University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2022 Oct;75(10):453.
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.
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.
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.
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.
美国正处于健康素养危机之中。国家教育统计中心和美国教育部表示，36%的成年人只有“基本”或“低于基本”的健康素养，43%的成年人阅读水平处于或低于基本水平。由于小册子需要理解书面材料，提供者对这种媒介的依赖可能导致低健康素养。本项目旨在评估：（1）提供者和患者对患者健康素养的感知；（2）诊所提供的教育材料的类型和可及性；（3）视频或小册子在传达信息方面是否更有效。假设是：（1）提供者和患者都将患者的健康素养评为低水平；（2）诊所提供的材料主要是小册子，可及性有限；（3）视频在提高保留率方面比小册子更有效。
第 1 阶段向 100 名妇产科和家庭医学提供者发送在线调查。该调查评估了提供者对患者健康素养的看法、提供者提供的教育资源的类型和可及性。第 2 阶段涉及创建玛丽亚医疗分钟视频和小册子，其中包含相同的围产期健康信息。参与诊所向患者提供一张带有访问权限的随机名片，可以访问小册子或视频。在咨询资源后，患者参加了一项调查，评估了以下方面：（1）患者对自己健康素养的看法；（2）他们对诊所提供资源的可及性的看法；（3）他们对玛丽亚医疗分钟资源的保留率。
提供者调查的回复率为 32%，共发送了 100 份调查。25%的提供者将患者的健康素养评为“低于平均水平”，而只有 3%的提供者表示患者的健康素养“高于平均水平”。78%的提供者在诊所提供小册子，而 25%的提供者提供视频。在对诊所资源的可及性进行排名时，提供者的回答平均为 10 分制的 6 分。没有患者表示自己的健康素养“低于平均水平”，而 50%的患者表示对儿科健康的知识“高于平均水平”或“远远高于平均水平”。在对诊所资源可及性进行排名时，患者的回答平均为 10 分制的 7.63 分。分配小册子的患者答对了 53%的保留问题，而观看视频的患者答对了 88%。
这项研究验证了以下假设：与视频相比，提供书面资源的提供者多于提供视频的提供者，视频似乎比小册子更能提高对信息的理解。本研究发现，提供者和患者对患者健康素养的评估存在很大差异，大多数提供者将患者的健康素养评为平均水平或以下水平。提供者自己也发现了诊所资源的可及性问题。
