UAMS.EDU

Current Projects

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

Principal Investigator

Kristie Hadden, PhD, 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.

Developing and Testing a Health-Literate Patient Decision Aid for Chest Pain: Phase 1

Principal Investigator

Kristie Hadden, PhD, UAMS Center for Health Literacy

Co-Investigators

Tina Moore, EdD, UAMS Center for Health Literacy
Heather McLemore, MD, UAMS Emergency Medicine

The specific aim is to develop, adapt, and field test a new patient decision aid for chest pain that is designed with health literacy as a framework and vetted by patients with low health literacy. Researchers will review existing literature and examples of patient decision aids for low risk chest pain and evaluate them according to readability and health literacy/numeracy best practices. A new decision aid will be developed/adapted that meets health literacy standards as defined by a collection of agencies and experts. The new decision aid will be field tested with two focus groups.

The Implementation of a Health-Literate Patient Decision Aid for Chest Pain in the Emergency Department: Phase 2

Principal Investigator

Rawle A. Seupaul, MD, UAMS Emergency Medicine

Co-Investigators

Kristie Hadden, PhD, UAMS Center for Health Literacy
Tina Moore, EdD, UAMS Center for Health Literacy
Heather McLemore, MD, UAMS Emergency Medicine

The specific aim of this study is to test the efficacy of a new health-literacy-tested patient decision aid for chest pain in a convenience sample of emergency department patients who used the decision aid compared to patients who were not exposed to the decision aid. Outcomes of interest include knowledge, decisional conflict and satisfaction prior to discharge.

It is hypothesized that:

1. Patients exposed to the decision aid will have higher knowledge scores compared to patients not exposed to the aid.
2. Patients exposed to the decision aid will report lower decisional conflict compared to patients not exposed to the aid.
3. Patients exposed to the decision aid will report higher satisfaction compared to patients not exposed to the aid.

Investigating the Health Literacy Demands of the SRS-30 for Patients with Low Health Literacy

Principal Investigators

Kristie Hadden, PhD, UAMS Center for Health Literacy
David Bumpass, MD, UAMS Orthopaedics

The purpose of this research study is to investigate the health literacy demands of the Scoliosis Research Society Questionnaire (SRS-30). The research team will evaluate, qualitatively, how patients complete the drawing item on the SRS-30 both without and then with assistance. The research question is “How do health literacy best practices impact how patients with low health literacy complete the SRS-30?”

Translational Research Institute/Institutional Review Board Informed Consent Research Project: Understandable to the Subject- Plain Language IRB Informed Consents

Principal Investigator

Tina Moore, EdD, UAMS Center for Health Literacy

Co-Investigator

Kristie Hadden, PhD, UAMS Center for Health Literacy

The purpose of this mixed methods study is to develop a plain language informed consent template, measure its effectiveness in improving readability, and field test its understandability with participants who screened as having inadequate health literacy. The Basic HHS Policy for Protection of Human Research Subjects §46.116 General requirements for informed consent includes “The information that is given to the subject or the representative shall be in language understandable to the subject or the representative.” Considering 43% of adults in the U.S. have basic or below basic literacy skills, the readability of informed consents for research could pose a barrier to fulfilling this general requirement. We hypothesized that the plain language template would result in informed consents with readability at or below the recommended 8th grade reading level and that individuals with low health literacy would prefer and better understand informed consents in this template than those not following plain language best practices.

TRI/IRB Plain Language for Informed Consent Project

Principal Investigator

Kristie Hadden, PhD, UAMS Center for Health Literacy

Co-Investigators

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

Co-Investigator

Fred Prior, PhD, 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, UAMS Center for Health Literacy

Research Team

Lowry Barnes, MD, UAMS Orthopaedics
Marty Bushmiaer, UAMS Orthopaedics
Tina Moore, EdD, UAMS Center for Health Literacy
Merritt Osment, University of Arkansas at Fayetteville
Latrina Prince, EdD, 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.