A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial

John D. Peipert; Thomas Lad; Pam G. Khosla; Sofia F. Garcia; Elizabeth A. Hahn

doi:10.1177/10732748211036783

A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial

John D. Peipert^*, Thomas Lad, Pam G. Khosla, Sofia F. Garcia, Elizabeth A. Hahn

^*Corresponding author for this work

Medical Social Sciences

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

We tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I–III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings. Each patient was assessed for outcomes at 4 timepoints: after starting treatment (baseline), during treatment, immediately after treatment, and at follow-up assessment. The primary outcomes were health beliefs, cancer knowledge, self-efficacy, and satisfaction with communication about cancer and its treatments. Health-related quality of life (HRQOL) was a secondary outcome. A total of 129 patients participated in the study (65 intervention and 64 control), and approximately 50% of these completed the study. Patients randomized to receive the CancerHelp-TT program had a significantly larger increase in their cancer knowledge in comparison to those randomized to the control arm (effect size =.48, P =.05). While effect sizes for differences between randomized groups in self-efficacy, health beliefs, HRQOL, and satisfaction with communication were small (.10–.48), there was a consistent trend that participants in the intervention group showed larger increases over time in all outcomes compared to the control group. The CancerHelp-TT software was favorably rated by intervention participants. The CancerHelp-TT program showed promise to increase vulnerable cancer patients’ cancer knowledge and adaptive health beliefs and attitudes. However, vulnerable patients may need additional interventional support in settings outside cancer clinics.

Original language	English (US)
Journal	Cancer Control
Volume	28
DOIs	https://doi.org/10.1177/10732748211036783
State	Published - 2021

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn). The authors thank the research assistants who recruited and interviewed study participants (Beatriz Menendez, Niraj Patel, Evie Sprague, Veronica Valenzuela), the CancerHelp Institute (Ed. Miller, Celia Muench), the programming and analysis staff (Michael Bass, MS, Jennifer Beaumont, MS, Mark Monforti, Monica Prudencio, Katy Wortman, MSW), co-investigators (David Cella, PhD, Jin-Shei Lai, PhD) and physicians and clinical staff at John H. Stroger Hospital of Cook County (Elizabeth Marcus, MD, Michael Mullane, MD), Advocate Illinois Masonic Medical Center (Maritess Caamic, RN, Ann Mauer, MD, Samir Undevia, MD), and Mt. Sinai Hospital (Grace Golden, Ervin Hire, MD, Gina Menyah, Anna Liza Rodriguez, RN. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn).

Keywords

cancer
health information technology
health literacy
underserved populations

ASJC Scopus subject areas

Hematology
Oncology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

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title = "A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial",

abstract = "We tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I–III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings. Each patient was assessed for outcomes at 4 timepoints: after starting treatment (baseline), during treatment, immediately after treatment, and at follow-up assessment. The primary outcomes were health beliefs, cancer knowledge, self-efficacy, and satisfaction with communication about cancer and its treatments. Health-related quality of life (HRQOL) was a secondary outcome. A total of 129 patients participated in the study (65 intervention and 64 control), and approximately 50% of these completed the study. Patients randomized to receive the CancerHelp-TT program had a significantly larger increase in their cancer knowledge in comparison to those randomized to the control arm (effect size =.48, P =.05). While effect sizes for differences between randomized groups in self-efficacy, health beliefs, HRQOL, and satisfaction with communication were small (.10–.48), there was a consistent trend that participants in the intervention group showed larger increases over time in all outcomes compared to the control group. The CancerHelp-TT software was favorably rated by intervention participants. The CancerHelp-TT program showed promise to increase vulnerable cancer patients{\textquoteright} cancer knowledge and adaptive health beliefs and attitudes. However, vulnerable patients may need additional interventional support in settings outside cancer clinics.",

keywords = "cancer, health information technology, health literacy, underserved populations",

author = "Peipert, {John D.} and Thomas Lad and Khosla, {Pam G.} and Garcia, {Sofia F.} and Hahn, {Elizabeth A.}",

note = "Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn). Funding Information: The authors thank the research assistants who recruited and interviewed study participants (Beatriz Menendez, Niraj Patel, Evie Sprague, Veronica Valenzuela), the CancerHelp Institute (Ed. Miller, Celia Muench), the programming and analysis staff (Michael Bass, MS, Jennifer Beaumont, MS, Mark Monforti, Monica Prudencio, Katy Wortman, MSW), co-investigators (David Cella, PhD, Jin-Shei Lai, PhD) and physicians and clinical staff at John H. Stroger Hospital of Cook County (Elizabeth Marcus, MD, Michael Mullane, MD), Advocate Illinois Masonic Medical Center (Maritess Caamic, RN, Ann Mauer, MD, Samir Undevia, MD), and Mt. Sinai Hospital (Grace Golden, Ervin Hire, MD, Gina Menyah, Anna Liza Rodriguez, RN. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn). Publisher Copyright: {\textcopyright} The Author(s) 2021.",

year = "2021",

doi = "10.1177/10732748211036783",

language = "English (US)",

volume = "28",

journal = "Cancer Control",

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AU - Lad, Thomas

AU - Khosla, Pam G.

