scholarly journals Developing an Asthma Self-management Intervention Through a Web-Based Design Workshop for People With Limited Health Literacy: User-Centered Design Approach

10.2196/26434 ◽  
2021 ◽  
Vol 23 (9) ◽  
pp. e26434
Author(s):  
Hani Salim ◽  
Ping Yein Lee ◽  
Sazlina Sharif-Ghazali ◽  
Ai Theng Cheong ◽  
Jasmine Wong ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Real Life ◽  
Mobile App ◽  
Self Management ◽  
Primary Care Center ◽  
Long Term Conditions ◽  
Web Based ◽  
Limited Health Literacy ◽  
Limited Health

Background Technology, including mobile apps, has the potential to support self-management of long-term conditions and can be tailored to enhance adoption. We developed an app to support asthma self-management among people with limited health literacy in a web-based workshop (to ensure physical distancing during the COVID-19 pandemic). Objective The aim of this study is to develop and test a prototype asthma self-management mobile app tailored to the needs of people with limited health literacy through a web-based workshop. Methods We recruited participants from a primary care center in Malaysia. We adapted a design sprint methodology to a web-based workshop in five stages over 1 week. Patients with asthma and limited health literacy provided insights into real-life self-management issues in stage 1, which informed mobile app development in stages 2-4. We recruited additional patients to test the prototype in stage 5 using a qualitative research design. Participants gave feedback through a concurrent thinking-aloud process moderated by a researcher. Each interview lasted approximately 1 hour. Screen recordings of app browsing activities were performed. Interviews were audio-recorded and analyzed using a thematic approach to identify utility and usability issues. Results The stakeholder discussion identified four themes: individual, family, friends, and society and system levels. Five patients tested the prototype. Participants described 4 ways in which the app influenced or supported self-management (utility): offering information, providing access to an asthma action plan, motivating control of asthma through support for medication adherence, and supporting behavior change through a reward system. Specific usability issues addressed navigation, comprehension, and layout. Conclusions This study proved that it was possible to adapt the design sprint workshop to a web-based format with the added advantage that it allowed the development and the testing process to be done efficiently through various programs. The resultant app incorporated advice from stakeholders, including sources for information about asthma, medication and appointment reminders, accessible asthma action plans, and sources for social support. The app is now ready to move to feasibility testing.

scholarly journals Developing an Asthma Self-management Intervention Through a Web-Based Design Workshop for People With Limited Health Literacy: User-Centered Design Approach (Preprint)

2020 ◽  
Author(s):  
Hani Salim ◽  
Ping Yein Lee ◽  
Sazlina Sharif-Ghazali ◽  
Ai Theng Cheong ◽  
Jasmine Wong ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Real Life ◽  
Mobile App ◽  
Self Management ◽  
Primary Care Center ◽  
Long Term Conditions ◽  
Web Based ◽  
Limited Health Literacy ◽  
Limited Health

BACKGROUND Technology, including mobile apps, has the potential to support self-management of long-term conditions and can be tailored to enhance adoption. We developed an app to support asthma self-management among people with limited health literacy in a web-based workshop (to ensure physical distancing during the COVID-19 pandemic). OBJECTIVE The aim of this study is to develop and test a prototype asthma self-management mobile app tailored to the needs of people with limited health literacy through a web-based workshop. METHODS We recruited participants from a primary care center in Malaysia. We adapted a design sprint methodology to a web-based workshop in five stages over 1 week. Patients with asthma and limited health literacy provided insights into real-life self-management issues in stage 1, which informed mobile app development in stages 2-4. We recruited additional patients to test the prototype in stage 5 using a qualitative research design. Participants gave feedback through a concurrent thinking-aloud process moderated by a researcher. Each interview lasted approximately 1 hour. Screen recordings of app browsing activities were performed. Interviews were audio-recorded and analyzed using a thematic approach to identify utility and usability issues. RESULTS The stakeholder discussion identified four themes: individual, family, friends, and society and system levels. Five patients tested the prototype. Participants described 4 ways in which the app influenced or supported self-management (utility): offering information, providing access to an asthma action plan, motivating control of asthma through support for medication adherence, and supporting behavior change through a reward system. Specific usability issues addressed navigation, comprehension, and layout. CONCLUSIONS This study proved that it was possible to adapt the design sprint workshop to a web-based format with the added advantage that it allowed the development and the testing process to be done efficiently through various programs. The resultant app incorporated advice from stakeholders, including sources for information about asthma, medication and appointment reminders, accessible asthma action plans, and sources for social support. The app is now ready to move to feasibility testing.

