Columbia University School of Nursing, New York, New York, United States.
Appl Clin Inform. 2019 Aug;10(4):643-654. doi: 10.1055/s-0039-1693713. Epub 2019 Sep 4.
Adherence to daily inhaled corticosteroid medication is important for asthma control but low health literacy is a barrier to comprehension of control status and may contribute to medication nonadherence. Infographics tailored with patients' own data can support comprehension of health status, but these have not been applied to asthma successfully.
This two-phased study developed and tested tailored infographics of (1) scores on the Asthma Control Questionnaire (ACQ), a self-report measure of symptom burden, and (2) pulmonary function test (PFT) results. The infographics are intended for use as communication and adherence-promotion tools in clinical interactions.
For both phases, participants (18+ years, English- or Spanish-speaking, persistent asthma) were recruited through two primary care clinics. In Phase I, we used a hybrid iterative participatory design process to refine prototype designs. In Phase II, we conducted individual comprehension assessment interviews with the finalized designs. Infographics were hand-tailored for each participant using their ACQ score and PFT results collected at the start of the interview. Two independent raters scored interview transcripts for gist and verbatim comprehension based on a predetermined rubric.
The five Phase I design sessions led to final prototypes that participants ( = 21) considered appealing and easy to comprehend. All Phase II participants ( = 10) demonstrated complete gist and verbatim comprehension. Participants reacted favorably to receiving their information via infographics and expressed intentions to engage in self-management behaviors (e.g., medication adherence, smoking cessation, weight loss, and review of their care plan) in response to the information.
This study provides preliminary evidence that infographics can support comprehension of asthma control status and promote self-management intentions among adults with persistent asthma. Infographics can be programmed into electronic health records and/or standalone applications to allow for instant tailoring at the point of care.
坚持每日吸入皮质类固醇药物对控制哮喘很重要,但低健康素养是理解控制状况的障碍,可能导致药物依从性差。针对患者自身数据定制的信息图表可以帮助理解健康状况,但尚未成功应用于哮喘。
本研究分两阶段开发和测试了(1)哮喘控制问卷(ACQ)评分和(2)肺功能测试(PFT)结果的定制信息图表。这些信息图表旨在作为临床互动中的沟通和促进依从性的工具。
在两个阶段中,参与者(18 岁及以上,讲英语或西班牙语,持续性哮喘)均通过两个初级保健诊所招募。在第一阶段,我们使用混合迭代参与式设计过程来完善原型设计。在第二阶段,我们使用最终设计进行了个体理解评估访谈。根据预定的评分标准,使用参与者在访谈开始时收集的 ACQ 评分和 PFT 结果,对手动定制的信息图表进行了定制。两位独立评分者根据预定的评分标准,对访谈记录进行了主旨和逐字理解的评分。
五项第一阶段设计会议产生了最终原型,参与者( = 21)认为这些原型设计具有吸引力且易于理解。所有第二阶段的参与者( = 10)都表现出了完全的主旨和逐字理解。参与者对通过信息图表接收信息表示欢迎,并表示愿意根据信息进行自我管理行为(例如,药物依从性、戒烟、减肥和审查他们的护理计划)。
本研究初步表明,信息图表可以帮助理解哮喘控制状况,并促进持续性哮喘成年人的自我管理意愿。信息图表可以编程到电子健康记录和/或独立应用程序中,以便在护理点即时定制。