AU - Garcia, Sofia F.

AU - Hahn, Elizabeth A.

N1 - Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn). Funding Information: The authors thank the research assistants who recruited and interviewed study participants (Beatriz Menendez, Niraj Patel, Evie Sprague, Veronica Valenzuela), the CancerHelp Institute (Ed. Miller, Celia Muench), the programming and analysis staff (Michael Bass, MS, Jennifer Beaumont, MS, Mark Monforti, Monica Prudencio, Katy Wortman, MSW), co-investigators (David Cella, PhD, Jin-Shei Lai, PhD) and physicians and clinical staff at John H. Stroger Hospital of Cook County (Elizabeth Marcus, MD, Michael Mullane, MD), Advocate Illinois Masonic Medical Center (Maritess Caamic, RN, Ann Mauer, MD, Samir Undevia, MD), and Mt. Sinai Hospital (Grace Golden, Ervin Hire, MD, Gina Menyah, Anna Liza Rodriguez, RN. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by AHRQ Grant # R18-HS017300 (awarded to E. A. Hahn). Publisher Copyright: © The Author(s) 2021.

PY - 2021

Y1 - 2021

N2 - We tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I–III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings. Each patient was assessed for outcomes at 4 timepoints: after starting treatment (baseline), during treatment, immediately after treatment, and at follow-up assessment. The primary outcomes were health beliefs, cancer knowledge, self-efficacy, and satisfaction with communication about cancer and its treatments. Health-related quality of life (HRQOL) was a secondary outcome. A total of 129 patients participated in the study (65 intervention and 64 control), and approximately 50% of these completed the study. Patients randomized to receive the CancerHelp-TT program had a significantly larger increase in their cancer knowledge in comparison to those randomized to the control arm (effect size =.48, P =.05). While effect sizes for differences between randomized groups in self-efficacy, health beliefs, HRQOL, and satisfaction with communication were small (.10–.48), there was a consistent trend that participants in the intervention group showed larger increases over time in all outcomes compared to the control group. The CancerHelp-TT software was favorably rated by intervention participants. The CancerHelp-TT program showed promise to increase vulnerable cancer patients’ cancer knowledge and adaptive health beliefs and attitudes. However, vulnerable patients may need additional interventional support in settings outside cancer clinics.

AB - We tested whether a low-literacy-friendly, multimedia information and assessment system used in daily clinical practice enhanced patient-centered care and improved patient outcomes. This was a prospective, parallel-group, randomized controlled trial with 2 arms, CancerHelp-Talking Touchscreen (CancerHelp-TT) versus control, among adults with Stage I–III breast or colorectal cancer receiving chemotherapy and/or radiation therapy in safety net settings. Each patient was assessed for outcomes at 4 timepoints: after starting treatment (baseline), during treatment, immediately after treatment, and at follow-up assessment. The primary outcomes were health beliefs, cancer knowledge, self-efficacy, and satisfaction with communication about cancer and its treatments. Health-related quality of life (HRQOL) was a secondary outcome. A total of 129 patients participated in the study (65 intervention and 64 control), and approximately 50% of these completed the study. Patients randomized to receive the CancerHelp-TT program had a significantly larger increase in their cancer knowledge in comparison to those randomized to the control arm (effect size =.48, P =.05). While effect sizes for differences between randomized groups in self-efficacy, health beliefs, HRQOL, and satisfaction with communication were small (.10–.48), there was a consistent trend that participants in the intervention group showed larger increases over time in all outcomes compared to the control group. The CancerHelp-TT software was favorably rated by intervention participants. The CancerHelp-TT program showed promise to increase vulnerable cancer patients’ cancer knowledge and adaptive health beliefs and attitudes. However, vulnerable patients may need additional interventional support in settings outside cancer clinics.

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KW - health literacy

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A Low Literacy, Multimedia Health Information Technology Intervention to Enhance Patient-Centered Cancer Care in Safety Net Settings Increased Cancer Knowledge in a Randomized Controlled Trial

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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