Wanzer, Melissa Bekelja, Ann M. Wojtaszczyk, Jessica Schimert, Lisa Missert, Susan Baker, Robert Baker, and Ben Dunkle. 2010. "Enhancing the “Informed” in Informed Consent: A Pilot Test of a Multimedia Presentation." Health Communication 25, no. 4: 365-374. Academic Search Premier, EBSCOhost (accessed October 11, 2010).
Though this reference hit some of my key words this seems like a result that I accepted before I decided to more narrowly refine my results. Though researchers claim to have had significantly higher results from those on an objective test than those that did not watch the multimedia program about the medical procedure. Less significantly doctors thought that families who had seen the multimedia presentation had a higher comprehension level about the procedure. This research does not include those with low literacy skills, but might be used as a vantage point to indicate those with average literacy skills are affected by engaging with new media.
Zyskind, Aviva, Karen Chance Jones, Karyn L. Pomerantz, and Amyre LaFaye Barker. 2009. "Exploring the use of computer based patient education resources to enable diabetic patients from underserved populations to self-manage their disease." Information Services & Use 29, no. 1: 29-43. Academic Search Premier, EBSCOhost (accessed October 11, 2010).
This research approaches an audience with low literacy. Their findings indicate those with low literacy and with additional training on computer skills have better results in managing their diabetes. This research is recent and also includes example of a post test for subjects will seemed useful and encouraging. Encouraging because perhaps I will not have to reinvent the wheel for every aspect of doing a survey and just incorporate and a fine tune work others have done.
Interactive multimedia in education and training
By Sanjaya Mishra, Ramesh C. Sharma
This was a book I found on Amazon. While it had a “Look Inside” feature I found the most useful thing was to copy the reference list at the back. This reference list yielded new key words and new avenues of research.
Rothman, Russell L., Darren A. DeWalt, Robb Malone, Betsy Bryant, Ayumi Shintani, Britton Crigler, Morris Weinberger, and Michael Pignone. 2004. "Influence of Patient Literacy on the Effectiveness of a Primary Care–Based Diabetes Disease Management Program." JAMA: Journal of the American Medical Association 292, no. 14: 1711-1716. Academic Search Premier, EBSCOhost (accessed October 13, 2010).
Made a PDF of this but again does not speak to those with low literacy.
Reference List
Hahn, Elizabeth A., David Cella, Deborah Dobrez, Gail Shiomoto, Elizabeth Marcus, Samuel G. Taylor, Mala Vohra, et al. 2004. "The talking touchscreen: A new approach to outcomes assessment in low literacy." Psycho-Oncology 13, no. 2: 86-95. Academic Search Premier, EBSCOhost (accessed October 13, 2010).
Includes interesting statistics on low literacy adults in the US especially as it applies to health literacy. Covers the development and design of interface of interactive touchscreen. Not really clear what the “new” is in “…new approach…” in the title. Results are not overwhelming: An ethnically diverse group of 126 cancer patients with a range of literacy skills and computer experience reported that the ‘talking touchscreen’ (TT) was easy to use, and commented on the usefulness of the multimedia approach. Even the “clinical implications” hardly got out on a limb finding: The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills. However they do hint at a completion of the educational process. That is the audience checking on how well they did and comparing to what they thought they knew. This research is older than others.
Thumboo, Julian, Wee Hwee-Lin, Cheung Yin-Bun, David Machin, Luo Nan, and Fong Kok-Yong. 2006. "Development of a Smiling Touchscreen Multimedia Program for HRQoL Assessment in Subjects with Varying Levels of Literacy." Value in Health 9, no. 5: 312-319. Academic Search Premier, EBSCOhost (accessed October 13, 2010).
This research took place in China. Points made in this quantitative analysis step beyond just low literacy and make cogent points that would likely be of interest to hospital administrators. Specifically the touchscreen computer was widely accepted by all reading levels and thus administrators could be confident that every incoming patient was seeing the same information. This and other research is opening my search about exactly were to potentially survey a patient about what they understand. Prior to starting research it seemed that discharge instructions was the point I would consider as it was what intersected with my day job. However I have seen at least three studies that focus on the point of admission, or at least at the point of where the patient is interviewed about what is going on with their health and what they understand so far. These two points, of course, are not disconnected, but narrowing down the research will likely require choosing one or the other.
Journal of Information Science
Michael Mackert, Brad Love and Pamela Whitten
Patient education on mobile devices: an e-health intervention for low health literate audiences
DOI: 10.1177/0165551508092258
2009 35: 82 originally published online 23 October 2008
This research contained the golden nugget as far as I see my own thesis: The improvement of diabetes knowledge after subjects viewed the Diabetes and You website is
consistent with previous research, as is the lack of a relationship between gain in knowledge and par- ticipants’ health literacy [58]. This lack of relationship between knowledge gain and health literacy further demonstrates that digital media have the capability to help work around patient-education barriers presented by health literacy. (my underline)
This research is also encouraging because it makes use of not-so-sophisticated off the shelf hardware and software. Content was delivered over smaller format PDAs with wireless connections via websites. The exact PDA is not mentioned but it is noted that the screens are smaller, as are the devices, and they are more portable. There is research quoted about the potential benefits of this new technological development on page 84 in citations 48-53.
However, one issue that arise from the success and potential of this new technology is how will these devices fit into the lives of low literacy patients and how will healthcare facilities keep track of them? If one possibility is hospitals give out the devices so that patients can learn how will hospitals keep them from someone from walking off with them? If another possibility is that the devices become inexpensive enough that patients can take them home will the devices have to be limited so that it patients can only focus on specific health related web pages. Which may ultimately ask the philosophical question if the information is free (and the hardware very cheap) who are the gate keepers and suppliers of information? This may inspire a new thesis question something to the effect of if you put a device in the hands of a low literacy patient, that they can take home, will they focus on the information the healthcare provider has prescribed? Can we extrapolate from research done on hard copies? Is there research done on telling low literacy patients to go home and look at a specific web site. Does new technology provide a new capability of prescribing information and is technology so dynamic that patients might lose their way? And how might you make a survey to figure that out?
