questionnaires, allow patients to create an individually tailored list of needs and concerns to share with their healthcare providers, and assist patients in preparing for the transition between active cancer treatment and follow-up care. A prospective randomized trial of 200 patients with breast or colorectal cancer will be conducted at three ambulatory cancer care centers in Chicago. Patients will be randomized to CancerHelp-TT or control/standard education and followed for a maximum of nine months (three to six months of treatment and three months of follow-up). The proposed study will: 1) test whether use of CancerHelp-TT improves satisfaction with healthcare communication, knowledge of cancer and treatment, self-efficacy, adherence to recommended treatment and health-related quality of life (HRQL) during cancer treatment;2) evaluate the relationships between patient characteristics, resources, needs, health behaviors and health outcomes using the Behavioral Model for Vulnerable Populations;and 3) assess whether use of CancerHelp-TT improves adherence to recommended follow-up care and HRQL during the early post-treatment surveillance period. The CancerHelp-TT intervention is a fully exportable, self-contained IT system that can be implemented in any cancer care center with minimal additional resources. It can also be adapted for other health conditions. This novel multimedia IT system may be especially helpful in addressing disparities in cancer care for vulnerable populations.
| Garcia, Sofia F; Hahn, Elizabeth A; Jacobs, Elizabeth A (2010) Addressing low literacy and health literacy in clinical oncology practice. J Support Oncol 8:64-9 |
