scholarly journals Reduced Hospitalizations, Emergency Room Visits, and Costs Associated with a Web-Based Health Literacy, Aligned-Incentive Intervention: Mixed Methods Study

10.2196/14772 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14772 ◽  
Author(s):  
Jeffrey C Greene ◽  
Jolie N Haun ◽  
Dustin D French ◽  
Susan L Chambers ◽  
Robert H Roswell
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Emergency Room ◽  
Health Information ◽  
Program Implementation ◽  
Perceived Value ◽  
Mixed Methods Study ◽  
Health Improvement ◽  
Emergency Room Visits ◽  
Web Based

Background The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. Objective In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program’s quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program’s perceived value. Methods We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. Results Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan’s annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; P<.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. Conclusions Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.

scholarly journals Reduced Hospitalizations, Emergency Room Visits, and Costs Associated with a Web-Based Health Literacy, Aligned-Incentive Intervention: Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Jeffrey C Greene ◽  
Jolie N Haun ◽  
Dustin D French ◽  
Susan L Chambers ◽  
Robert H Roswell
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Emergency Room ◽  
Health Information ◽  
Program Implementation ◽  
Perceived Value ◽  
Mixed Methods Study ◽  
Health Improvement ◽  
Emergency Room Visits ◽  
Web Based

BACKGROUND The association between health literacy and health care costs, particularly for hospitalizations and emergency room services, has been previously observed. Health information interventions aimed at addressing the negative impacts of inadequate health literacy are needed. The MedEncentive Mutual Accountability and Information Therapy (MAIT) Program is a Web-based system designed to improve health and lower costs by aligning patient-doctor incentives. OBJECTIVE In this mixed methods study of a Web-based patient-doctor aligned-incentive, information therapy program conducted in an 1800-member employee health plan, we aimed to (1) determine the program’s quantitative impact on hospitalization and emergency room utilization and costs, and (2) assess survey responses about the program’s perceived value. METHODS We used a mixed methods, single within-group, pre-post, descriptive study design. We analyzed quantitative data using pre-post mean utilization and cost differences and summarized the data using descriptive statistics. We used open-ended electronic survey items to collect descriptive data and analyzed them using thematic content analysis. RESULTS Hospitalizations and emergency room visits per 1000 decreased 32% (26.5/82.4) and 14% (31.3/219.9), respectively, after we implemented the program in 2015-2017, relative to 2013-2014. Correspondingly, the plan’s annual per capita expenditures declined US $675 (95% CI US $470-865), or 10.8% ($675/$6260), after program implementation in 2015-2017 (US $5585 in 2013-2014 dollars), relative to the baseline years of 2013-2014 (US $6260; <italic>P</italic>&lt;.05). Qualitative findings suggested that respondents valued the program, benefiting from its educational and motivational aspects to better self-manage their health. CONCLUSIONS Analyses suggested that the reported reductions in hospitalizations, emergency room visits, and costs were associated with the program. Qualitative findings indicated that targeted users perceived value in participating in the MAIT Program. Further research with controls is needed to confirm these outcomes and more completely understand the health improvement and cost-containment capabilities of this Web-based health information, patient-doctor, aligned-incentive program.

scholarly journals Deaf Adults’ Health Literacy and Access to Health Information: Protocol for a Multicenter Mixed Methods Study

10.2196/14889 ◽  
2019 ◽  
Vol 8 (10) ◽  
pp. e14889 ◽  
Author(s):  
Michael M McKee ◽  
Peter C Hauser ◽  
Sara Champlin ◽  
Michael Paasche-Orlow ◽  
Kelley Wyse ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Data Collection ◽  
Health Information ◽  
Visual Learning ◽  
Mixed Methods Study ◽  
Web Based ◽  
Literacy Interventions ◽  
Limited Health Literacy ◽  
Limited Health

Background Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. Objective This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. Methods This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. Results Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. Conclusions The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. International Registered Report Identifier (IRRID) PRR1-10.2196/14889

scholarly journals Deaf Adults’ Health Literacy and Access to Health Information: Protocol for a Multicenter Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Michael M McKee ◽  
Peter C Hauser ◽  
Sara Champlin ◽  
Michael Paasche-Orlow ◽  
Kelley Wyse ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Data Collection ◽  
Health Information ◽  
Visual Learning ◽  
Mixed Methods Study ◽  
Web Based ◽  
Literacy Interventions ◽  
Limited Health Literacy ◽  
Limited Health

BACKGROUND Deaf American Sign Language (ASL) users often struggle with limited health literacy compared with their hearing peers. However, the mechanisms driving limited health literacy and how this may impact access to and understanding of health information for Deaf individuals have not been determined. Deaf individuals are more likely than hearing individuals to use the internet, yet they continue to report significant barriers to health information. This study presents an opportunity to identify key targets that impact information access for a largely marginalized population. OBJECTIVE This study aims to elucidate the role of information marginalization on health literacy in Deaf ASL users and to better understand the mechanisms of health literacy in this population for the purpose of identifying viable targets for future health literacy interventions. METHODS This is an exploratory mixed methods study to identify predictors and moderators of health literacy in the Deaf population. These predictors of health literacy will be used to inform the second step that qualitatively explains the findings, including how Deaf individuals access and understand Web-based health information. Multiple interviewer- and computer-based instruments underwent translation and adaptation, from English to ASL, to make them accessible for the Deaf participants in our study. A planned sample of 450 Deaf ASL users and 450 hearing native English speakers, aged 18 to 70 years, will be recruited from 3 partnering sites: Rochester, NY; Flint, MI; and Chicago, IL. These individuals will participate in a single data collection visit. A subset of participants (approximately 30) with key characteristics of interest will be invited for a second data collection visit to observe and inquire more about their ability to directly access, navigate, and comprehend Web-based health information. The study will help assess how the ways health literacy and information are visualized may differ between Deaf individuals and hearing individuals. The study will also survey participants’ ownership and use of computer and mobile devices and their level of Web-based information use, including health information. RESULTS Adaptation and translation of protocols and instruments have been completed and are now in use for the study. Recruitment is underway and will continue until late 2020. Results from this study will be used to provide a guide on how to structure Web-based health information in a way that maximizes accessibility and improves health literacy for Deaf individuals. CONCLUSIONS The results from this mixed methods proposal will advance what is known about health literacy and health information accessibility for Deaf individuals. This innovative study will generate rich data on how to formulate health information and health literacy interventions more accurately to take advantage of visual learning skills. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/14889

