A Digital Initiative to Improve Patient Health Literacy.

BACKGROUND

The U.S. is in the midst of a health literacy crisis. The National Center for Education Statistics and the U.S. Department of Education indicate 36 percent of adults have only "basic" or "below basic" health literacy, and 43 percent of adults were either at or below basic reading literacy. Since pamphlets require comprehension of written material, providers' reliance on this medium may be contributing to low health literacy. This project seeks to assess (1) providers' and patient's perception of patients' health literacy, (2) the type and accessibility of educational materials clinics provide, and (3) whether videos or pamphlets are more effective in conveying information. The hypotheses are (1) both providers and patients will rank patients' health literacy low, (2) clinic-provided material is mainly pamphlets with limited accessibility, and (3) videos will be more effective in improving retention than pamphlets.

METHODS

Phase-1 involved disseminating an online survey to 100 obstetrics and family medicine providers. This survey assessed providers' perspectives of patients' health literacy, the type and accessibility of educational resources providers offer. Phase-2 involved creating Maria's Medical Minutes videos and pamphlets with identical perinatal health information. Participating clinics provided patients with a randomly chosen business card with access to either the pamphlets or videos. After consulting the resource, patients took a survey that assessed (1) patients' perception of their health literacy, (2) their opinions of the accessibility of clinic-provided resources, and (3) their retention of the Maria's Medical Minutes resource.

RESULTS

The provider survey had a 32 percent response rate with 100 surveys sent. Twenty-five percent of providers classified patients' health literacy as "below average," while only 3 percent indicated that patients' health literacy was "above average." Seventy-eight percent of providers offer pamphlets in clinic, while 25 percent provide videos. When ranking the accessibility of clinic resources, providers' responses averaged 6 on a 10-point scale. No patient indicated their health literacy as "below average," while 50 percent indicated "above average" or "far above average" knowledge of pediatric health. When ranking clinic resource accessibility, patients' responses averaged 7.63 on a 10-point Likert scale. Patients assigned pamphlets answered 53 percent of the retention questions correctly, while video viewers answered 88 percent correctly.

CONCLUSIONS

This study validated the hypotheses that more providers offer written resources than videos, and videos appear to improve comprehension of information compared to pamphlets. This study found a substantial discrepancy between providers' and patients' assessments of patients' health literacy with most providers ranking patients' health literacy either at or below average. The providers themselves identified accessibility concerns with clinic resources.