scholarly journals Health literacy levels and its determinants among people with asthma in Malaysian primary healthcare settings: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
H. Salim ◽  
S. Shariff Ghazali ◽  
P. Y. Lee ◽  
A. T. Cheong ◽  
N. H. Harrun ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Cross Sectional Study ◽  
Self Management ◽  
Cross Sectional ◽  
Limited Health Literacy ◽  
Healthcare Settings ◽  
History Of ◽  
Limited Health ◽  
Asthma Action Plan

Abstract Background Limited health literacy among people with asthma is associated with poor adherence to self-management activities, thus poor clinical outcomes. This study aimed to determine the prevalence of health literacy level and its determinants among people with asthma in the Malaysian primary healthcare settings. Method A cross-sectional study was conducted among participants aged > 18 years with asthma who attended five primary health clinics in Malaysia. Systematic random sampling was employed with a final sample of 550 participants. The questionnaires included the validated Malay version of Health Literacy Scale (HLS) and asthma control questionnaire (ACQ). Statistical analysis was done using SPSS version 25. Multiple logistic regression was performed to determine the determinants for limited health literacy. Results The participants mean age of the participants was 48 (SD15.4) years. Most of the participants were women (64%) and of Malay ethnicity (51.1%). Nearly half had a secondary level of education, n = 112, (45.8%). Mean duration of asthma diagnosis is 20.6 (SD 15.9) years. More than half (62.5%) had a family history of asthma. About half (50.9%) had uncontrolled asthma, with 87.3% self-rated themselves as having controlled asthma. About a third (29.1%) received education on of asthma action plan, but only 7.1% of these owned a written version an asthma action plan. Limited health literacy accounts for 60.5% of the participants. The significant determinants for limited health literacy included lower educational attainment (p < 0.001), family history of asthma (p = 0.034), < 20 years duration of asthma diagnosis (p = 0.031) and not receiving asthma action plan education (p < 0.001). Conclusion In this study population, more than half of the people living with asthma were found to have limited health literacy, which was associated with not having received self-management education supported by an asthma action plan. Future interventions should include strategies that ensure they meet the needs of people with limited health literacy.

The importance of health literacy for self-management: A scoping review of reviews

2021 ◽  
pp. 174239532110354
Author(s):  
Marieke van der Gaag ◽  
Monique Heijmans ◽  
Cristina Spoiala ◽  
Jany Rademakers
Keyword(s):  
Health Care ◽  
Health Literacy ◽  
Health Care System ◽  
Medical Management ◽  
Self Management ◽  
Limited Health Literacy ◽  
Limited Health ◽  
Behavioural Aspects ◽  
The Relationship ◽  
Care System

Objectives Self-management of chronic diseases is rather complex, especially for patients with limited health literacy. In this review, we aim to disentangle the specific difficulties patients with limited health literacy face in relation to self-management and their associated needs with respect to self-management support. Methods We performed a literature search in five databases. We used a broad definition of health literacy and self-management was categorized into four types of activities: medical management, changing lifestyle, communicating and navigating through the health care system and coping. Included reviews described the relationship between health literacy and different domains of self-management and were published after 2010. Results A total of 28 reviews were included. Some clear difficulties of patients with limited health literacy emerged, predominantly in the area of medical management (especially adherence), communication and knowledge. Other associations between health literacy and self-management were inconclusive. Barriers from the patients’ perspective described mainly medical management and the communication and navigation of the health care system. Discussion Patients with limited health literacy experience difficulties with specific domains of self-management. For a better understanding of the relationship between health literacy and self-management, a broader conceptualization of health literacy is warranted, including both cognitive and behavioural aspects.

