Reducing Assessment Barriers for Patients With Low Literacy

NCT ID: NCT03584490

Last Updated: 2024-10-15

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

View full results

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

729 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-14

Study Completion Date

2023-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The purpose of this study is to determine the effects of health literacy on questionnaire-based measurement.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Low health literacy as a barrier to healthcare. Health literacy is defined as "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions." A vast body of research shows that lower health literacy is associated with poorer outcomes, including higher hospitalization rates, worse health, and greater mortality. Approximately 75 million U.S. adults have low health literacy. Worse yet, racial and ethnic minorities and older individuals (age 65+) are more likely to have low health literacy, creating another mechanism for health disparities. These data indicate that many people will have difficulties adhering to treatment regimens that require health literacy, as well as completing questionnaires for public health and health research and care.

Improving self-report assessment. Health surveys are ubiquitous, but almost no questionnaires used across the country have been validated for use with people who have low health literacy. This is a glaring shortcoming in current survey validation methodology; inaccurate surveys lead to false conclusions and threaten the empirical foundation of everyone's efforts to understand and improve public health, healthcare, and health outcomes. Our goal is to rectify this shortcoming. This study will 1) determine the effect of health literacy on widely-used questionnaires, 2) determine the stability of psychometric properties of questionnaires over time, and 3) test various testing formats to determine which ones work best for people with low health literacy.

Due to the COVID-19 pandemic, the study will implement phone-based assessments in addition to the original in-person protocol described above. The phone-based assessments will only be available to enrolled or previously enrolled participants. Participants will be asked questionnaires over the phone by a research coordinator at 3 time-points over 6 months.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Health Literacy

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study is a two-group, three time-point experimental design. The two study groups are paper-and-pencil questionnaires versus a computerized talking touchscreen interface. The three time points are baseline, 3-month follow-up, and 6-month follow-up.

Additionally, due to the COVID-19 pandemic, participants can optionally enroll in a phone-based assessment that includes 3 time-points over 6 months.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Pen-and-paper format

Based on randomization, participants in this group will receive traditional pen-and-paper questionnaires about health.

Group Type ACTIVE_COMPARATOR

Phone Administration of Questionnaires

Intervention Type OTHER

This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.

Computerized Talking Touchscreen

This group will receive the Computerized Talking Touchscreen intervention.

Based on randomization, participants in this group will receive a computerized talking touchscreen version of our health questionnaires, which allows the participant to have questions and answer choices read aloud to them by the computer.

Group Type EXPERIMENTAL

Computerized Talking Touchscreen

Intervention Type OTHER

The intervention is a computerized talking touchscreen designed to aid people with low health literacy.

All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand.

Phone Administration of Questionnaires

Intervention Type OTHER

This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Computerized Talking Touchscreen

The intervention is a computerized talking touchscreen designed to aid people with low health literacy.

All Participants in both arms will complete a battery of health questionnaires. One group will complete questionnaires in traditional pen-and-paper format. The other group will receive the computerized talking touchscreen, which reads questions to participants on demand.

Intervention Type OTHER

Phone Administration of Questionnaires

This intervention will pilot questionnaire administration over the phone with currently enrolled or previously enrolled participants from the original intervention. This method was used during the COVID-19 pandemic.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Be 18 years of age or older
* Be willing to provide informed consent, including signing the consent form
* Be willing to be randomized to administration method
* Be willing to complete questionnaires and interviews
* Be fluent in English and/or Spanish
* Be willing to attend three face-to-face sessions
* Have no plans to move out of the study area in the next six months

Exclusion Criteria

* Significant cognitive or neurologic impairment
* Being a prisoner, detainee, or in police custody
* Unable to complete the consent process
* Inadequate vision to see study materials (worse than 20/80 corrected)
* Inadequate hearing or manual dexterity to use the computer system

Phone-based protocol:

2. Access to reliable phone connection
3. Be willing to participant in three phone-based sessions


1. Unable to complete the consent process
2. Inadequate hearing for phone-based assessments
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

National Institute on Minority Health and Health Disparities (NIMHD)

NIH

Sponsor Role collaborator

Northwestern University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

James W Griffith

Research Assistant Professor of Medical Social Sciences

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

James Griffith, PhD

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Northwestern University

Chicago, Illinois, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Health literacy: report of the Council on Scientific Affairs. Ad Hoc Committee on Health Literacy for the Council on Scientific Affairs, American Medical Association. JAMA. 1999 Feb 10;281(6):552-7.

Reference Type BACKGROUND
PMID: 10022112 (View on PubMed)

Paasche-Orlow MK, Wolf MS. The causal pathways linking health literacy to health outcomes. Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S19-26. doi: 10.5555/ajhb.2007.31.supp.S19.