scholarly journals Exploring the role of health literacy in the evaluation of online health information: Insights from a mixed-methods study

2016 ◽  
Vol 99 (6) ◽  
pp. 1017-1025 ◽  
Author(s):  
Nicola Diviani ◽  
Bas van den Putte ◽  
Corine S. Meppelink ◽  
Julia C.M. van Weert
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Health Information ◽  
Mixed Methods Study ◽  
Online Health Information

scholarly journals Development and validity testing of the Adolescent Health Literacy Questionnaire (AHLQ): Protocol for a mixed methods study within the Irish school setting

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039920
Author(s):  
Ailbhe Spillane ◽  
Sarahjane Belton ◽  
Clare McDermott ◽  
Johann Issartel ◽  
Richard H Osborne ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Health Literacy ◽  
Young People ◽  
Adolescent Health ◽  
Pearson Correlation ◽  
Adult Population ◽  
School Setting ◽  
Mixed Methods Study ◽  
Advisory Panel ◽  
Validity Testing

IntroductionHealth literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young people because of the developmental characteristics that impact on adolescents’ behaviour, including impulse control and judgement skills. This protocol describes the intended development and validity testing of a questionnaire to measure health literacy in adolescents.Methods and analysisThis protocol describes this mixed methods study that has three phases: the first phase will involve grounded research with adolescents using qualitative group interviews, co-design and concept mapping workshops to understand what health and healthy behaviours mean to adolescents and to explore their health literacy needs and the potential domains for the questionnaire. The draft health literacy domains identified will be presented to the youth advisory panel, and the questionnaire will be altered based on their feedback. Cognitive pretesting of the questionnaire items will also be conducted. Phase 2 will involve piloting the questionnaire to a two-stage random sample of young people in five urban and rural schools in Ireland. Test–retest reliability will be conducted using Pearson correlation coefficient. Confirmatory factor analysis will also be conducted to analyse the psychometric properties of the questionnaire. Phase 3 will involve the questionnaire being rolled out to a nationally representative sample of adolescents (n=6052) in Ireland to assess their levels of health literacy.Ethics and disseminationEthical approval to conduct this study has been granted from the University College Dublin Human Research Ethics Committee – Sciences (LS-20–08). Informed assent from adolescents and informed consent from parents/guardians will be sought. The findings of this research will be disseminated at national and international conferences, as well as through publication in peer-reviewed journals.

scholarly journals The use of smartphones on General Internal Medicine wards

2014 ◽  
Vol 05 (03) ◽  
pp. 814-816 ◽  
Author(s):  
D. Morra ◽  
V. Lo ◽  
S. Quan ◽  
R. Wu ◽  
K. Tran
Keyword(s):  
Internal Medicine ◽  
Mixed Methods ◽  
Health Information ◽  
General Internal Medicine ◽  
Mixed Methods Study ◽  
Personal Health Information ◽  
Medical Specialties ◽  
General Internal ◽  
Work Related ◽  
Internal Medicine Wards

Summary Objective: To describe the uses of institutional and personal smartphones on General Internal Medicine wards and highlight potential consequences from their use. Methods: A mixed methods study consisting of both quantitative and qualitative research methods was conducted in General Internal Medicine wards across four academic teaching hospitals in Toronto, Ontario. Participants included medical students, residents, attending physicians and allied health professionals. Data collection consisted of work shadowing observations, semi-structured interviews and surveys. Results: Personal smartphones were used for both clinical communication and non-work-related activities. Clinicians used their personal devices to communicate with their medical teams and with other medical specialties and healthcare professionals. Participants understood the risks associated with communicating confidential health information via their personal smartphones, but appear to favor efficiency over privacy issues. From survey responses, 9 of 23 residents (39%) reported using their personal cell phones to email or text patient information that may have contained patient identifiers. Although some residents were observed using their personal smartphones for non-work-related activities, personal use was infrequent and most residents did not engage in this activity. Conclusion: Clinicians are using personal smartphones for work-related purposes on the wards. With the increasing popularity of smartphone devices, it is anticipated that an increasing number of clinicians will use their personal smartphones for clinical work. This trend poses risks to the secure transfer of confidential personal health information and may lead to increased distractions for clinicians. Citation: Tran K, Morra D, Lo V, Quan S, Wu R. The use of smartphones on General Internal Medicine wards: A mixed methods study. Appl Clin Inf 2014; 5: 814–823http://dx.doi.org/10.4338/ACI-2014-02-RA-0011

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