Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
J Pediatr. 2021 Feb;229:118-126.e1. doi: 10.1016/j.jpeds.2020.10.001. Epub 2020 Oct 15.
To assess the Uniformed Services Constipation Action Plan (USCAP) as an evidence-based, personalized, clinical action tool with pictograms to aid clinicians and families in the management of functional constipation.
The USCAP facilitates the management functional constipation by using a health literacy-informed approach to provide instructions for pharmacotherapies and lifestyle modifications. This study included part 1 (pictogram validation) and part 2 (assessment). For part 1, pictogram transparency, translucency, and recall were assessed by parent survey (transparency ≥85%, mean translucency score ≥5, recall ≥85% required for validation). For part 2, the USCAP was assessed by parents, clinical librarians, and clinicians. Parental perceptions (n = 65) were assessed using the Consumer Information Rating Form (17 questions) to gauge comprehensibility, design quality and usefulness. Readability was assessed by 5 formulas and a Readability Composite Score was calculated. Clinical librarians (n = 3) used the Patient Education Materials Assessment Tool to measure understandability (19 questions) and actionability (7 questions) (>80% rating was acceptable). Suitability was assessed by clinicians (n = 34) using Doak's Suitability Assessment of Materials (superior ≥70% rating).
All 12 pictograms demonstrated appropriate transparency, translucency, and recall. Parental perceptions reflected appropriate comprehensibility, design quality, and usefulness. The Readability Composite Score was consistent with a fifth-grade level. Clinical librarians reported acceptable understandability and actionability. Clinicians reported superior suitability.
The USCAP met all criteria for clinical implementation and future study of USCAP implementation for treating children with chronic functional constipation.
评估统一服务便秘行动计划（USCAP）作为一种基于证据的、个性化的临床行动工具，使用图表帮助临床医生和家庭管理功能性便秘。
USCAP 通过使用健康素养知情方法为药物治疗和生活方式改变提供指导来促进功能性便秘的管理。本研究包括第 1 部分（图表验证）和第 2 部分（评估）。第 1 部分通过家长调查评估图表的透明度、半透明度和召回率（透明度≥85%，平均半透明度评分≥5，召回率≥85%为验证要求）。第 2 部分由家长、临床图书管理员和临床医生评估 USCAP。使用消费者信息评分表（17 个问题）评估家长的看法（n=65），以评估可理解性、设计质量和有用性。使用 5 种公式评估可读性，并计算可读性综合评分。临床图书管理员（n=3）使用患者教育材料评估工具来衡量理解性（19 个问题）和可操作性（7 个问题）（>80%的评分是可接受的）。临床医生（n=34）使用 Doak 的材料适宜性评估来评估适宜性（优秀≥70%的评分）。
所有 12 个图表均表现出适当的透明度、半透明度和召回率。家长的看法反映了适当的可理解性、设计质量和有用性。可读性综合评分与五年级水平一致。临床图书管理员报告了可接受的理解性和可操作性。临床医生报告了卓越的适宜性。
USCAP 满足了临床实施的所有标准，未来将对 USCAP 治疗慢性功能性便秘儿童的实施进行研究。