Reference Type BACKGROUND
PMID: 17931132 (View on PubMed)

Omachi TA, Sarkar U, Yelin EH, Blanc PD, Katz PP. Lower health literacy is associated with poorer health status and outcomes in chronic obstructive pulmonary disease. J Gen Intern Med. 2013 Jan;28(1):74-81. doi: 10.1007/s11606-012-2177-3. Epub 2012 Aug 14.

Reference Type BACKGROUND
PMID: 22890622 (View on PubMed)

Schillinger D, Grumbach K, Piette J, Wang F, Osmond D, Daher C, Palacios J, Sullivan GD, Bindman AB. Association of health literacy with diabetes outcomes. JAMA. 2002 Jul 24-31;288(4):475-82. doi: 10.1001/jama.288.4.475.

Reference Type BACKGROUND
PMID: 12132978 (View on PubMed)

Baker DW, Parker RM, Williams MV, Clark WS. Health literacy and the risk of hospital admission. J Gen Intern Med. 1998 Dec;13(12):791-8. doi: 10.1046/j.1525-1497.1998.00242.x.

Reference Type BACKGROUND
PMID: 9844076 (View on PubMed)

Davis TC, Arnold C, Berkel HJ, Nandy I, Jackson RH, Glass J. Knowledge and attitude on screening mammography among low-literate, low-income women. Cancer. 1996 Nov 1;78(9):1912-20. doi: 10.1002/(sici)1097-0142(19961101)78:93.0.co;2-0.

Reference Type BACKGROUND
PMID: 8909311 (View on PubMed)

Bennett CL, Ferreira MR, Davis TC, Kaplan J, Weinberger M, Kuzel T, Seday MA, Sartor O. Relation between literacy, race, and stage of presentation among low-income patients with prostate cancer. J Clin Oncol. 1998 Sep;16(9):3101-4. doi: 10.1200/JCO.1998.16.9.3101.

Reference Type BACKGROUND
PMID: 9738581 (View on PubMed)

Wolf MS, Davis TC, Osborn CY, Skripkauskas S, Bennett CL, Makoul G. Literacy, self-efficacy, and HIV medication adherence. Patient Educ Couns. 2007 Feb;65(2):253-60. doi: 10.1016/j.pec.2006.08.006. Epub 2006 Nov 21.

Reference Type BACKGROUND
PMID: 17118617 (View on PubMed)

Wolf MS, Knight SJ, Lyons EA, Durazo-Arvizu R, Pickard SA, Arseven A, Arozullah A, Colella K, Ray P, Bennett CL. Literacy, race, and PSA level among low-income men newly diagnosed with prostate cancer. Urology. 2006 Jul;68(1):89-93. doi: 10.1016/j.urology.2006.01.064.

Reference Type BACKGROUND
PMID: 16844451 (View on PubMed)

Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes. Arch Intern Med. 1998 Jan 26;158(2):166-72. doi: 10.1001/archinte.158.2.166.

Reference Type BACKGROUND
PMID: 9448555 (View on PubMed)

Wolf MS, Davis TC, Arozullah A, Penn R, Arnold C, Sugar M, Bennett CL. Relation between literacy and HIV treatment knowledge among patients on HAART regimens. AIDS Care. 2005 Oct;17(7):863-73. doi: 10.1080/09540120500038660.

Reference Type BACKGROUND
PMID: 16120503 (View on PubMed)

Kalichman SC, Ramachandran B, Catz S. Adherence to combination antiretroviral therapies in HIV patients of low health literacy. J Gen Intern Med. 1999 May;14(5):267-73. doi: 10.1046/j.1525-1497.1999.00334.x.

Reference Type BACKGROUND
PMID: 10337035 (View on PubMed)

Mancuso CA, Rincon M. Impact of health literacy on longitudinal asthma outcomes. J Gen Intern Med. 2006 Aug;21(8):813-7. doi: 10.1111/j.1525-1497.2006.00528.x.

Reference Type BACKGROUND
PMID: 16881939 (View on PubMed)

Coyne KS, Kaplan SA, Chapple CR, Sexton CC, Kopp ZS, Bush EN, Aiyer LP; EpiLUTS Team. Risk factors and comorbid conditions associated with lower urinary tract symptoms: EpiLUTS. BJU Int. 2009 Apr;103 Suppl 3:24-32. doi: 10.1111/j.1464-410X.2009.08438.x.

Reference Type BACKGROUND
PMID: 19302499 (View on PubMed)

Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, Richter HE, Myers D, Burgio KL, Gorin AA, Macer J, Kusek JW, Grady D; PRIDE Investigators. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009 Jan 29;360(5):481-90. doi: 10.1056/NEJMoa0806375.