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

Derivation, Evaluation, and Validation of Illustrations of Key Counselling Points for a Pediatric Eczema Action Plan

2017 ◽  
Vol 22 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Alana McEvoy ◽  
Maxwell B. Sauder ◽  
Katherine McDonald ◽  
Phillipe Suter ◽  
Annie Pouliot ◽  
...  
Keyword(s):  
Health Literacy ◽  
Action Plan ◽  
Medical Team ◽  
Action Plans ◽  
Structured Interviews ◽  
Short Term ◽  
Limited Health Literacy ◽  
Future Studies ◽  
Limited Health ◽  
Graphic Elements

Background: Current eczema action plans (EAP) are based on written instructions without illustrations. Incorporating validated illustrations into EAPs can significantly improve comprehension and usability. Objective: To produce and validate a set of illustrations for key counselling points of a pediatric EAP. Methods: Illustrations were developed using key graphic elements and refined by subject experts. Illustrations were evaluated during one-on-one structured interviews with parents/caregivers of children ages 9 and younger, as well as with children ages 10 to 17 years between September 2015 and June 2016. The concepts of transparency, translucency, and short-term recall were assessed for validation. Results: Of 245 participants, 81.3% were parents and/or caregivers of children 0 to 9 years old, and 18.7% were children between 10 and 17 years old. A total of 15 illustrations and 2 storyboards were evaluated; 9 illustrations and 2 storyboards were redesigned to reach the preset validation targets. Overall, 13 illustrations and 2 storyboards were validated. Conclusion: A set of illustrations for use in an EAP was prospectively designed and validated, achieving acceptable transparency, translucency, and recall, with input from patients and a multidisciplinary medical team. The incorporation of validated illustrations into eczema action plans benefits patients with limited health literacy. Future studies should evaluate if illustrations improve understanding of eczema management and translate into improved clinical outcomes.

scholarly journals Does Depression and Anxiety Mediate the Relation between Limited Health Literacy and Diet Non-Adherence?

2020 ◽  
Vol 17 (21) ◽  
pp. 7913
Author(s):  
Ivana Skoumalova ◽  
Andrea Madarasova Geckova ◽  
Jaroslav Rosenberger ◽  
Maria Majernikova ◽  
Peter Kolarcik ◽  
...  
Keyword(s):  
Health Literacy ◽  
Hierarchical Cluster ◽  
Cross Sectional Study ◽  
Self Management ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Limited Health Literacy ◽  
Gender And Education ◽  
Limited Health

Limited health literacy (HL), depression and anxiety are common in dialyzed patients and affect health outcomes and self-management. We explored whether depression and anxiety mediate the association of HL with diet non-adherence (DN-A) in dialyzed patients. We performed a cross-sectional study in 20 dialysis clinics in Slovakia (n = 452; mean age: 63.6 years; males: 60.7%). Hierarchical cluster analysis was performed to create three HL groups. Logistic regression adjusted for age, gender and education was used to explore whether depression and anxiety mediate the association of HL with DN-A. Patients in the moderate HL group were more likely to be non-adherent to diet (OR (Odds Ratio)/95% CI: 2.19/1.21–3.99) than patients in the high HL group. Patients in the low HL and moderate HL group more likely reported depression or anxiety. Patients reporting depression (OR/95% CI: 1.94/1.26–2.98) or anxiety (OR/95% CI: 1.81/1.22–2.69) were more likely to be non-adherent with diet. Adjustment for depression reduced the association between moderate HL and DN-A by 19.5%. Adjustment for anxiety reduced the association between moderate HL and DN-A by 11.8%. Anxiety and depression partly mediated the association of HL with DN-A. More attention should be paid to treating patients’ psychological distress to ensure adequate adherence with recommended diet.

scholarly journals A systematic review of interventions addressing limited health literacy to improve asthma self-management

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hani Salim ◽  
Siti Nurkamilla Ramdzan ◽  
Sazlina Shariff Ghazali ◽  
Ping Yein Lee ◽  
Ingrid Young ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Literacy ◽  
Self Management ◽  
Limited Health Literacy ◽  
Limited Health
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