UAMS.EDU

Current Projects

Health Literacy Intervention to Improve Diabetes Outcomes among Rural Primary Care Patients

Principal Investigator

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy

Co-Investigators

Jean McSweeney, PhD, UAMS College of Nursing
Jody Ciolino, PhD, Northwestern University
Laura Curtis, MS, Northwestern University
Michael Wolf, PhD, MPH, Northwestern University
Connie Arnold, PhD, Louisiana State University Health Sciences Center in Shreveport
Terry Davis, PhD, Louisiana State University Health Sciences Center in Shreveport

This is a four-year study funded by the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases. The study aims to determine the best way to deliver diabetes care, education, and coaching to patients in rural areas. The study is designed to improve health outcomes for patients with diabetes in Arkansas and includes a diabetes health literacy intervention at patient-centered medical homes in UAMS Family Medical Centers located in Magnolia, Texarkana, Pine Bluff, Fort Smith, Fayetteville, and Jonesboro. Recruitment of participants will begin in the fall of 2016.

TRI/IRB Plain Language for Informed Consent Project

Principal Investigator

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy

Co-Investigators

Laura James, MD, UAMS Translational Research Institute
Tina Moore, MEd, EdS, UAMS Center for Health Literacy

The Center for Health Literacy (CHL) is collaborating with the UAMS Translational Research Institute and the UAMS Institutional Review Board to improve the readability of informed consent forms. It is recommended that informed consent documents be written at a 6th to 8th grade reading level so that potential participants can easily read and understand information about the study and know their rights as a participant. Consent forms used in research studies are difficult to read and understand due to length, complex information regarding study procedures, and unfamiliar research and/or legal terminology. The purpose of this project is to address the need for plain language informed consent documents to improve comprehension by research participants and to increase representation of individuals with literacy challenges in research.

The specific aims of this study are to 1) establish baseline readability of investigator-initiated informed consent forms approved by the IRB from 2013 through 2015; 2) implement a pilot workflow that routes investigator-initiated informed consents through the CHL Plain Pages portal, www.PlainPages.org; 3) implement “intervention” strategies to improve use of the new plain language informed consent templates and submission process; and 4) conduct readability assessments of investigator-initiated informed consents for 12 months after the intervention (January – December 2016).

Patient Health Literacy Screening and Population Health

Principal Investigator

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy

Co-Investigator

Fred Prior, PhD, Professor and Chair, UAMS Biomedical Informatics

Research has shown that 90% of patients feel that it is useful for physicians and nurses to know if they are having difficulties related to low health literacy. Based on recent research in health literacy, a single screening question, asked verbally of patients, can identify those who have inadequate health literacy with 81% accuracy (true positives and true negatives). The purpose of this study is to pilot a health literacy screening question in the UAMS electronic medical record. Collecting this data will allow clinicians to examine outcomes and quality issues in our patient population that may be related to health literacy so that effective interventions can be developed, implemented, and tested to improve patient outcomes, safety and quality of care.

Assessing Health Literacy in Joint Academy Participants

Principal Investigator

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy

Research Team

Lowry Barnes, MD, UAMS Orthopaedics
Marty Bushmiaer, UAMS Orthopaedics
Tina Moore, MEd, EdS, UAMS Center for Health Literacy
Merritt Osment, University of Arkansas at Fayetteville
Latrina Prince, MEd, UAMS Center for Health Literacy
Keith Williams, PhD, MPH, UAMS College of Medicine
Jackson Bridges, Hendrix College

The specific aims of this study are to 1) compare health literacy levels of patients to the reading level of patient education materials in a Hip/Knee Academy patient education class for preoperative hip and knee replacement patients; 2) explore relationships between health literacy and patient expectations for hip and knee replacement surgery; and 3) validate a health literacy measure with health literacy screening data in patients’ electronic medical record. Lastly, the data from this study will be used to examine differences between health literacy levels of patients and their “coaches” who attend the Hip/Knee Academy with them so that they can assist in following discharge instructions when the patient is incapacitated.

Health Literacy Demands of Patient-Reported Evaluation Tools in Hand Surgery

Principal Investigator

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy

Co-Investigator

John Stephenson, MD, UAMS Orthopaedics

The purpose of this mixed methods study is to evaluate the readability of patient-reported evaluation tools that are commonly used in orthopaedic hand surgery. This study also aims to understand what elements of these instruments need to be improved from a patient perspective. Based on existing literature on the readability of patient materials in orthopaedics, we hypothesize that the reading level of the patient-reported evaluation tools will be above plain language recommendations. This study will use mixed methods, including patient feedback to analyze readability of the evaluation tools used in hand surgery. Readability assessments will use readability formulae appropriate for the documents, and scores will be reported by grade level equivalents for each instrument. Focus groups will be conducted to gather patient feedback on the patient-reported evaluation tools.

The Economic Cost of Low Health Literacy in the State of Arkansas

Principal Investigator

Qayyim Said, PhD

Co-Investigators

Kristie Hadden, PhD, Executive Director, UAMS Center for Health Literacy
Antonio Trujillo, PhD, John Hopkins Bloomberg School of Public Health

The purpose of this study is to estimate the healthcare costs of low health literacy in Arkansas. The study will estimate the cost of low health literacy at the state and county levels. A study by Vernon et al. (2007) estimated the annual cost of low health literacy in the US to be $106 billion to $238 billion, which is equal to 7% and 17% of all personal healthcare expenditures, respectively. Friedland (2002) attributed $32 billion to $58 billion in US healthcare spending in 2001 to low health literacy. We will use the methodologies used in these reports and others to estimate the economic cost of low health literacy in Arkansas.