Reference Type BACKGROUND
PMID: 19179316 (View on PubMed)

Yost KJ, Webster K, Baker DW, Choi SW, Bode RK, Hahn EA. Bilingual health literacy assessment using the Talking Touchscreen/la Pantalla Parlanchina: Development and pilot testing. Patient Educ Couns. 2009 Jun;75(3):295-301. doi: 10.1016/j.pec.2009.02.020. Epub 2009 Apr 21.

Reference Type BACKGROUND
PMID: 19386462 (View on PubMed)

Meade CD, Menard J, Martinez D, Calvo A. Impacting health disparities through community outreach: utilizing the CLEAN look (culture, literacy, education, assessment, and networking). Cancer Control. 2007 Jan;14(1):70-7. doi: 10.1177/107327480701400110.

Reference Type BACKGROUND
PMID: 17242673 (View on PubMed)

McKee MM, Paasche-Orlow MK. Health literacy and the disenfranchised: the importance of collaboration between limited English proficiency and health literacy researchers. J Health Commun. 2012;17 Suppl 3(Suppl 3):7-12. doi: 10.1080/10810730.2012.712627.

Reference Type BACKGROUND
PMID: 23030557 (View on PubMed)

Braveman P. Health disparities and health equity: concepts and measurement. Annu Rev Public Health. 2006;27:167-94. doi: 10.1146/annurev.publhealth.27.021405.102103.

Reference Type BACKGROUND
PMID: 16533114 (View on PubMed)

Osborn CY, Paasche-Orlow MK, Davis TC, Wolf MS. Health literacy: an overlooked factor in understanding HIV health disparities. Am J Prev Med. 2007 Nov;33(5):374-8. doi: 10.1016/j.amepre.2007.07.022.

Reference Type BACKGROUND
PMID: 17950402 (View on PubMed)

Institute of Medicine (US) Committee on Health Literacy; Nielsen-Bohlman L, Panzer AM, Kindig DA, editors. Health Literacy: A Prescription to End Confusion. Washington (DC): National Academies Press (US); 2004. Available from http://www.ncbi.nlm.nih.gov/books/NBK216032/

Reference Type RESULT
PMID: 25009856 (View on PubMed)

Wolf MS, Gazmararian JA, Baker DW. Health literacy and functional health status among older adults. Arch Intern Med. 2005 Sep 26;165(17):1946-52. doi: 10.1001/archinte.165.17.1946.

Reference Type RESULT
PMID: 16186463 (View on PubMed)

Sudore RL, Yaffe K, Satterfield S, Harris TB, Mehta KM, Simonsick EM, Newman AB, Rosano C, Rooks R, Rubin SM, Ayonayon HN, Schillinger D. Limited literacy and mortality in the elderly: the health, aging, and body composition study. J Gen Intern Med. 2006 Aug;21(8):806-12. doi: 10.1111/j.1525-1497.2006.00539.x.

Reference Type RESULT
PMID: 16881938 (View on PubMed)

Kalichman SC, Rompa D. Functional health literacy is associated with health status and health-related knowledge in people living with HIV-AIDS. J Acquir Immune Defic Syndr. 2000 Dec 1;25(4):337-44. doi: 10.1097/00042560-200012010-00007.

Reference Type RESULT
PMID: 11114834 (View on PubMed)

Scott TL, Gazmararian JA, Williams MV, Baker DW. Health literacy and preventive health care use among Medicare enrollees in a managed care organization. Med Care. 2002 May;40(5):395-404. doi: 10.1097/00005650-200205000-00005.

Reference Type RESULT
PMID: 11961474 (View on PubMed)

Dolan NC, Ferreira MR, Davis TC, Fitzgibbon ML, Rademaker A, Liu D, Schmitt BP, Gorby N, Wolf M, Bennett CL. Colorectal cancer screening knowledge, attitudes, and beliefs among veterans: does literacy make a difference? J Clin Oncol. 2004 Jul 1;22(13):2617-22. doi: 10.1200/JCO.2004.10.149.

Reference Type RESULT
PMID: 15226329 (View on PubMed)

Hurstak EE, Paasche-Orlow MK, Hahn EA, Henault LE, Taddeo MA, Moreno PI, Weaver C, Marquez M, Serrano E, Thomas J, Griffith JW. The mediating effect of health literacy on COVID-19 vaccine confidence among a diverse sample of urban adults in Boston and Chicago. Vaccine. 2023 Apr 6;41(15):2562-2571. doi: 10.1016/j.vaccine.2023.02.059. Epub 2023 Mar 2.

Reference Type DERIVED
PMID: 36907736 (View on PubMed)

Provided Documents

Download supplemental materials such as informed consent forms, study protocols, or participant manuals.

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form: Original Protocol

View Document

Document Type: Informed Consent Form: Verbal Consent - Phone Protocol

View Document

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

1R01MD010440-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

STU00202907

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Promoting Cholesterol Screening
NCT01930149 COMPLETED NA
Agent-Enhanced Document Explanation
NCT02668705 TERMINATED NA